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2.
Eur Rev Med Pharmacol Sci ; 25(7): 2843-2851, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33877649

RESUMO

OBJECTIVE: Uterine myomas are the most common benign tumors in females, and at least 25% of affected patients experience symptoms severe enough to need treatment, like heavy hemorrhage, pelvic pain, and infertility. Currently, a non-invasive approach is preferred in women of childbearing age who desire pregnancy. The aim of our study was to determine the effect of oral supplementation with a combination of vitamin D plus epigallocatechin gallate (EGCG) and vitamin B6 in women with myomas. PATIENTS AND METHODS: Between April and December 2020, we enrolled 95 women of childbearing age, afferent to our hospital, displaying at least one myoma with a diameter <4 cm. Patients were divided in two groups: 41 women were treated daily with two tablets of 25 µg vitamin D + 150 mg EGCG + 5 mg vitamin B6 for 4 months; 54 women, representing the control group, received no treatment. Total volume and vascularization of myomas were analyzed ultrasonographically. Bleeding and pelvic pain was also evaluated, as well as patients' quality of life and health through questionnaire Short Form Health Survey (SF-36) and Patient Global Impression of improvement (PGI-I). RESULTS: After treatment myomas' total volume and peripherical vascularization significantly decreased respectively by 37.9% (p<0.001) and 7.7%. On the other hand, we observed an increase in myomas' volume by 5.5 % and of peripherical vascularization by 5% in the control group. The treated group reported an improvement in SF-36 (p<0.001) and PGI-I (85.4%) questionnaire scores. CONCLUSIONS: We demonstrated, in young women who want to preserve fertility, that the combined supplementation of vitamin D, EGCG, and vitamin B6 reduced myomas' volume and improved patients' quality of life, without side effects.


Assuntos
Antineoplásicos/uso terapêutico , Catequina/análogos & derivados , Leiomioma/tratamento farmacológico , Mioma/tratamento farmacológico , Neoplasias Uterinas/tratamento farmacológico , Vitamina D/uso terapêutico , Administração Oral , Adulto , Antineoplásicos/administração & dosagem , Catequina/administração & dosagem , Catequina/uso terapêutico , Feminino , Humanos , Leiomioma/diagnóstico , Mioma/diagnóstico , Comprimidos/administração & dosagem , Comprimidos/uso terapêutico , Neoplasias Uterinas/diagnóstico , Vitamina D/administração & dosagem
3.
Rev. chil. obstet. ginecol. (En línea) ; 85(6): 678-684, dic. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1508026

RESUMO

OBJETIVO: Reportar el caso de una torsión de útero, trompas y ambos ovarios a nivel de cuello uterino. Describir la patogenia, sintomatología y tratamiento, como un caso infrecuente y potencialmente grave, en la práctica clínica diaria. MATERIAL Y MÉTODOS: Analizar el curso de esta extremadamente rara patología, en una mujer postmenopáusica de 59 años. Se trata de un caso raro de torsión uterina en un útero no gestante, reportando los hallazgos en los exámenes previos a la cirugía y los hallazgos intraoperatorios e histopatológicos postcirugía. La resonancia magnética fue fundamental en el diagnóstico de la paciente y la laparotomía realizada demostró una torsión de cuerpo uterino de 360 ° a nivel de cérvix, y un gran mioma pediculado con signos de necrosis. Hemos revisado los últimos artículos de esta rara patología RESULTADOS Y DISCUSIÓN: La paciente fue operada. Se realizó una histerectomía total mediante una laparotomía media supra e infraumbilical. Los ovarios no tenían signos de necrosis. CONCLUSIONES: Debemos tener en cuenta esta posibilidad diagnóstica, en pacientes con aumento de tamaño uterino y clínica de dolor abdominal, ya que aunque es muy infrecuente, su diagnóstico es importante, ya que puede ser peligroso para la vida de la paciente.


