Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 63
Filtrar
2.
Clin Biochem ; 61: 12-17, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30236831

RESUMO

BACKGROUND: Early identification of asymptomatic postmenopausal women (PW), who are more predisposed to developing cardiovascular disease (CVD), is an important preventive strategy. Autophagy-related 16-like 1 (ATG16L1) is an autophagy gene known to control host immune responses and is associated with a variety of diseases, including CVD. OBJECTIVE: The aim of the study was to associate the ATG16L1 polymorphism variant with subclinical carotid atherosclerosis in asymptomatic PW. STUDY DESIGN: This cross-sectional study included 210 Brazilian postmenopausal women (age ≥ 45 years with amenorrhea ≥12 months). Clinical, anthropometric and biochemical assessments were performed to evaluate the cardiovascular risk factors. DNA was extracted from buccal cells and the ATG16L1 (T300A) polymorphism was determined by the polymerase chain reaction (PCR). The carotid intima-media thickness and/or the presence of plaques were evaluated by carotid duplex ultrasound. For statistical analysis, the t-test, logistic regression and analysis of covariance (ANCOVA) were used. RESULTS: The presence of the polymorphic allele forATG16L1 (T300A) was found in 77.47% (A/G = 49.87%, G/G = 27.60%). The ATG16L1 (T300A) polymorphism is significantly associated with increased carotid intima-media thickness (IMT) after adjustments of the confounding variables (P < .037). No significant associations were observed between the polymorphism with other risk factors for CVD in PW. CONCLUSION: In postmenopausal women, the ATG16L1 (T300A) polymorphism is significantly associated with increased carotid IMT (marker of atherosclerotic disease) after adjustments of the confounding variables (P < .037). Thus, identifying the ATG16L1 polymorphism is an important strategy for screening asymptomatic PW who are more predisposed to developing CVD.


Assuntos
Doenças Assintomáticas , Proteínas Relacionadas à Autofagia/genética , Doenças Cardiovasculares/genética , Espessura Intima-Media Carotídea , Predisposição Genética para Doença , Polimorfismo Genético , Pós-Menopausa , Idoso , Alelos , Substituição de Aminoácidos , Proteínas Relacionadas à Autofagia/metabolismo , Brasil/epidemiologia , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/metabolismo , Fatores de Confusão Epidemiológicos , Estudos Transversais , Feminino , Frequência do Gene , Estudos de Associação Genética , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar , Fatores de Risco
3.
J Steroid Biochem Mol Biol ; 174: 284-289, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-29031688

RESUMO

This study aimed to evaluate the association between pretreatment vitamin D (VD) deficiency with breast cancer prognostic features in Brazilian postmenopausal women. An analytical cross sectional study was conducted with 192 women, aged 45-75 years, attended at University Hospital. Women with recent diagnosis of breast cancer, in amenorrhea >12months and age ≥45 years, without medication use or clinical conditions that interfere with VD values were included. Clinical and anthropometric data were collected. Serum level of 25 hydroxyvitamin D [25(OH)D] was measured in all patients until 20days after breast cancer diagnosis, and was classified as normal (≥30ng/mL), insufficiency (20-29ng/mL) and deficiency (<20ng/mL). Data on breast cancer (histopathological type, grade, tumor stage, lymph node status), hormone status (estrogen receptor, ER, progesterone receptor, PR), human epidermal growth factor receptor type 2 (HER2) and epithelial proliferative activity (Ki-67) were collected. For statistical analysis, the t-student test, the Gamma Distribution (asymmetric variables), the chi-square test and the logistic regression (OR-odds ratio) were used. The median 25(OH)D level was 25.8ng/mL (range 12.0-59.2ng/mL). Sufficient vitamin D levels were detected in 65 patients (33.9%), whereas insufficient levels in 92 patients (47.9%), and deficient levels in 35 patients (18.2%). Participants with insufficient and deficient 25(OH)D levels had a higher proportion of tumors with a high grade and locally advanced and metastatic disease, more positive lymph node, a lower proportion of ER, PR positives tumors and higher Ki-67(p<0.05). Patients with normal vitamin D had a higher frequency of luminal A (47.7%) and luminal B (32.2%) tumors when compared to patients with vitamin D insufficiency or deficiency. Furthermore, all cases of triple negative were detected in women with low VD levels. Multivariate analysis, after adjusting for age, time since menopause and BMI, showed that insufficient and deficient level of vitamin D were significantly associated with negative estrogen receptor (OR 3.77 CI 95% 1.76-8.09 and OR 3.99 CI 95% 1.83-8.68), high Ki-67 (OR 2.50, CI 95% 1.35-4.63, and OR 2.62, CI 95% 1.40-4.98), and positive axillary lymph node status (OR 1.59, CI 95% 1.03-2.33, and OR 1.58, CI 95% 1.02-2.92) respectively. In Brazilian postmenopausal women with breast cancer, there was an association between vitamin D insufficiency or deficiency and tumors with worse prognostic features. Low vitamin D levels were shown to be a risk factor for ER negative tumors, with positive axilla and a higher rate of cell proliferation.


Assuntos
Neoplasias da Mama/epidemiologia , Pós-Menopausa , Deficiência de Vitamina D/epidemiologia , Idoso , Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/sangue , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Estudos Transversais , Feminino , Humanos , Antígeno Ki-67/metabolismo , Pessoa de Meia-Idade , Razão de Chances , Pós-Menopausa/sangue , Pós-Menopausa/metabolismo , Prognóstico , Receptor ErbB-2/metabolismo , Receptores Estrogênicos/metabolismo , Receptores de Progesterona/metabolismo , Carga Tumoral , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/metabolismo
4.
Rev Bras Ginecol Obstet ; 38(5): 225-30, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27144804