OBJECTIVE: To report a case of torsion of the uterus, fallopian tubes and both ovaries around the uterine collum and the symptomatology, pathogenesis and treatment of this uncommon pathology. MATERIAL AND METHODS: The article analyses the course of this extremely rare pathology in a postmenopausical woman of 59 years. It is a rare case like a non gravid uterine torsion in a postmenopausical woman. We have the exams previous to the surgery, the finds intraoperative and the histolopathological reports postsurgery. RMN was the most important in diagnosis and the laparotomy showed a 360° an uterus increased on size and a big pedunculated myoma with signs of necrosis We have reviewed the latest articles on this strange pathology RESULTS AND DISCUSSION: The patient was operated. A infra-supra medium laparotomy was practiced and a total hysterectomy was made. Ovarians had not signs of necrosis. CONCLUSIONS: We must take into account, in patients with pathologies that increase uterine size and abdominal pain, the possibility of uterine torsion. Although it is a very infrequent pathology, its diagnosis is important, since it can be dangerous for the life of the patient


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Anormalidade Torcional/etiologia , Neoplasias Uterinas/complicações , Mioma/complicações , Anormalidade Torcional/cirurgia , Anormalidade Torcional/diagnóstico por imagem , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/diagnóstico , Imageamento por Ressonância Magnética , Histerectomia , Mioma/cirurgia , Mioma/diagnóstico
4.
Eur Radiol ; 30(5): 2473-2482, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32040725

RESUMO

OBJECTIVES: Since 2004, uterine fibroids have been treated with MR-HIFU, but there are persevering doubts on long-term efficacy to date. In the Focused Ultrasound Myoma Outcome Study (FUMOS), we evaluated long-term outcomes after MR-HIFU therapy, primarily to assess the reintervention rate. METHODS: Data was retrospectively collected from 123 patients treated with MR-HIFU at our hospital from 2010 to 2017. Follow-up duration and baseline (MRI) characteristics were retrieved from medical records. Treatment failures, adverse events, and the nonperfused volume percentage (NPV%) were determined. Patients received a questionnaire about reinterventions, recovery time, satisfaction, and pregnancy outcomes. Restrictive treatment protocols were compared with unrestrictive (aiming for complete ablation) treatments. Subgroups were analyzed based on the achieved NPV < 50 or ≥ 50%. RESULTS: Treatment failures occurred in 12.1% and the number of adverse events was 13.7%. Implementation of an unrestrictive treatment protocol significantly (p = 0.006) increased the mean NPV% from 37.4% [24.3-53.0] to 57.4% [33.5-76.5]. At 63.5 ± 29.0 months follow-up, the overall reintervention rate was 33.3% (n = 87). All reinterventions were performed within 34 months follow-up, but within 21 months in the unrestrictive group. The reintervention rate significantly (p = 0.002) decreased from 48.8% in the restrictive group (n = 43; follow-up 87.5 ± 7.3 months) to 18.2% in the unrestrictive group (n = 44; follow-up 40.0 ± 22.1 months). The median recovery time was 2.0 [1.0-7.0] days. Treatment satisfaction rate was 72.4% and 4/11 women completed family planning after MR-HIFU. CONCLUSIONS: The unrestrictive treatment protocol significantly increased the NPV%. Unrestrictive MR-HIFU treatments led to acceptable reintervention rates comparable to other reimbursed uterine-sparing treatments, and no reinterventions were reported beyond 21 months follow-up. KEY POINTS: • All reinterventions were performed within 34 months follow-up, but in the unrestrictive treatment protocol group, no reinterventions were reported beyond 21 months follow-up. • The NPV% was negatively associated with the risk of reintervention; thus, operators should aim for complete ablation during MR-guided HIFU therapy of uterine fibroids. • Unrestrictive treatments have led to acceptable reintervention rates after MR-guided HIFU therapy compared to other reimbursed uterine-sparing treatments.


Assuntos
Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Imagem por Ressonância Magnética Intervencionista/métodos , Mioma/terapia , Neoplasias Uterinas/terapia , Adulto , Protocolos Clínicos , Feminino , Seguimentos , Humanos , Leiomioma/cirurgia , Masculino , Pessoa de Meia-Idade , Mioma/diagnóstico , Estudos Retrospectivos , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia
5.
Acta Clin Croat ; 58(4): 627-631, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32595247

RESUMO

The aim of our study was to determine the prevalence of endometrial premalignant and malignant lesions in women undergoing hysteroscopy and to identify anthropologic factors related to the presence of malignancy. Data on 3470 women with submucosal myomas or endometrial polyps suspected on ultrasound were retrospectively analyzed. Hysteroscopy was performed in all these women in order to make a more precise diagnosis. Histologic analysis of endometrial samples obtained during hysteroscopy was used to confirm the diagnosis. Statistical analysis was performed using the SPSS 20.0.0 software. The mean age of study women was 49.1±13.3 years. The number of procedures performed due to the referral diagnosis of endometrial or submucosal myoma significantly increased over the 16-year study period. A significantly higher number of women had a benign histopathologic diagnosis. Histologic analysis revealed malignancy in 67 women. The youngest woman and oldest woman with malignant findings was aged 32 and 75, respectively. A significantly higher number of women with atypical hyperplasia and malignancy were in menopause. A comparable number of women with different histologic findings lived in urban and rural areas. There were a significantly larger proportion of widows among women with the histologic diagnosis of atypical hyperplasia or malignancy. The prevalence rate of malignancy in women having undergone hysteroscopy for polyps and myoma found by ultrasound was 1.93%. Postmenopausal status and older age were associated with an increased risk of malignancies, but premalignant changes and malignancies were also found in young and premenopausal women. Therefore, diagnostic hysteroscopy can be recommended in women of all age groups.


Assuntos
Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/cirurgia , Mioma/diagnóstico , Mioma/cirurgia , Pólipos/diagnóstico , Pólipos/cirurgia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Endométrio/fisiopatologia , Feminino , Humanos , Histeroscopia/métodos , Pessoa de Meia-Idade , Mioma/fisiopatologia , Pólipos/fisiopatologia , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/fisiopatologia , Lesões Pré-Cancerosas/cirurgia , Prevalência , Estudos Retrospectivos , Ultrassonografia/métodos , Neoplasias Uterinas/fisiopatologia , Adulto Jovem
7.
J Obstet Gynaecol Res ; 44(6): 1163-1168, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29516586

RESUMO

A 45-year-old multipara woman was referred due to the rapid enlargement of an asymptomatic pelvic mass that was detected during a regular check up. She had undergone laparoscopic-assisted myomectomy 15 years previously. At the time, the uncontained extraction of an intraligamental myoma with electric power morcellation had been performed. Multimodal imaging revealed a heterogeneous mass in the vesicouterine pouch that was found to be supplied by the left gastro-omental and superior vesical arteries. Although malignancy could not be completely denied, parasitic peritoneal myoma with myxoid degeneration was the most probable diagnosis. Single-port laparoscopic excision of the peritoneal mass was performed along with laparoscopic-assisted vaginal hysterectomy and bilateral salpingo-oophorectomy. The excised peritoneal mass was placed into a retrieval bag and extracted through the vagina. The pathological diagnosis was a parasitic peritoneal myoma with myxoid degeneration. The postoperative course was uneventful, and there was no recurrence of parasitic myoma in the 1-year follow up after surgery.


Assuntos
Laparoscopia/métodos , Morcelação/efeitos adversos , Mioma , Inoculação de Neoplasia , Neoplasias Peritoneais , Miomectomia Uterina/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , Imagem Multimodal , Mioma/diagnóstico , Mioma/etiologia , Mioma/patologia , Mioma/cirurgia , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia , Neoplasias Peritoneais/secundário , Neoplasias Peritoneais/cirurgia
8.
Hawaii J Med Public Health ; 76(9): 253-257, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28900580

RESUMO

Cardiac myxomas are rare clinical findings. They are frequently found in the left atrium and more commonly affect women. Clinical presentation can vary widely and symptoms can be vague and non-specific. We present a case of a 67-year-old woman presenting with 3 weeks of progressive heart failure symptoms that failed to respond to oral diuretic therapy. On physical exam, she was found to have a diastolic murmur, rumble and an early diastolic plop. Transthoracic echocardiogram revealed a 5.6 cm × 2.5 cm × 4.3 cm left atrial mass attached to the mitral valve causing left atrial outflow obstruction. The patient subsequently underwent surgical resection of the mass with resolution of symptoms immediately thereafter. Lack of recognition of this pathologic process as a cause of heart failure symptoms and lack of a quality physical exam can lead to a delay in diagnosis and treatment.