RESUMO

Introduction Proper physical activity is related to the prevention and the treatment of osteoporosis. Purpose To assess the level of physical activity (PA) in post-menopausal women with low bone mineral density (BMD). Methods This cross-sectional clinical study included 123 post-menopausal women. The inclusion criteria were: age of ≥ 45 years with last menses at least 12 months prior to the initiation of the study, and bone density scan (BDS) values measured over the preceding 12 months. Women with severe osteoarthritis were excluded. Women were allocated into three groups, according to BMD measured by BDS [osteoporosis (OP; 54 women), osteopenia (35 women), and normal bone density (NBD; 35 women)], and compared for general, clinical, and anthropometric data, and for PA level. The latter was assessed using the International Physical Activity Questionnaire (IPAQ), in metabolic equivalent of task (MET) units. Participants were classified as sedentary, active or very active. Quantitative variables were compared using ANOVA followed by Tukey's test. Associations between qualitative variables were tested by Chi-square (χ2) or Fisher's exact test. In order to check for differences among groups and IPAQ domains, a generalized linear model with Gamma distribution was adjusted for values in METs. Results The OP group differed from the NBD group regarding age (61.8 ± 10.1 and 52.9 ± 5.4 years), percentage of participants with self-declared white ethnicity (43.9 and 28.0%), body mass index (BMI - 25.7 ± 5.4 and 30.9 ± 5.1 kg/m(2)), and time since menopause (15.5 ± 7.5 and 5.8 ± 4.5 years). Smoking rates were higher in the OP (55.6%) and NBD groups (33.3%) than in the osteopenia group (11.1%). Within the OP group, the rate of subjects with sedentary lifestyles was higher (42.6%), and time spent sitting was greater (344.3 ± 204.8 METs) than in the groups with osteopenia (20.0% and 300.9 ± 230.6 METs) and NBD (17.7% and 303.2 ± 187.9 METs). Conclusions The rate of sedentary lifestyles was higher in post-menopausal women with OP than in those with either osteopenia or NBD. In order to change this physical inactivity profile, strategies should be created to address this group of patients.


Assuntos
Densidade Óssea , Exercício Físico , Pós-Menopausa , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade
5.
Rev. bras. ginecol. obstet ; 38(5): 225-230, tab
Artigo em Inglês | LILACS | ID: lil-787661

RESUMO

Abstract Introduction Proper physical activity is related to the prevention and the treatment of osteoporosis. Purpose To assess the level of physical activity (PA) in post-menopausal women with low bone mineral density ( BMD ). Methods This cross-sectional clinical study included 123 post-menopausal women. The inclusion criteria were: age of 45 years with last menses at least 12 months prior to the initiation of the study, and bone density scan (BDS) values measured over the preceding 12 months. Women with severe osteoarthritis were excluded. Women were allocated into three groups, according to BMD measured by BDS [osteoporosis (OP; 54 women), osteopenia (35 women), and normal bone density (NBD; 35 women)], and compared for general, clinical, and anthropometric data, and for PA level. The latter was assessed using the International Physical Activity Questionnaire (IPAQ), in metabolic equivalent of task (MET) units. Participants were classified as sedentary, active or very active. Quantitative variables were compared using ANOVA followed by Tukey's test. Associations between qualitative variables were tested by Chi-square (χ2) or Fisher's exact test. In order to check for differences among groups and IPAQ domains, a generalized linear model with Gamma distribution was adjusted for values in METs. Results The OP group differed from the NBD group regarding age (61.8 10.1 and 52.9 5.4 years), percentage of participants with self-declared white ethnicity (43.9 and 28.0%), body mass index (BMI - 25.7 5.4 and 30.9 5.1 kg/m2), and time since menopause (15.5 7.5 and 5.8 4.5 years). Smoking rates were higher in the OP (55.6%) and NBD groups (33.3%) than in the osteopenia group (11.1%). Within the OP group, the rate of subjects with sedentary lifestyles was higher (42.6%), and time spent sitting was greater (344.3 204.8 METs) than in the groups with osteopenia (20.0 % and 300.9 230.6 METs) and NBD (17.7% and 303.2 187.9 METs). Conclusions The rate of sedentary lifestyles was higher in post-menopausal women with OP than in those with either osteopenia or NBD. In order to change this physical inactivity profile, strategies should be created to address this group of patients.


Resumo Introdução Atividade física adequada está relacionada com a prevenção e o tratamento da osteoporose. Objetivo Avaliar o nível de atividade física em mulheres na pós-menopausa com baixa densidade mineral óssea ( DMO ). Métodos Este estudo clínico transversal incluiu 123 mulheres na pós-menopausa. Os critérios de inclusão foram idade 45 anos, com última menstruação pelo menos 12 meses antes do início do estudo, e DMO medida nos últimos 12 meses. Foram excluídas mulheres com osteoartrite grave. As mulheres foram divididas em três grupos, de acordo com DMO medida por densitometria óssea [osteoporose (OP; 54 mulheres), osteopenia (35 mulheres) e DMO normal (NBD; 35 mulheres)], e comparadas com dados gerais, clínicos e antropométricos, e quanto ao nível de atividade física. Este último foi avaliado pelo International Physical Activity Questionnaire (IPAQ), em unidades de metabolic equivalent of task (METs). As participantes foram classificadas como sedentárias, ativas ou muito ativas. As variáveis quantitativas foram comparadas por ANOVA seguida pelo teste de Tukey. As associações entre as variáveis qualitativas foram testadas por Qui-quadrado (χ2) ou exato de Fisher. Para verificar diferenças entre os grupos e domínios do IPAQ, um modelo linear generalizado com distribuição Gama foi ajustado para os valores em METs. Resultados O grupo OP diferiu do NBD quanto à idade (61,8 10,1 e 52,9 5 , 4 anos), porcentagem de etnia autorrelatada branca (43,9 e 28,0%), índice de massa corporal (25,7 5,4 e 30,9 5,1 kg/m2) e tempo da menopausa (15,5 7,5 e 5,8 4,5 anos). As taxas de tabagismo foram maiores nos grupos com OP (55,6 % ) e NBD (33,3%) do que no com osteopenia (11,1%). No grupo com OP, sedentarismo (42,6%) e tempo gasto sentado foram maiores (344,3 204.8 METs) do que nos com osteopenia (20,0% e 300,9 230,6 METs) e NBD (17,7% e 303,2 187,9 METs). Conclusões O sedentarismo foi maior em mulheres na pós-menopausa com osteoporose do que naquelas com osteopenia ou NBD. Estratégias devem ser criadas para alterar este perfil de inatividade física neste grupo de pacientes.