Assuntos
Átrios do Coração/anormalidades , Átrios do Coração/patologia , Mioma/diagnóstico , Exame Físico/normas , Idoso , Ecocardiografia Doppler em Cores/métodos , Feminino , Havaí , Átrios do Coração/diagnóstico por imagem , Insuficiência Cardíaca/diagnóstico , Humanos , Mioma/cirurgia , Exame Físico/métodos
9.
Rev. cuba. obstet. ginecol ; 43(3): 152-156, jul.-set. 2017. ilus
Artigo em Espanhol | CUMED | ID: cum-73566

RESUMO

Los leiomiomas, también llamados miomas o fibromas, son tumores del músculo liso que puede localizarse en cualquier parte del cuerpo, pero más comúnmente en los tractos genital y gastrointestinal. El objetivo del trabajo es presentar un caso de mioma vaginal en una mujer de 42 años. La paciente acudió a la consulta por presentar, desde hace varios meses, una masa redondeada, indolora y de crecimiento gradual, a nivel del introito vaginal. Se constata, mediante examen clínico e imagenológico, la presencia de una tumoración redondeada de implantación sésil, en la cara anterior de la vagina. Fue realizada la exéresis quirúrgica, la cual se envió para un estudio histopatológico. Se comprobó que se trataba de un leiomioma de la vagina. La paciente no presentó complicaciones posoperatorias(AU)


Leiomyomas, also called myomas or fibroids, are smooth muscle tumors that can be located anywhere in the body, but more commonly in the genital and gastrointestinal tracts. The objective of the paper is to present a case of vaginal myoma in a 42-year-old woman. This patient came to the consultation for presenting a painless gradually-growing round mass at the level of the vaginal introitus, for several months. The presence of a rounded mass of sessile implantation on the anterior side of the vagina is confirmed by clinical and imaging examination. Surgical exeresis was performed, which was histopathologically studied. It was found to be a vagina leiomyoma. The patient did not present postoperative complications(AU)


Assuntos
Humanos , Feminino , Adulto , Mioma/cirurgia , Mioma/diagnóstico , Mioma/patologia , Mioma
10.
Rev. cuba. obstet. ginecol ; 43(3): 152-156, jul.-set. 2017. ilus
Artigo em Espanhol | LILACS, CUMED | ID: biblio-901322

RESUMO

Los leiomiomas, también llamados miomas o fibromas, son tumores del músculo liso que puede localizarse en cualquier parte del cuerpo, pero más comúnmente en los tractos genital y gastrointestinal. El objetivo del trabajo es presentar un caso de mioma vaginal en una mujer de 42 años. La paciente acudió a la consulta por presentar, desde hace varios meses, una masa redondeada, indolora y de crecimiento gradual, a nivel del introito vaginal. Se constata, mediante examen clínico e imagenológico, la presencia de una tumoración redondeada de implantación sésil, en la cara anterior de la vagina. Fue realizada la exéresis quirúrgica, la cual se envió para un estudio histopatológico. Se comprobó que se trataba de un leiomioma de la vagina. La paciente no presentó complicaciones posoperatorias(AU)


Leiomyomas, also called myomas or fibroids, are smooth muscle tumors that can be located anywhere in the body, but more commonly in the genital and gastrointestinal tracts. The objective of the paper is to present a case of vaginal myoma in a 42-year-old woman. This patient came to the consultation for presenting a painless gradually-growing round mass at the level of the vaginal introitus, for several months. The presence of a rounded mass of sessile implantation on the anterior side of the vagina is confirmed by clinical and imaging examination. Surgical exeresis was performed, which was histopathologically studied. It was found to be a vagina leiomyoma. The patient did not present postoperative complications(AU)


Assuntos
Humanos , Feminino , Adulto , Mioma/cirurgia , Mioma/diagnóstico , Mioma/patologia , Mioma/diagnóstico por imagem
12.
Rev. electron ; 41(12)dic.2016. tab
Artigo em Espanhol | CUMED | ID: cum-65991

RESUMO

Fundamento: el fibroma uterino constituye un problema de salud que afecta a las mujeres en edad reproductiva, los tratamientos electivos, basados en la cirugía y la embolización de la arteria uterina, aunque reportan éxito, son invasivos y riesgosos.Objetivo: evaluar los efectos del tratamiento combinado de la magnetoterapia con laserterapia y homeopatía en mujeres con mioma uterino, remitidas a la consulta de medicina natural y tradicional del policlínico universitario Rafael Izquierdo”, entre julio de 2015 y marzo de 2016.Métodos: se realizó una intervención en 25 mujeres entre 20 y 49 años, con diagnóstico de mioma uterino, en el periodo de tiempo y área antes mencionados. Las pacientes se distribuyeron al azar en dos grupos, al primero le fue aplicada la terapia combinada y al segundo el tratamiento hormonal (medroxiprogesterona). El seguimiento se hizo de forma clínica y por ultrasonograma, a los tres y seis meses después de culminar el tratamiento.Resultados: a los seis meses el grupo estudio redujo el tamaño del tumor en 21,34 mm3, más que el control; en este último, a los tres meses el 7,7 por ciento redujo intensamente el tumor, mientras en el 92,3 por ciento fue moderada; a los seis meses los pacientes con reducción intensa se incrementaron al 30,8 por ciento; en el grupo de estudio solo el 16,7 por ciento alcanzaron la reducción intensa del tumor. En la reducción del tamaño del útero no existieron diferencias significativas entre ambos grupos. La evolución clínica fue superior en el grupo control.Conclusiones: la terapia hormonal mostró mejores resultados clínicos y ultrasonográficos; en ambos tratamientos se demostró inocuidad (AU)


Background: uterine fibroma is a health problem that affects women in reproductive age. Elective treatments based on surgery and uterine arterial embolization, although successful, are invasive and risky.Objective: to assess the effects of a combined treatment with magnetic therapy, laser therapy and homeopathy in women with uterine myoma referred to the department of natural and traditional medicine at “Rafael Izquierdo” Teaching Polyclinic from July 2015 to March 2016.Methods: an intervention study was carried out with 25 women of the 20 to 49 age group with a diagnosis of uterine myoma, in the place and during the period herein mentioned. Patients were distributed at random into two groups. The first group received a combined therapy, while the second group received hormonal treatment (medroxiprogesterone). Follow-up was conducted clinically and by ultrasound, at 3 and 6 months after the end of the treatment. Results: at 6 months of treatment, the study group reduced the tumor size in 21, 34 mm3, more than in the control group; the latter, at 3 months, reduced the tumor intensively in 7,7 percent, while 92,3 percent was moderate. At 6 months, the patients with intense reduction increased to 30,8 percent. In the study group only 16,7 percent reached the intense reduction of the tumor. Concerning the reduction of the uterus size there were no remarkable differences between the two groups. Clinical progress was higher in the control group.Conclusions: Hormonal therapy showed better clinical and ultrasonographic results; both treatments were Harmless (AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Mioma/diagnóstico , Mioma/terapia , Terapia a Laser , Magnetoterapia , Trombidium muscae domesticae
13.
Taiwan J Obstet Gynecol ; 55(5): 646-649, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27751409

RESUMO

OBJECTIVE: To report our experiences with 40 patients who were treated with magnetic resonance-guided focused ultrasound surgery (MRgFUS) for uterine fibroids and their 6-month follow-up status. MATERIALS AND METHODS: A total of 40 patients with uterine fibroids underwent MRgFUS from January 2009 to November 2011. The Uterine Fibroid Symptoms and Quality of Life Questionnaire was used to determine the patients' Symptom Severity Scores (SSS) prior to and 6 months after treatment. The nonperfused volume (NPV) values and NPV ratio were obtained immediately at the end of the treatment and at 6 months follow-up. RESULTS: No procedure-related complications were noted throughout the 6-month follow-up period among the 40 patients who underwent MRgFUS for uterine fibroids. The mean reduction in SSS in our patients after 6 months was 43.7%, and the mean reduction of fibroid volume was 31.7%. In addition, the mean reduction of NPV and mean NPV ratio was 52.7% and 33.3%, respectively. CONCLUSION: The results obtained from this study demonstrated that MRgFUS can be safely and effectively used to ablate uterine fibroids to produce a significant decrease in mean fibroid volume and improve SSS for up to 6 months after treatment.