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Densidade Óssea , Exercício Físico , Pós-Menopausa , Estudos Transversais
6.
Menopause ; 23(3): 267-74, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26554884

RESUMO

OBJECTIVE: To evaluate the effect of isolated vitamin D supplementation (VITD) on the rate of falls and postural balance in postmenopausal women fallers. METHODS: In this double-blind, placebo-controlled trial, 160 Brazilian younger postmenopausal women were randomized into two groups: VITD group, vitamin D3 supplementation 1,000 IU/day/orally (n = 80) and placebo group (n = 80). Women with amenorrhea at least 12 months, age 50 to 65 years, and a history of falls (previous 12 months) were included. Those with neurological or musculoskeletal disorders, vestibulopathies, drugs use that could affect balance and osteoporosis were excluded. The intervention time was 9 months. Postural balance was assessed by stabilometry (computerized force platform) and investigation on the occurrence/recurrence of falls was performed by interviews. The plasma concentration of 25-hydroxyvitamin D [25(OH)D] was measured by high-performance liquid chromatography. Statistical analysis was achieved by intention-to-treat, using analysis of variance, Student's t test, Tukey test, chi-square, and logistic regression. RESULTS: After 9 months, mean values of 25(OH)D increased from 15.0 ±â€Š7.5 ng/mL to 27.5 ±â€Š10.4 ng/mL (+45.4%) in the VITD group, and decreased from 16.9 ±â€Š6.7 ng/mL to 13.8 ±â€Š6.0 ng/mL (-18.5%) in the placebo group (P < 0.001). The occurrence of falls was higher in the placebo group (+46.3%) with an adjusted risk of 1.95 (95% confidence interval [CI] 1.23-3.08) times more likely to fall and 2.80 (95% CI 1.43-5.50) times higher for recurrent falls compared to the VITD group (P < 0.001). There was reduction in body sway by stabilometry, with lower amplitude of antero-posterior (-35.5%) and latero-lateral (-37.0%) oscillation, only in the VITD group (P < 0.001). CONCLUSIONS: In Brazilian postmenopausal women fallers, isolated vitamin D supplementation for 9 months resulted in a lower incidence of falls and improvement in postural balance.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Pós-Menopausa , Equilíbrio Postural/efeitos dos fármacos , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Acidentes por Quedas/prevenção & controle , Acidentes por Quedas/estatística & dados numéricos , Idoso , Conservadores da Densidade Óssea/sangue , Brasil , Calcifediol/sangue , Calcifediol/deficiência , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa , Equilíbrio Postural/fisiologia , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/fisiopatologia
7.
Rev Bras Ginecol Obstet ; 37(1): 30-5, 2015 Jan.
Artigo em Português | MEDLINE | ID: mdl-25607127

RESUMO

PURPOSE: To evaluate the prevalence of low bone mineral density (BMD) in postmenopausal breast cancer survivors. METHODS: In this cross-sectional study, 115 breast cancer survivors, seeking healthcare at a University Hospital in Brazil, were evaluated. Eligibility criteria included women with amenorrhea ≥ 12 months and age ≥ 45 years, treated for breast cancer and metastasis-free for at least five years. BMD was measured by DEXA at the lumbar spine (L1-L4) and femoral neck. Low BMD was considered when total-spine and/or femoral-neck T-score values were <-1.0 Delphi Score (DP) (osteopenia and osteoporosis). The risk factors for low BMD were assessed by interview. Data were analyzed statistically by the χ(2) test and Fisher's exact test. RESULTS: The mean age of breast cancer survivors was 61.6 ± 10.1 years and time since menopause was 14.2 ± 5.6 years, with a mean follow-up of 10.1 ± 3.9 years. Considering spine and femoral neck, 60% of breast cancer survivors had low BMD. By evaluating the risk factors for low BMD, a significant difference was found in the percent distribution for age (higher % of women >50 years with low BMD), personal history of previous fracture (11.6% with low BMD versus 0% with normal BMD) and BMI. A higher frequency of obesity was observed among women with normal BMD (63%) compared to those with low BMD (26.1%) (p<0.05). CONCLUSION: Postmenopausal breast cancer survivors had a high prevalence of osteopenia and osteoporosis.


Assuntos
Doenças Ósseas Metabólicas/epidemiologia , Neoplasias da Mama , Osteoporose/epidemiologia , Pós-Menopausa , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Sobreviventes
8.
Rev. bras. ginecol. obstet ; 37(1): 30-35, 01/2015. tab
Artigo em Português | LILACS | ID: lil-732873

RESUMO

OBJETIVO: Avaliar a prevalência da baixa densidade mineral óssea (DMO) em mulheres na pós-menopausa tratadas de câncer de mama. MÉTODOS: Estudo de corte transversal que incluiu 115 mulheres tratadas de câncer de mama atendidas em Hospital Universitário do Sudeste do Brasil. Foram incluídas mulheres com amenorreia há 12 meses ou mais e 45 anos ou mais de idade, tratadas de câncer de mama e livres de doença há pelo menos 5 anos. A DMO foi mensurada pelos raios-X de dupla energia em coluna lombar (L1 a L4) e colo de fêmur. Considerou-se baixa DMO quando valores de T-score de coluna total e/ou colo de fêmur <-1,0 Score de Delphi (DP) (osteopenia e osteoporose). Por meio de entrevista, foram avaliados fatores de risco para baixa DMO. Na análise estatística, empregaram-se os testes do χ2 ou Exato de Fisher. RESULTADOS: A média de idade das pacientes foi 61,6±10,1 anos e o tempo de menopausa, 14,2±5,6 anos, com tempo médio de seguimento de 10,1±3,9 anos. Considerando coluna e colo de fêmur, 60% das mulheres tratadas de câncer de mama apresentavam baixa DMO. Avaliando os fatores de risco para baixa DMO, foi encontrada diferença significativa na distribuição percentual quanto à idade (maior porcentagem de mulheres com mais de 50 anos e baixa DMO), história pessoal de fratura prévia (11,6% com baixa DMO e nenhuma com DMO normal) e índice de massa corpórea. Maior frequência de obesidade foi observada entre mulheres com DMO normal (63%) quando comparadas àquelas com baixa DMO (26,1%; p<0,05). CONCLUSÃO: Mulheres na pós-menopausa tratadas de câncer de mama apresentaram elevada prevalência de baixa DMO (osteopenia e/ou osteoporose). .