Assuntos
Técnicas de Ablação/métodos , Imageamento por Ressonância Magnética/métodos , Mioma/cirurgia , Qualidade de Vida , Cirurgia Assistida por Computador/métodos , Procedimentos Cirúrgicos Ultrassônicos/métodos , Neoplasias Uterinas/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Mioma/diagnóstico , Estudos Retrospectivos , Taiwan , Resultado do Tratamento , Neoplasias Uterinas/diagnóstico
14.
Reprod Biol Endocrinol ; 14(1): 64, 2016 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-27716434

RESUMO

BACKGROUND: Iatrogenic parasitic myomas (PMs), caused by intra-corporeal power morcellation during laparoscopy is gradually increasing. However, the pathogenesis and medical treatment of PMs remain largely unelucidated. METHODS: Laparoscopically-induced PM xenografted mouse model was conducted by xenografting human uterine myoma fragments into the abdominal cavity of SCID mice and hormonal manipulation was performed using this mouse model to demonstrate the role of oestrogen in the development of implanted PMs. Immunohistochemistry of oestrogen receptor α (ERα), progesterone receptor (PR), vimentin, vascular endothelial growth factor (VEGF), microvessel density (MVD) and Ki-67 index was performed and compared. RESULTS: In the patient with PMs, ERα, PR, angiogenesis and proliferative property expression were upregulated in PM lesions compared to uterine myomas. In the laparoscopically-induced PM mouse model, implanted myomas had more steroid receptor expressions, angiogenesis and proliferative property compared with pre-xenografted or non-implanted myoma. Depletion of oestrogen in the ovariectomized (OVX) mice decreased laparoscopically-induced PM implantations. In comparison, the implantations of PMs were increased with additional E2 supplement. Hormonal manipulation in the PM mouse model, including AI, GnRHa and SERM groups, were compared and AI significantly decreased the implantations, steroid receptor, angiogenesis, cell density, and proliferative index of PMs compared with control group. Furthermore, GnRHa significantly decreased VEGF and MVD expressions compared with control group. CONCLUSIONS: These data highlight the crucial role of oestrogen in the development of laparoscopically-induced PMs and suggest that hormone manipulation may be a potential therapeutic agent. TRIAL REGISTRATION: This protocol was approved by the Human and Animal Institutional Review Board of Taipei Veterans General Hospital ( VGHIRB No 2014-10-002C on Nov. 17th, 2014; IACUC 2014-119 on Aug. 22nd, 2014).


Assuntos
Estrogênios/farmacologia , Laparoscopia/efeitos adversos , Leiomioma/diagnóstico , Morcelação/efeitos adversos , Neovascularização Fisiológica/efeitos dos fármacos , Doenças Parasitárias/diagnóstico , Neoplasias Uterinas/diagnóstico , Cavidade Abdominal/parasitologia , Adulto , Animais , Feminino , Humanos , Leiomioma/etiologia , Leiomioma/cirurgia , Camundongos , Camundongos SCID , Mioma/diagnóstico , Mioma/etiologia , Mioma/cirurgia , Neovascularização Fisiológica/fisiologia , Doenças Parasitárias/etiologia , Doenças Parasitárias/cirurgia , Transplante Heterólogo/métodos , Neoplasias Uterinas/etiologia , Neoplasias Uterinas/cirurgia
15.
Clin Exp Obstet Gynecol ; 43(1): 131-3, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27048035

RESUMO

Incarceration of gravid uterus is a rare condition, occurring in one in 3,000 to 10,000 pregnancies during second trimester. Incarceration of uterus can cause several complications, such as uterine rupture, labor dystocia, and uncontrollable postpartum hemorrhage. Early diagnosis is important to prevent these complications, but there are no standard treatments of incarceration of gravid uterus. The authors present a case report of incarceration of gravid uterus caused by growing subserosal myoma, which was treated with myomectomy during second trimester.