PURPOSE: To evaluate the prevalence of low bone mineral density (BMD) in postmenopausal breast cancer survivors. METHODS: In this cross-sectional study, 115 breast cancer survivors, seeking healthcare at a University Hospital in Brazil, were evaluated. Eligibility criteria included women with amenorrhea ≥12 months and age ≥45 years, treated for breast cancer and metastasis-free for at least five years. BMD was measured by DEXA at the lumbar spine (L1-L4) and femoral neck. Low BMD was considered when total-spine and/or femoral-neck T-score values were <-1.0 Delphi Score (DP) (osteopenia and osteoporosis). The risk factors for low BMD were assessed by interview. Data were analyzed statistically by the χ2 test and Fisher's exact test. RESULTS: The mean age of breast cancer survivors was 61.6±10.1 years and time since menopause was 14.2±5.6 years, with a mean follow-up of 10.1±3.9 years. Considering spine and femoral neck, 60% of breast cancer survivors had low BMD. By evaluating the risk factors for low BMD, a significant difference was found in the percent distribution for age (higher % of women >50 years with low BMD), personal history of previous fracture (11.6% with low BMD versus 0% with normal BMD) and BMI. A higher frequency of obesity was observed among women with normal BMD (63%) compared to those with low BMD (26.1%) (p<0.05). CONCLUSION: Postmenopausal breast cancer survivors had a high prevalence of osteopenia and osteoporosis. .


Assuntos
Animais , Ratos , Ácidos e Sais Biliares/metabolismo , Canalículos Biliares/metabolismo , Proteínas de Transporte/metabolismo , Hidroxiesteroide Desidrogenases , Glicoproteínas de Membrana , Adenosina Trifosfatases/metabolismo , Transporte Biológico , Células COS , Antígeno Carcinoembrionário/biossíntese , Proteínas de Transporte/biossíntese , Primers do DNA , DNA Complementar , Íleo/metabolismo , Cinética , Mutagênese Sítio-Dirigida , Proteínas Recombinantes de Fusão/biossíntese , Proteínas Recombinantes de Fusão/metabolismo , Transfecção , Ácido Taurocólico/metabolismo
9.
Rev Bras Ginecol Obstet ; 36(11): 489-496, 2014 Nov.
Artigo em Português | MEDLINE | ID: mdl-25493400

RESUMO

PURPOSE: To evaluate the predictive clinical factors for the development of endometrial polyps in postmenopausal women. METHODS: Observational cohort study with postmenopausal women who had been at a public university hospital. Clinical, anthropometrical, laboratorial, and ultrasonographic data of 132 patients with a histopathological diagnosis of endometrial polyps and 264 women without endometrial alterations (control) were compared in order to evaluate the predictive factors of endometrial polyps. Women with amenorrhea ≥12 months and ≥45 years of age were included in the study at a proportion of 1 case for 2 controls. The Student's t, χ2, and logistic regression tests were used for statistical analysis - odds ratio (OR). RESULTS: Patients with endometrial polyps were older and had been in menopause for a longer time compared to control (p<0.0001). The percentage of obese women with polyps (72.0%) was higher compared to the Control Group (39%; p<0.0001). The measurement of waist circumference was superior among patients with polyps (p=0.0001). We observed a higher incidence of diabetes, hypertension and dyslipidemia in patients with endometrial polyps (p<0.0001). According to the US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria, 48.5% of women with polyps and 33.3% of the Control Group were classified as having metabolic syndrome (p=0.004). Analysis of risk for endometrial polyps formation showed higher chances of occurrence of the disorder in patients with: BMI≥25 kg/m2 (OR=4.6; 95%CI 2.1-10.0); glucose ≥100 mg/dL (OR=2.8; 95%CI 1.3-5.9); dyslipidemia (OR=7.0; 95%CI 3.7-13.3); diabetes (OR=2.5; 95%CI 1.0-6.3), and metabolic syndrome (OR=2.7; 95%CI 1.1-6.4) compared to the Control Group. CONCLUSION: In postmenopausal women, obesity, dyslipidemia, hyperglycemia and presence of metabolic syndrome were predictive factors for the development of endometrial polyps.

10.
Säo Paulo med. j ; 132(6): 321-331, Nov-Dec/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-726377

RESUMO

CONTEXT AND OBJECTIVE: Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation. DESIGN AND SETTING: Observational, single cohort, retrospective study, conducted in a tertiary public hospital. METHODS: A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used. RESULTS: The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001), premenstrual symptoms (P < 0.001), dysmenorrhea (P = 0.019) and noncyclic pelvic pain (P = 0.001); and reductions in the number of sexual intercourse occurrences per week (P = 0.001) and in libido (P = 0.001). Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions. CONCLUSION: Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity. .


CONTEXTO E OBJETIVO: A ligadura tubária é um dos métodos contraceptivos mais utilizados em todo o mundo. Como a controvérsia sobre seus possíveis efeitos ainda continua, o objetivo deste estudo foi avaliar as repercussões clínicas e psíquicas da laqueadura videolaparoscópica. TIPO DE ESTUDO E LOCAL: Estudo observacional de coorte único, retrospectivo, conduzido em hospital público terciário. MÉTODOS: Foi aplicado um questionário a 130 mulheres, entre 21-46 anos, submetidas à ligadura tubária videolaparoscópica, pelas técnicas de eletrocoagulação bipolar/secção ou inserção do anel tubário, entre janeiro de 1999 e dezembro de 2007. Nesse questionário avaliou-se: intervalo do ciclo menstrual, intensidade e duração do sangramento, sintomas pré-menstruais, dismenorreia, dispareunia, dor pélvica não cíclica e grau de satisfação sexual. Cada mulher serviu como seu próprio controle, foi realizada análise comparativa entre os períodos pré- e pós-cirúrgico e entre as duas técnicas utilizadas. RESULTADOS: As repercussões clínicas e psicológicas mostraram-se significativas, com aumento de sangramento (P = 0,001), de sintomas pré-menstruais (P < 0,001), dismenorreia (P = 0,019), dor pélvica não cíclica (P = 0,001), e redução no número de relações sexuais por semana (P = 0,001) e na libido (P = 0,001). Mulheres com idade ≤ 35 anos, no momento da laqueadura, mostraram-se mais propensas a desenvolverem alterações menstruais. A técnica de eletrocoagulação bipolar mostrou maiores repercussões clínicas e psíquicas. CONCLUSÃO: A ligadura tubária videolaparoscópica, independentemente da técnica, repercutiu com ...


Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Laparoscopia , Distúrbios Menstruais/etiologia , Esterilização Tubária/efeitos adversos , Esterilização Tubária/psicologia , Coito/psicologia , Serviços de Planejamento Familiar/métodos , Libido , Produtos de Higiene Menstrual , Ciclo Menstrual/fisiologia , Satisfação do Paciente , Estudos Retrospectivos , Inquéritos e Questionários , Esterilização Tubária/métodos , Centros de Atenção Terciária
11.
Rev. bras. ginecol. obstet ; 36(11): 489-496, 11/2014. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: lil-730569

RESUMO

OBJETIVO: Avaliar os fatores clínicos preditivos para o desenvolvimento dos pólipos endometriais em mulheres na pós-menopausa. MÉTODOS: Estudo de coorte observacional com mulheres na pós-menopausa, que haviam sido atendidas em hospital público universitário. Dados clínicos, antropométricos, laboratoriais e ultrassonográficos de 132 pacientes com diagnóstico anatomopatológico de pólipo endometrial e de 264 mulheres sem alterações endometriais (controle) foram comparados para avaliar os fatores preditivos do pólipo endometrial. Foram incluídas no estudo mulheres com amenorreia ≥12 meses e idade ≥45 anos, em uma proporção de 1 caso para 2 controles. Para a análise estatística, foram empregados os testes t de Student, χ2 e regressão logística — odds ratio (OR). RESULTADOS: As pacientes com pólipo endometrial apresentaram idade mais avançada e maior tempo de menopausa quando comparadas ao controle (p<0,0001). A porcentagem de mulheres obesas com pólipo (72,0%) foi superior à do Grupo Controle (39%; p<0,0001). A medida da circunferência da cintura foi superior entre as pacientes com pólipo (p=0,0001). Observou-se uma incidência de diabetes, hipertensão e dislipidemias mais elevada nas pacientes com pólipo endometrial (p<0,0001). De acordo com os critérios do US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III), 48,5% das mulheres com pólipo e 33,3% do Grupo Controle foram classificadas como portadoras de síndrome metabólica (p=0,004). Em relação ao Grupo Controle, apresentaram maior chance de desenvolvimento de pólipo endometrial as pacientes com: IMC≥25 kg/m2 (OR=4,6; IC95% 2,1–10,0); glicose ≥100 mg/dL (OR=2,8; IC95% 1,3–5,9); dislipidemia (OR=7,0; IC95% 3,7–13,3); ...


PURPOSE: To evaluate the predictive clinical factors for the development of endometrial polyps in postmenopausal women. METHODS: Observational cohort study with postmenopausal women who had been at a public university hospital. Clinical, anthropometrical, laboratorial, and ultrasonographic data of 132 patients with a histopathological diagnosis of endometrial polyps and 264 women without endometrial alterations (control) were compared in order to evaluate the predictive factors of endometrial polyps. Women with amenorrhea ≥12 months and ≥45 years of age were included in the study at a proportion of 1 case for 2 controls. The Student's t, χ2, and logistic regression tests were used for statistical analysis – odds ratio (OR). RESULTS: Patients with endometrial polyps were older and had been in menopause for a longer time compared to control (p<0.0001). The percentage of obese women with polyps (72.0%) was higher compared to the Control Group (39%; p<0.0001). The measurement of waist circumference was superior among patients with polyps (p=0.0001). We observed a higher incidence of diabetes, hypertension and dyslipidemia in patients with endometrial polyps (p<0.0001). According to the US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria, 48.5% of women with polyps and 33.3% of the Control Group were classified as having metabolic syndrome (p=0.004). Analysis of risk for endometrial polyps formation showed higher chances of occurrence of the disorder in patients with: BMI≥25 kg/m2 (OR=4.6; 95%CI 2.1–10.0); glucose ≥100 mg/dL (OR=2.8; 95%CI 1.3–5.9); dyslipidemia (OR=7.0; 95%CI 3.7–13.3); diabetes (OR=2.5; 95%CI 1.0–6.3), and metabolic syndrome (OR=2.7; 95%CI 1.1–6.4) compared to the Control Group. CONCLUSION: In postmenopausal women, obesity, dyslipidemia, hyperglycemia and presence of metabolic syndrome were predictive ...

12.
Sao Paulo Med J ; 132(6): 321-31, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25351752

RESUMO

CONTEXT AND OBJECTIVE: Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation. DESIGN AND SETTING: Observational, single cohort, retrospective study, conducted in a tertiary public hospital. METHODS: A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used. RESULTS: The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001), premenstrual symptoms (P < 0.001), dysmenorrhea (P = 0.019) and noncyclic pelvic pain (P = 0.001); and reductions in the number of sexual intercourse occurrences per week (P = 0.001) and in libido (P = 0.001). Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions. CONCLUSION: Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity.


Assuntos
Laparoscopia , Distúrbios Menstruais/etiologia , Esterilização Tubária/efeitos adversos , Esterilização Tubária/psicologia , Adulto , Coito/psicologia , Serviços de Planejamento Familiar/métodos , Feminino , Humanos , Libido , Ciclo Menstrual/fisiologia , Produtos de Higiene Menstrual , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Retrospectivos , Esterilização Tubária/métodos , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
13.
Metab Syndr Relat Disord ; 12(6): 330-8, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25051240

RESUMO

BACKGROUND: The aim of this study was to assess clinical and inflammatory markers in nonalcoholic fatty liver disease (NAFLD) in postmenopausal women with metabolic syndrome. METHODS: This cross-sectional study included 180 Brazilian women (age ≥45 years and amenorrhea ≥12 months). Metabolic syndrome was diagnosed by the presence of at least three of the following indicators: Waist circumference (WC) >88 cm, triglycerides (TGs) ≥150 mg/dL, high-density lipoprotein (HDL) <50 mg/dL; blood pressure ≥130/85 mmHg; and glucose ≥100 mg/dL. NAFLD was diagnosed by abdominal ultrasound. Participants were divided into three groups: Metabolic syndrome alone (n=53); metabolic syndrome+NAFLD (n=67); or absence of metabolic syndrome or NAFLD (control, n=60). Clinical, anthropometric, and biochemical variables were quantified. The inflammatory profile included adiponectin, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). Data were submitted to statistical analysis using a Tukey test, analysis of variance (ANOVA), chi-squared, Pearson correlation, and logistic regression (odds ratio, OR). RESULTS: Women with metabolic syndrome+NAFLD, abdominal obesity, high glucose, and insulin resistance by HOMA-IR were compared to women with metabolic syndrome alone and controls (P<0.05). High values of IL-6 and TNF-α and low values of adiponectin were observed among women with metabolic syndrome alone or metabolic syndrome+NAFLD when compared to controls (P<0.05). In multivariate analysis, the variables considered as risk of NAFLD development were: High systolic blood pressure (SBP) [(OR 1.02, 95% confidence interval (CI) 1.0-1.04]; large WC (OR 1.07, 95% CI 1.01-1.13); insulin resistance (OR 3.81, 95% CI 2.01-7.13); and metabolic syndrome (OR 8.68, 95% CI 3.3-24.1). Adiponectin levels reduced NAFLD risk (OR 0.88, 95% CI 0.80-0.96). CONCLUSION: In postmenopausal women, metabolic syndrome, abdominal obesity, and insulin resistance were risk markers for the development of NAFLD, whereas higher adiponectin values indicated a protection marker.


Assuntos
Biomarcadores/sangue , Inflamação/sangue , Síndrome Metabólica/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Pós-Menopausa/sangue , Adiponectina/sangue , Idoso , Antropometria , Estudos Transversais , Feminino , Humanos , Resistência à Insulina , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Atividade Motora , Hepatopatia Gordurosa não Alcoólica/complicações , Fumar/efeitos adversos
14.
Mol Immunol ; 61(1): 23-7, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24861434

RESUMO

BACKGROUND: Inflammatory responses may be altered in postmenopausal women and predispose to cardiovascular disease (CVD). Genetic factors can also influence susceptibility to CVD. Mannose-binding lectin (MBL) is a component of the innate immune system and an activator of the complement cascade. We evaluated the association of genetic polymorphism of MBL (MBL2) on risk factors for CVD in postmenopausal women. METHODS: In this cross-sectional study, 311 Brazilian women (age ≥45 years and amenorrhea ≥12 months) were included. EXCLUSION CRITERIA: presence of previous or current CVD, insulin dependent diabetes, chronic kidney disease, autoimmune diseases and cancer. Clinical, anthropometric and biochemical assessments were performed to evaluate the cardiovascular risk factors. DNA was extracted from buccal cell and polymorphisms at codons 54 and 57 in the MBL2 were determined by polymerase chain reaction (PCR). For statistical analysis, the chi-square and logistic regression (odds ratio, OR) were used. RESULTS: The presence of the polymorphic allele for codon 54 was found in 25.8% of women (A/B=22.6%, B/B=3.2%) and for codon 57 in 12.2% (A/C=10.8%, C/C=1.4%). The polymorphism at codon 54 was significantly associated with the presence of hypertension (OR 0.55, 95% CI 0.31-0.99, p=0.044) and insulin resistance assessed by HOMA-IR (OR 0.46, 95% CI 0.24-0.91, p=0.025). No significant associations were observed between the polymorphism at codon 57 with risk factors for CVD. CONCLUSION: In postmenopausal women, the polymorphism at codon 54 of the MBL2 was associated with lower risk for hypertension and insulin resistance that are important risk factors for CVD.


Assuntos
Doenças Cardiovasculares/genética , Predisposição Genética para Doença/genética , Lectina de Ligação a Manose/genética , Polimorfismo de Nucleotídeo Único , Pós-Menopausa , Idoso , Distribuição de Qui-Quadrado , Códon/genética , Estudos Transversais , Feminino , Frequência do Gene , Genótipo , Humanos , Hipertensão/genética , Resistência à Insulina/genética , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Risco
15.
Menopause ; 21(9): 982-9, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24518151

RESUMO

OBJECTIVE: This study aims to evaluate clinical and inflammatory markers of subclinical carotid atherosclerosis (ATS) in asymptomatic postmenopausal women. METHODS: This cross-sectional study included 268 Brazilian women (aged ≥45 y and amenorrhea ≥12 mo). Subclinical ATS was defined as increased carotid intima-media thickness (>1.0 mm) and/or the presence of plaques evaluated by carotid duplex ultrasound. Inflammatory markers included C-reactive protein (CRP), as well as heat shock protein (HSP) 60 and HSP70 and their antibodies. Pearson's correlation and stepwise logistic regression were used for statistical analysis. RESULTS: Among the women studied, 45.9% (123 of 268) had a diagnosis of ATS, and 54.1% (145 of 268) had normal carotid ultrasound scans (controls). Women with ATS were older (56.6 vs 52.5 y), and their time since menopause was longer (6.0 vs 4.0 y). In addition, higher prevalences of metabolic syndrome (39.0% vs 25.5%), hypertension (52.0% vs 30.3%), and diabetes (11.4% vs 4.8%), and elevated circulating levels of CRP and HSP60, were observed in women with ATS compared with controls (P < 0.05). Intima-media thickness was positively correlated with anti-HSP70 antibodies (r = 0.110, P = 0.049) and CRP (r = 0.167, P = 0.009). ATS risk increased with age at menopause (odds ratio [OR], 1.18; 95% CI, 1.10-1.26), time since menopause (OR, 1.12; 95% CI, 1.02-1.14), and glucose of 100 mg/dL or higher (OR, 2.17; 95% CI, 1.12-4.20). Serum HSP70 levels (OR, 0.71; 95% CI, 0.47-0.98) were associated with a lower ATS risk (P < 0.05). CONCLUSIONS: In postmenopausal women, age, menopause status, and hyperglycemia are associated with a higher prevalence of ATS, whereas elevated serum HSP70 is associated with a lower prevalence of ATS.


Assuntos
Aterosclerose/epidemiologia , Artéria Carótida Primitiva/diagnóstico por imagem , Pós-Menopausa , Fatores Etários , Idoso , Aterosclerose/sangue , Aterosclerose/diagnóstico por imagem , Aterosclerose/patologia , Biomarcadores , Brasil/epidemiologia , Proteína C-Reativa/metabolismo , Chaperonina 60/sangue , Estudos Transversais , Feminino , Proteínas de Choque Térmico HSP70/sangue , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Fatores de Risco , Túnica Íntima/diagnóstico por imagem , Ultrassonografia
16.
Rev. bras. cineantropom. desempenho hum ; 15(6): 726-736, Nov.-Dec. 2013. tab
Artigo em Português | LILACS-Express | LILACS | ID: lil-690206