Assuntos
Mioma/diagnóstico , Complicações na Gravidez , Doenças Uterinas/diagnóstico , Adulto , Feminino , Humanos , Gravidez , Ultrassonografia Pré-Natal
16.
Fertil Steril ; 104(2): 426-34.e1, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26003270

RESUMO

OBJECTIVE: To study the in vivo mechanisms of action of ulipristal acetate (UPA) on uterine myomas. DESIGN: Retrospective histologic and immunohistochemical (IHC) study of myomas. SETTING: Academic research unit. PATIENT(S): Among 59 women with symptomatic myomas who underwent myomectomy, 42 were treated preoperatively with UPA, while 17 were not. INTERVENTION(S): Histology and IHC were analyzed on tissue microarrays obtained from surgical specimens. MAIN OUTCOME MEASURE(S): Proliferation, apoptosis, extracellular matrix (ECM) remodeling, and matrix metalloproteinase 2 (MMP-2) expression. RESULT(S): Proliferation was low in all conditions, with no statistical difference between groups. Terminal deoxynucleotide transferase-mediated dUTP nick-end labeling assay showed an increase in cell death in UPA-treated myomas compared with untreated myomas, but only after short-term treatment; this was not associated with elevated levels of cleaved caspase-3. After long-term treatment, cell density was higher and the ECM volume fraction lower in UPA-treated myomas than in untreated myomas. MMP-2 expression was found to be increased after treatment, showing the highest level after long-term treatment, compared with untreated myomas. CONCLUSION(S): Regarding sustained clinical volume reduction of myomas, this study strongly points to multifactorial mechanisms of action of UPA, involving: 1) a persistently low cell proliferation rate; 2) a limited period of cell death; and 3) ECM remodeling concomitant with stimulation of MMP-2 expression.


Assuntos
Anticoncepcionais/administração & dosagem , Leiomioma/tratamento farmacológico , Mioma/tratamento farmacológico , Norpregnadienos/administração & dosagem , Neoplasias Uterinas/tratamento farmacológico , Adulto , Método Duplo-Cego , Feminino , Humanos , Leiomioma/diagnóstico , Leiomioma/cirurgia , Pessoa de Meia-Idade , Mioma/diagnóstico , Mioma/cirurgia , Cuidados Pré-Operatórios/métodos , Resultado do Tratamento , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia
17.
Arch Gynecol Obstet ; 291(6): 1347-54, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25524536

RESUMO

PURPOSE: To determine the accuracy of hysteroscopy in diagnosing endometrial cancer, hyperplasia, polyps and submucous myomas. METHODS: Relevant articles were retrieved from the MEDLINE and the Cochrane Library (1986-2011). Studies were selected blindly. Results for diagnostic accuracy were extracted to form separate 2 × 2 tables (for endometrial cancer, hyperplasia, polyps and submucous myomas). A summary sensitivity and specificity point reflected the average accuracy observed. Summary ROCs (SROCs) were also calculated according to the HSROC model. RESULTS: For endometrial cancer, the estimated sensitivity was 82.6% (95% CR 66.9-91.8%) and the specificity was 99.7% (95% CR 98.1-99.9%). For endometrial hyperplasia, sensitivity was 75.2% (95% CR 55.4-88.1 %), while specificity was 91.5% (95% CR 85.7-95.0%). For endometrial polyps, sensitivity was 95.4% (95% CR 87.4-98.4%) and specificity was 96.4% (95% CR 93.7-98.0%). Finally, for submucous myomas, sensitivity was estimated to 97.0% (95% CR 89.8-99.2%) and specificity to 98.9% (95% CR 93.3-99.8%). CONCLUSIONS: Diagnostic accuracy for hysteroscopy is high for endometrial cancer, polyps and submucous myomas, but only moderate for endometrial hyperplasia.