RESUMO

O estudo teve como objetivo investigar o efeito isolado e combinado do treinamento contrarresistência (TCR) e da suplementação de isoflavona da soja (ISO) sobre a densidade mineral óssea (DMO) e a remodelação óssea em mulheres na pós-menopausa (MPM). Tratou-se de estudo clínico, prospectivo, placebo-controlado, duplo-cego (ISO) e randomizado, envolvendo 80 MPM sedentárias, com idade entre 45-70 anos, randomizadas em quatro grupos (71 completaram nove meses): TCR+ISO (n=15); sem TCR+ISO (n=20); TCR+ placebo (n=18); sem TCR + placebo (n=18). As participantes randomizadas no grupo ISO receberam 100mg/dia/VO (via oral) de isoflavona e as no grupo TCR realizaram sessões supervisionadas de exercícios contrarresistência (mínimo de 2 dias/ semana). Nos momentos inicial e final do estudo, a DMO do colo do fêmur e da coluna lombar foram estimadas pela absortometria radiológica de feixes duplos de energia (DXA) e a força muscular pelo teste de 1-RM. Os valores plasmáticos de telopeptídeos carboxiterminais do colágeno tipo I (CTX), osteocalcina e fator de crescimento semelhante à insulina (IGF-1) foram dosados como marcadores de remodelação óssea. Após 9 meses de intervenção não foram observados efeitos independentes ou aditivos do TCR e ISO sobre a DMO bem como sobre os valores de osteocalcina, CTX e IGF-1 (p>0,05). Houve aumento da força muscular (+ 35,2%) somente nos grupos submetidos ao TCR (p=0,02). Conclui-se que o TCR e ISO não apresentam efeitos combinados ou independentes sobre a DMO do fêmur e da coluna lombar e marcadores da remodelação óssea em MPM após nove meses de intervenção.


This study aimed to investigate the independent and additive effects of counter-resistance training (RT) and soy isoflavone supplement (ISO) on bone mineral density (BMD) and bone turnover in postmenopausal women. This study used a placebo-controlled, double-blinded (soy), randomized two (ISO vs. placebo) x two (RT vs. no RT) design. Eighty sedentary postmenopausal women, aged 45-70 years, were randomly assigned to one of four groups (71 completed a 9-month intervention): RT+ISO (n=15); no RT+ISO (n=20); RT+placebo (n=18); no RT+placebo (n=18). Participants randomized to ISO received 100mg/ day/oral of soy isoflavone; and those to RT attended supervised counter-resistance training sessions at least twice a week. At baseline and 9-month, BMD was estimated by dual-energy X-ray absorptiometry (DXA). Serum levels of C-terminal cross-linked telopeptide of type I collagen (CTX), osteocalcin, and insulin-like growth factor-1 (IGF-1) were measured as bone turnover. ANOVA with time as the repeated measure and test t were used in the statistical analysis. After 9 months of intervention, neither ISO nor RT alone affected BMD at any site or levels of CTX, osteocalcin, and IGF-1 (p>0.05). ISO and RT had no additive effects on BMD and bone turnover. RT groups showed significantly increased muscle strength (+ 35.2%) (p=0.02). We found no additive effects of resistance training and soy isoflavone on bone mineral density or bone turnover in postmenopausal women after 9-months.

17.
Rev. bras. ginecol. obstet ; 35(11): 490-496, nov. 2013.
Artigo em Português | LILACS | ID: lil-697976

RESUMO

OBJETIVO: Foi avaliar a frequência e os fatores de risco de quedas em mulheres na pós-menopausa. MÉTODOS: Estudo clínico, transversal, envolvendo 358 mulheres (idade entre 45 e 65 anos e amenorreia >12 meses) com tempo de pós-menopausa <10 anos. Os critérios de exclusão foram: doença neurológica ou músculo esquelético, vestibulopatias, hipertensão arterial não controlada, hipotensão postural, déficit visual sem correção, uso de medicamentos (sedativos e hipnóticos). A queda foi definida como mudança de posição inesperada, não intencional, que faz com que o indivíduo permaneça em nível inferior à posição inicial. Foram analisados o histórico de quedas (últimos 24 meses) e as características clínicas, antropométricas (índice de massa corpórea (IMC) e circunferência da cintura (CC)) e densidade mineral óssea. Na comparação segundo grupo de mulheres com e sem histórico de queda, foi empregado o Teste do Qui-quadrado ou Exato de Fisher e regressão logística com cálculo do odds ratio (OR). RESULTADOS: Entre as mulheres incluídas, 48,0% (172/358) referiram queda, com fratura em 17,4% (30/172). A queda ocorreu dentro de casa em 58,7% (101/172). A média de idade foi 55,7±6,5 anos, tempo de menopausa de 5,8±3,5anos, IMC 28,3±4,6 kg/m² e CC 89,0±11,4 cm. Foi observada maior frequência de tabagismo e diabetes entre as mulheres com histórico de quedas quando comparadas àquelas sem queda, de 25,6 versus 16,1% e 12,8 versus 5,9%, respectivamente (p<0,05). Na análise multivariada em função das variáveis clínicas influentes, o risco de queda aumentou com o tabagismo atual (OR 1,93; IC95% 1,01-3,71). Demais variáveis clínicas e antropométricas não influenciaram no risco de queda. CONCLUSÕES: Em mulheres na pós-menopausa inicial houve expressiva frequência de quedas. O tabagismo foi indicador clínico de risco para queda. Com o reconhecimento de fatores determinantes para queda, medidas preventivas são importantes, como a orientação de abolir o tabagismo.


PURPOSE: It was to evaluate the frequency and the risk factors of falls in early postmenopausal women. METHODS: A cross-sectional study was conducted on 358 women (age: 45-65 years and amenorrhea >12 months) with time since menopause <10 years. Exclusion criteria were: neurological or musculoskeletal disorders, vestibulopathies, uncorrected visual deficit, uncontrolled hypertension and postural hypotension, or drug use (sedative and hypnotic agents). A fall was identified as an unexpected unintentional change in position which causes an individual to remain in a lower level in relation to the initial position. The history of self-reported falls during the previous 24 months, and clinical and anthropometric data (body mass index (BMI) and waist circumference (WC)) and bone densitometric measures were analyzed. For statistical analysis, c² trend test and the logistic regression method (odds ratio (OR)) were used for the comparison between groups of women with and without falls. RESULTS: Of the 358 women, 48.0% (172/358) had a history of falls and 17.4% (30/172) had fractures. The fall occurred indoors (at home) in 58.7% (101/172). The mean age was 53.7±6.5 years, time since menopause 5.8±3.5 years, BMI 28.3±4.6 kg/m² and WC 89.0±11.4 cm. There were differences as the occurrence of smoking and diabetes, with greater frequency among fallers vs. non-fallers, 25.6 versus 16.1% and 12.8 versus 5.9%, respectively (p<0.05). By evaluating the risk of falls in the presence of influential variables, it was observed that risk increased with current smoking status (OR 1.93; 95%CI 1.01-3.71), whereas other clinical and anthropometric variables did not influence this risk. CONCLUSIONS: In early postmenopausal women there was higher frequency of falls. Current smoking was clinical indicators of risk for falls. With the recognition of factors for falling, preventive measures become important, as the orientation of abolishing smoking.