Assuntos
Histeroscopia/métodos , Hemorragia Uterina/diagnóstico , Hiperplasia Endometrial/diagnóstico , Hiperplasia Endometrial/patologia , Neoplasias do Endométrio/diagnóstico , Neoplasias do Endométrio/patologia , Feminino , Humanos , Hiperplasia/diagnóstico , Hiperplasia/patologia , Mioma/diagnóstico , Mioma/patologia , Pólipos/diagnóstico , Pólipos/patologia , Sensibilidade e Especificidade , Hemorragia Uterina/etiologia , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/patologia
19.
Ginecol Obstet Mex ; 83(12): 803-6, 2015 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-27290805

RESUMO

OBJECTIVES: To describe the clinical-diagnostic importance of cystic appearance of a cervical myoma large elements result produced secondary METHOD: We described a case of a 40-year-old with abdominal discomfort producing difficulty walking, dyspareunia, urinary retention seven months of evolution. The USG diagnosis was a cystic mass consistent with a right ovarian cyst. The surgical abdominal total hysterectomy is performed. RESULTS: Histopathological study of approximately 1 3x6 cm uterus with myoma fund of approximately 4 cm and myoma level cervical posterior surface of 15x12 cm.


Assuntos
Mioma/complicações , Retenção Urinária/etiologia , Neoplasias do Colo do Útero/complicações , Adulto , Feminino , Humanos , Histerectomia/métodos , Mioma/diagnóstico , Mioma/cirurgia , Cistos Ovarianos/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/cirurgia
20.
Reprod. clim ; 30(1): 5-10, 2015. tab
Artigo em Português | LILACS | ID: lil-766825

RESUMO

Objetivo: Descrever o perfil epidemiológico e clínico de pacientes inférteis com endometriose. Métodos: Estudo transversal que avaliou 450 prontuários de mulheres que procuraram tratamentos de reprodução assistida entre outubro de 2006 e maio de 2012. Analisaram-se sintomas como dismenorreia, intensidade da dor, alterações intestinais e doenças associadas. O software estatístico usado foi o Stata 11.0.Resultados: A mediana de idade foi 34 anos. A dismenorreia acometeu 84,2% das pacientes, de intensidade grave em 40,4%. Alterações intestinais presentes em 54,4%. Dentre as doenças ginecológicas associadas, destaca-se mioma em 23,3%. Em relação às doenças em tratamento, destaca-se a metabólica (8,4%). Discussão: Sabe-se que a dismenorreia é o sintoma mais prevalente nas mulheres com endometriose, assim como alterações intestinais, presente em 6% a 30% das mulheres com a endometriose profunda. Justifica-se a relação com outras doenc¸as também estrogênio-dependentes, como miomas e pólipos, devido ao endométrio dessas mulheres ter aromatases p450 e cyp19, que gerariam ambiente hiperestrogênico. No grupo estudado de mulheres brasileiras, o perfil de idade compreende a quarta década de vida, com infertilidade predominantemente primária, significativa prevalência de dismenorreia grave e associação com pólipos e mioma.


Aims: To describe epidemiological and clinical aspects of infertile patients with endometriosis. Methods: Cross section study of 450 medical records of infertile patients with endometriosis from October, 2006 to May, 2012. Symptoms such as dysmenorrhea, pain intensity, intestinal disorders where analyzed, as well as, associated diseases and treatments. The statistical software used was Stata 11.0. Results: The median age was 34 years. 84.2% of patients presented dysmenorrhea and 40.4% had severe pain intensity. Intestinal disorders was found in 54.4%. From the associated gynecologic diseases, 23.3% had myoma. Metabolic disease was found in 8.4% among the diseases in treatment. Discussion: It is known that dysmenorrhea is the most prevalent symptom in women with endometriosis, as well as intestinal disorders, that can be found between 6% and 30% women with severe endometriosis. Other studies have demonstrated the relationship of estrogen-dependent disease and women with endometrial endometriosis with aromatase enzyme P450 CYP19 mutations; which generate a hyperestrogenic environment, contributing to the development of polyps and myomas. The profile of these patients was traced as being inthe fourth decade of life, with predominantly primary infertility with prevalent symptoms of severe dysmenorrhea and association with polyps and myomas.


Assuntos
Humanos , Feminino , Dismenorreia/diagnóstico , Dismenorreia/epidemiologia , Endometriose/diagnóstico , Endometriose/epidemiologia , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/epidemiologia , Mioma/diagnóstico , Mioma/epidemiologia
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