Assuntos
Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Acidentes por Quedas/estatística & dados numéricos , Estudos Transversais , Pós-Menopausa , Medição de Risco , Fatores de Risco
18.
Femina ; 41(1): 33-38, jan-fev.
Artigo em Português | LILACS | ID: lil-694476

RESUMO

Pólipos endometriais são neoformações resultantes de uma hiperplasia focal da camada basal do endométrio associada a um hiperestímulo hormonal. Sua etiologia ainda não está bem estabelecida, não havendo consenso sobre sua história natural, seu real significado como entidade patológica e sua relação com a neoplasia endometrial. Os pólipos endometriais são a principal indicação de histeroscopia cirúrgica, sem que haja, no entanto, um protocolo definido para seu melhor manejo. Uma visão abrangente sobre essa condição pode auxiliar na escolha da conduta mais adequada. (AU)


Endometrial polyps are neoformations that result from focal hyperplasia of the endometrial basal layer associated with hormonal hyperstimulation. Their pathogenesis is still unclear, and there is no consensus on their natural history, actual relevance as pathologic entities, and relationship with endometrial neoplasia. Endometrial polyps are the most frequent indication of surgical hysteroscopy, but their optimal management remains controversial. Therefore, an overview of this condition may help choosing the most adequate treatment strategies.(AU)


Assuntos
Humanos , Feminino , Pólipos/cirurgia , Pólipos/diagnóstico , Pólipos/tratamento farmacológico , Pólipos/epidemiologia , Histeroscopia , Endométrio/patologia , Imuno-Histoquímica , Fatores de Risco , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/metabolismo
19.
Menopause ; 20(10): 1049-54, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23481125

RESUMO

OBJECTIVE: This study aims to evaluate the effects of soy isoflavones on breast tissue in postmenopausal women. METHODS: In this randomized, double-blind, placebo-controlled study, 80 women (aged ≥ 45 y and with amenorrhea >12 mo) with vasomotor symptoms were randomized to receive either 250 mg of standardized soy extract corresponding to isoflavone 100 mg/day (n = 40) or placebo (n = 40) for 10 months. Breasts were evaluated through mammographic density and breast parenchyma using ultrasound (US) at baseline and 10-month follow-up. Independent t test, analysis of variance, Mann-Whitney U test, and χ2 trend test were used in statistical analysis. RESULTS: Baseline clinical characteristics showed no significant differences between the isoflavone group and the placebo group, with mean (SD) age of 55.1 (6.0) and 56.2 (7.7) years, mean (SD) menopause duration of 6.6 (4.8) and 7.1 (4.2) years, and mean (SD) body mass index of 29.7 (5.0) and 28.5 (4.9) kg/m2, respectively (P > 0.05). The study was completed by 32 women on isoflavone and 34 women on placebo. The groups did not differ in mammographic density or breast parenchyma by US (P > 0.05). Within each group, the baseline and final moments did not differ in mammography or US parameters significantly (P > 0.05). CONCLUSIONS: The use of soy isoflavone extract for 10 months does not affect breast density, as assessed by mammography and US, in postmenopausal women.


Assuntos
Neoplasias da Mama , Mama/efeitos dos fármacos , Isoflavonas/administração & dosagem , Isoflavonas/efeitos adversos , Glândulas Mamárias Humanas/anormalidades , Pós-Menopausa , Soja/química , Índice de Massa Corporal , Densidade da Mama , Método Duplo-Cego , Feminino , Genisteína/sangue , Humanos , Isoflavonas/sangue , Mamografia , Pessoa de Meia-Idade , Placebos , Extratos Vegetais/administração & dosagem , Ultrassonografia Mamária
20.
Menopause ; 20(4): 448-54, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23149866

RESUMO

OBJECTIVE: The aim of this study was to assess the risk of metabolic syndrome (MetS) in postmenopausal breast cancer survivors as compared with postmenopausal women without breast cancer. METHODS: In this cross-sectional study, 104 postmenopausal breast cancer survivors were compared with 208 postmenopausal women (controls) attending a university hospital. Eligibility criteria included the following: amenorrhea longer than 12 months and aged 45 years or older, treated for breast cancer, and metastasis-free for at least 5 years. The control group consisted of women with amenorrhea longer than 12 months and aged 45 years or older and without breast cancer, matched by age and menopause status (in a proportion of 1:2 as sample calculation). Clinical and anthropometric data were collected. Biochemical parameters, including total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, and C-reactive protein, were measured. Women showing three or more diagnostic criteria were diagnosed as having MetS: waist circumference of 88 cm or larger, blood pressure of 130/85 mm Hg or higher, triglycerides level of 150 mg/dL or higher, high-density lipoprotein cholesterol level lower than 50 mg/dL, and glucose level of 100 mg/dL or higher. For statistical analysis, Student's t test, χ2 test, and logistic regression (odds ratio [OR]) were used. RESULTS: The mean (SD) age of breast cancer survivors was 60.6 (8.6) years, with a mean (SD) follow-up of 9.4 (4.4) years. A higher percentage of breast cancer survivors (46.2%) were obese as compared with controls (32.7%; P < 0.05), and a smaller percentage showed optimal values for low-density lipoprotein cholesterol, glucose, and C-reactive protein versus controls (P < 0.05). MetS was diagnosed in 50% of breast cancer survivors and in 37.5% of control group women (P < 0.05). Among the MetS diagnostic criteria, the most prevalent was abdominal obesity (waist circumference >88 cm), affecting 62.5% and 67.8% of the participants, respectively. In the control group, breast cancer survivors had a higher risk for MetS (OR, 1.66; 95% CI, 1.04-2.68), dysglycemia (OR, 1.05; 95% CI, 1.09-3.03), and hypertension (OR, 1.71; 95% CI, 1.02-2.89). CONCLUSIONS: Postmenopausal breast cancer survivors present a higher risk of developing MetS as compared with women without breast cancer.


Assuntos
Neoplasias da Mama/complicações , Síndrome Metabólica/epidemiologia , Pós-Menopausa , Idoso , Glicemia/análise , Pressão Sanguínea , Proteína C-Reativa/análise , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade Abdominal/complicações , Fatores de Risco , Sobreviventes , Triglicerídeos/sangue , Circunferência da Cintura
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA