Artigos e Materiais de Revistas Científicas - LIM/58
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A coleção de Artigos e Materiais de Revistas Científicas engloba artigos originais, artigos de revisão, artigos de atualização, artigos técnicos, relatos de experiências, resenhas, ensaios, editoriais, cartas ao editor, debates, notas científicas e técnicas, depoimentos, entrevistas e pontos de vista. Consideram-se como artigos científicos originais os trabalhos redigidos para divulgação de informações e resultados sobre determinada pesquisa científica, publicados em periódico científico após avaliação por outros pesquisadores.
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- Skin-sparing mastectomy for the treatment of breast cancer(2023) MOTA, B. S.; BEVILACQUA, J. L. B.; BARRETT, J.; RICCI, M. D.; MUNHOZ, A. M.; FILASSI, J. R.; BARACAT, E. C.; RIERA, R.Background: Skin-sparing mastectomy (SSM) is a surgical technique that aims to maximize skin preservation, facilitate breast reconstruction, and improve cosmetic outcomes. Despite its use in clinical practice, the benefits and harms related to SSM are not well established. Objectives: To assess the effectiveness and safety of skin-sparing mastectomy for the treatment of breast cancer. Search methods: We searched Cochrane Breast Cancer's Specialized Register, CENTRAL, MEDLINE, Embase, LILACS, the World Health Organization's International Clinical Trials Registry Platform (WHO ICTRP), and ClinicalTrials.gov on 9 August 2019. Selection criteria: Randomized controlled trials (RCTs), quasi-randomized or non-randomized studies (cohort and case-control) comparing SSM to conventional mastectomy for treating ductal carcinoma in situ (DCIS) or invasive breast cancer. Data collection and analysis: We used standard methodological procedures expected by Cochrane. The primary outcome was overall survival. Secondary outcomes were local recurrence free-survival, adverse events (including overall complications, breast reconstruction loss, skin necrosis, infection and hemorrhage), cosmetic results, and quality of life. We performed a descriptive analysis and meta-analysis of the data. Main results: We found no RCTs or quasi-RCTs. We included two prospective cohort studies and twelve retrospective cohort studies. These studies included 12,211 participants involving 12,283 surgeries (3183 SSM and 9100 conventional mastectomies). It was not possible to perform a meta-analysis for overall survival and local recurrence free-survival due to clinical heterogeneity across studies and a lack of data to calculate hazard ratios (HR). Based on one study, the evidence suggests that SSM may not reduce overall survival for participants with DCIS tumors (HR 0.41, 95% CI 0.17 to 1.02; P = 0.06; 399 participants; very low-certainty evidence) or for participants with invasive carcinoma (HR 0.81, 95% CI 0.48 to 1.38; P = 0.44; 907 participants; very low-certainty evidence). For local recurrence-free survival, meta-analysis was not possible, due to high risk of bias in nine of the ten studies that measured this outcome. Informal visual examination of effect sizes from nine studies suggested the size of the HR may be similar between groups. Based on one study that adjusted for confounders, SSM may not reduce local recurrence-free survival (HR 0.82, 95% CI 0.47 to 1.42; P = 0.48; 5690 participants; very low-certainty evidence). The effect of SSM on overall complications is unclear (RR 1.55, 95% CI 0.97 to 2.46; P = 0.07, I2 = 88%; 4 studies, 677 participants; very low-certainty evidence). Skin-sparing mastectomy may not reduce the risk of breast reconstruction loss (RR 1.79, 95% CI 0.31 to 10.35; P = 0.52; 3 studies, 475 participants; very low-certainty evidence), skin necrosis (RR 1.15, 95% CI 0.62 to 2.12; P = 0.22, I2 = 33%; 4 studies, 677 participants; very low-certainty evidence), local infection (RR 2.04, 95% CI 0.03 to 142.71; P = 0.74, I2 = 88%; 2 studies, 371 participants; very low-certainty evidence), nor hemorrhage (RR 1.23, 95% CI 0.47 to 3.27; P = 0.67, I2 = 0%; 4 studies, 677 participants; very low-certainty evidence). We downgraded the certainty of the evidence due to the risk of bias, imprecision, and inconsistency among the studies. There were no data available on the following outcomes: systemic surgical complications, local complications, explantation of implant/expander, hematoma, seroma, rehospitalization, skin necrosis with revisional surgery, and capsular contracture of the implant. It was not possible to perform a meta-analysis for cosmetic and quality of life outcomes due to a lack of data. One study performed an evaluation of aesthetic outcome after SSM: 77.7% of participants with immediate breast reconstruction had an overall aesthetic result of excellent or good versus 87% of participants with delayed breast reconstruction. Authors' conclusions: Based on very low-certainty evidence from observational studies, it was not possible to draw definitive conclusions on the effectiveness and safety of SSM for breast cancer treatment. The decision for this technique of breast surgery for treatment of DCIS or invasive breast cancer must be individualized and shared between the physician and the patient while considering the potential risks and benefits of available surgical options.
- AUGS-IUGA Joint Clinical Consensus Statement on Enhanced Recovery After Urogynecologic Surgery(2023) LATTHE, Pallavi; MARQUINI, Gisele Vissoci; ACHTARI, Chahin; HADDAD, Jorge; PANZA, Joseph; JANKOWSKI, Christopher. J.; HEISLER, Christine. A.; REAGAN, Krista; HICKMAN, Lisa. C.
- Follitropin delta combined with menotropin in patients at risk for poor ovarian response during in vitro fertilization cycles: a prospective controlled clinical study(2024) DUARTE-FILHO, Oscar Barbosa; MIYADAHIRA, Eduardo Hideki; MATSUMOTO, Larissa; YAMAKAMI, Lucas Yugo Shiguehara; TOMIOKA, Renato Bussadori; PODGAEC, SergioBackground The maximum daily dose of follitropin delta for ovarian stimulation in the first in vitro fertilization cycle is 12 mu g (180 IU), according to the algorithm developed by the manufacturer, and based on patient's ovarian reserve and weight. This study aimed to assess whether 150 IU of menotropin combined with follitropin delta improves the response to stimulation in women with serum antimullerian hormone levels less than 2.1 ng/mL.Methods This study involved a prospective intervention group of 44 women who received 12 mu g of follitropin delta combined with 150 IU of menotropin from the beginning of stimulation and a retrospective control group of 297 women who received 12 mu g of follitropin delta alone during the phase 3 study of this drug. The inclusion and exclusion criteria and other treatment and follow-up protocols in the two groups were similar. The pituitary suppression was achieved by administering a gonadotropin-releasing hormone (GnRH) antagonist. Ovulation triggering with human chorionic gonadotropin or GnRH agonist and the option of transferring fresh embryos or using freeze-all strategy were made according to the risk of developing ovarian hyperstimulation syndrome.Results Women who received follitropin delta combined with menotropin had higher estradiol levels on trigger day (2150 pg/mL vs. 1373 pg/mL, p < 0.001), more blastocysts (3.1 vs. 2.4, p = 0.003) and more top-quality blastocysts (1.8 vs. 1.3, p = 0.017). No difference was observed in pregnancy, implantation, miscarriage, and live birth rates after the first embryo transfer. The incidence of ovarian hyperstimulation syndrome did not differ between the groups. However, preventive measures for the syndrome were more frequent in the group using both drugs than in the control group (13.6% vs. 0.6%, p < 0.001).Conclusions In women with serum antimullerian hormone levels less than 2.1 ng/mL, the administration of 150 IU of menotropin combined with 12 mu g of follitropin delta improved the ovarian response, making it a valid therapeutic option in situations where ovulation triggering with a GnRH agonist and freeze-all embryos strategy can be used routinely.
- Association of early cleavage, morula compaction and blastocysts ploidy of IVF embryos cultured in a time-lapse system and biopsied for genetic test for aneuploidy(2024) MARTIN, H. De; BONETTI, T. C. S.; NISSEL, C. A. Z.; GOMES, A. P.; FUJII, M. G.; MONTELEONE, P. A. A.IVF embryos have historically been evaluated by morphological characteristics. The time-lapse system (TLS) has become a promising tool, providing an uninterrupted evaluation of morphological and dynamic parameters of embryo development. Furthermore, TLS sheds light on unknown phenomena such as direct cleavage and incomplete morula compaction. We retrospectively analyzed the morphology (Gardner Score) and morphokinetics (KIDScore) of 835 blastocysts grown in a TLS incubator (Embryoscope+), which were biopsied for preimplantation genetic testing for aneuploidy (PGT-A). Only the embryos that reached the blastocyst stage were included in this study and time-lapse videos were retrospectively reanalysed. According to the pattern of initial cleavages and morula compaction, the embryos were classified as: normal (NC) or abnormal (AC) cleavage, and fully (FCM) or partially compacted (PCM) morulae. No difference was found in early cleavage types or morula compaction patterns between female age groups (< 38, 38-40 and > 40 yo). Most of NC embryos resulted in FCM (congruent to 60%), while no embryos with AC resulted in FCM. Aneuploidy rate of AC-PCM group did not differ from that of NC-FCM group in women < 38 yo, but aneuploidy was significantly higher in AC-PCM compared to NC-FCM of women > 40 yo. However, the quality of embryos was lower in AC-PCM blastocysts in women of all age ranges. Morphological and morphokinetic scores declined with increasing age, in the NC-PCM and AC-PCM groups, compared to the NC-FCM. Similar aneuploidy rates among NC-FCM and AC-PCM groups support the hypothesis that PCM in anomalous-cleaved embryos can represent a potential correction mechanism, even though lower morphological/morphokinetic scores are seen on AC-PCM. Therefore, both morphological and morphokinetic assessment should consider these embryonic development phenomena.
- Oral probiotics and vaginal microbiome in post-menopause women: an opinion for the improvement of natural therapies in gynecology(2024) SILVA, Virginia Franco; REFINETTI, Paulo; VICARIOTTO, Franco; BARACAT, Edmund Chada; SOARES JUNIOR, Jose Maria
- Association of intrauterine synechiae with pituitary gonadotrophin pulse patterns: A pilot study(2023) GIANFALDONI, Arlete; ROA, Cristiane; SIMOES, Ricardo dos Santos; BARACAT, Maria Candida P.; FONSECA, Angela Maggio da; BAGNOLI, Vicente Renato; SOPRESO, Isabel Cristina Esposito; RIVAS, Fernando Wladimir Silva; MONTELEONE, Pedro; BARACAT, Edmund C.; JR, Jose Maria SoaresBackgroundIntrauterine synechiae (IS) is an acquired uterine condition that occurs when scar tissues (adhesions) form within the uterus and/or cervix, causing menstrual disturbance. However, approximately 50% of patients with IS are refractory to treatment. Therefore, other endocrine disturbances, such as gonadotropin disturbance, may affect treatment success.Study aimTo analyze gonadotropin levels in women with and without IS.MethodsTen women with refractory IS experiencing amenorrhea since at least 6 months and nine with normal menstrual cycles (control group) were included in this study. Blood sample were collected every 10 minutes during a 4-h period. The serial ultrasound was performed in both groups for evaluating the cycle phase. Blood was collected when the follicles size was between 5-10 mm. Serum LH, FSH, progesterone and estradiol concentrations were measured. To detect LH and FSH pulses, the technique proposed by Santen and Bardin was adopted; therefore, one pulse was defined as a 20% increase in the concentrations as to the preceding point, followed by an important decrease.ResultsNo differences were observed between the study groups at baseline. Estradiol levels were lower in the IS group than in the control group, but the difference was not statistically significant. During the first hour of monitoring, cumulative FSH pulsatile frequency of IS group was lower than one of control.ConclusionOur data suggest that the estradiol levels of IS participants are lower than those of women with normal menstrual cycle. The role of this finding in the physiology of uterine synechiae requires further investigation.
- Effects of estrogen and raloxifene on synaptic density in the hippocampal CA1 region of ovariectomized rats(2023) MENEZESDASILVA, Glaucia Mara; VEIGA, Eduardo Carvalho de Arruda; SIMOES, Manuel Jesus; SIMOES, Ricardo Santos; SHIROMA, Marcos Eiji; BARACAT, Maria Candida Pinheiro; CAVALCANTI, Givanna Santos; SOARES JUNIOR, Jose Maria; BARACAT, Edmund ChadaIntroduction: The CA1 region of the hippocampus has an important role in learning and memory. It has been shown that estrogen deficiency may reduce the synaptic density in the region and that hormone replacement ther-apy may attenuate the reduction. Objectives: This study aimed to evaluate the effects of estrogen and raloxifene on the synaptic density profile in the CA1 region of the hippocampus in ovariectomized rats.Methods: Sixty ovariectomized three-month-old virgin rats were randomized into six groups (n = 10). Treatments started either three days (early treatment) or sixty days (late treatment) after ovariectomy. The groups received propylene glycol vehicle (0.5 mL/animal/day), equine conjugated estrogens (50 mu g/animal/day), or raloxifene (3 mg/kg/day) either early or late after ovariectomy. The drugs were administered orally by gavage for 30 days. At the end of the treatments, the animals were anesthetized and transcardially perfused with ether and saline solu-tion. The brains were removed and prepared for analysis under transmission electron microscopy and later fixed. Results: Results showed a significant increase in the synaptic density profile of the hippocampal CA1 region in both the early estrogen (0.534 +/- 0.026 mu/m2) and the early raloxifene (0.437 +/- 0.012 mu/m2) treatment groups compared to the early or late vehicle-treated control groups (0.338 +/- 0.038 mu/m2 and 0.277 +/- 0.015 mu/m2 respectively).Conclusions: The present data suggest that the raloxifene effect may be lower than that of estrogen, even early or late treatment, on synaptic density in the hippocampus.
- Locally advanced breast cancer: breast-conserving surgery and other factors linked to overall survival after neoadjuvant treatment(2023) NOBREGA, Gabriela Bezerra; MOTA, Bruna Salani; FREITAS, Gabriela Boufelli de; MAESAKA, Jonathan Yugo; MOTA, Rosa Maria Salani; GONCALVES, Rodrigo; TRINCONI, Angela Francisca; RICCI, Marcos Desiderio; PIATO, Jose Roberto; SOARES-JR, Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose RobertoBackground Recent data suggest that breast-conserving surgery (BCS) may positively impact overall survival (OS) in early breast cancer. However, the role of BCS in locally advanced breast cancer (LABC) following neoadjuvant therapy (NAT) remains uncertain.Methods We conducted a retrospective cohort study involving 530 LABC patients who underwent surgery after NAT between 2010 and 2015. Outcomes examined included OS, distant recurrence rates (DRR), and loco-regional recurrence rates (LRRs).Results Among the 927 breast cancer patients who received NAT, 530 were eligible for our study. Of these, 24.6% underwent BCS, while 75.4% underwent mastectomy (MS). The median follow-up duration was 79 months. BCS patients exhibited a higher pathological complete response (PCR) rate compared to those who underwent MS (22.3% vs. 10%, p < 0.001). The 6-year OS rates for BCS and MS were 81.5% and 62%, respectively (p < 0.000). In multivariate OS analysis, MS was associated with worse outcomes (OR 1.678; 95% CI 1.069-2.635; p = 0.024), as was body mass index (BMI) (OR 1.031; 95% CI 1.006-1.058; p = 0.017), and stage IIIB or IIIC (OR 2.450; 95% CI 1.561-3.846; p < 0.000). Conversely, PCR (OR 0.42; 95% CI 0.220-0.801; p = 0.008) was associated with improved survival. DRR was significantly lower in BCS (15.4%) compared to MS (36.8%) (OR 0.298; 95% CI 0.177-0.504). LRRs were comparable between BCS (9.2%) and MS (9.5%) (OR 0.693; 95% CI 0.347-1.383).Conclusion Our findings suggest that BCS is oncologically safe, even for patients with large lesions, and is associated with superior OS rates compared to MS. Additionally, lower BMI, lower pretreatment stage, and achieving PCR were associated with improved survival outcomes.
- Does bisphenol A (BPA) participates in the pathogenesis of Polycystic Ovary Syndrome (PCOS)?(2023) URBANETZ, Lorena Ana Mercedes Lara; JR, Jose Maria Soares; MACIEL, Gustavo Arantes Rosa; SIMOES, Ricardo dos Santos; BARACAT, Maria Candida Pinheiro; BARACAT, Edmund ChadaPCOS is an endocrine disorder characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries. Its etiology is uncertain. It is debated whether BPA would be a component of the environmental factor in the etiology of PCOS. Contamination by BPA can occur from food packaging (exposure during the diet) and through skin absorption and/or inhalation. It can be transferred to the fetus via the placenta or to the infant via breast milk, and it can be found in follicular fluid, fetal serum, and amniotic fluid. The phenolic structure of BPA allows it to interact with Estrogen Receptors (ERs) through genomic signaling, in which BPA binds to nuclear ER alpha or Er beta, or through nongenomic signaling by binding to membrane ERs, prompting a rapid and intense response. With daily and constant exposure, BPA's tendency to bioaccumulate and its ability to activate nongenomic signaling pathways can alter women's metabolic and reproductive function, leading to hyperandrogenism, insulin resistance, obesity, atherogenic dyslipidemia, chronic inflammatory state, and anovulation and favoring PCOS. The harmful changes caused by BPA can be passed on to future generations without the need for additional exposure because of epigenetic modifications. Not only high BPA levels can produce harmful effects, but at low levels, BPA may be harmful when exposure occurs during the most vulnerable periods, such as the fetal and neonatal periods, as well as during the prepubertal age causing an early accumulation of BPA in the body. Learning how BPA participates in the pathogenesis of PCOS poses a challenge and further studies should be conducted.
- Influence of Phenotypes on the Metabolic Syndrome of Women with Polycystic Ovary Syndrome over a Six-Year Follow-Up in Brazil(2023) JR, Jose Maria Soares; HAYASHIDA, Sylvia Asaka Yamashita; MARCONDES, Jose Antonio Miguel; MACIEL, Gustavo Arantes Rosa; BARCELLOS, Cristiano Roberto Grimaldi; MAFFAZIOLI, Giovana De Nardo; MONTEIRO, Karla Krislaine Alves Costa; TURRI, Jose Antonio Orellana; AZZIZ, Ricardo; BARACAT, Edmund ChadaBackground: We followed polycystic ovary syndrome (PCOS) women with metabolic syndrome (MS) over a six-year treatment period and evaluated the influence of PCOS phenotypes on MS and on the risk for type 2 diabetes mellitus (T2DM). Methods: This was an observational study of 457 PCOS women, whose demographic, clinical, hormonal, and metabolic data underwent analysis. The PCOS women were divided into four groups per NIH recommendations. Results: After a follow-up of a mean of six years (1-20 years), 310 patients were selected to assess the development of T2DM and MS. The clinical and biochemical parameters, along with the Rotterdam phenotypes, were evaluated. Data were analyzed using Student's t- and the Pearson chi-square tests for data variation and group proportions, respectively. Additionally, multivariate analysis was applied to evaluate the effect of PCOS phenotypes on the risk for MS and T2DM. Patients of the four PCOS phenotypes did not differ in age, body mass index, total testosterone, insulin resistance, and dyslipidemia, but phenotype A patients showed the highest risk for T2DM. A decrease in androgen levels was not followed by an improved metabolic profile; instead, there was a significant increase in the number of T2DM cases. Conclusion: Phenotype A women are at the highest risk for type 2 diabetes mellitus.
- Assessing the safety and use of medicinal herbs during pregnancy: a cross-sectional study in São Paulo, Brazil(2023) IM, Hyea Bin; GHELMAN, Ricardo; PORTELLA, Caio Fabio Schlechta; HWANG, Jung Hye; CHOI, Dain; KUNWOR, Sangita Karki; MORAES, Sandra Dircinha Teixeira de Araujo; HAN, DongwoonBackground: Despite the lack of evidence supporting the safety and clinical efficacy of herbal medicine (HM), its use among pregnant women continues to increase. Given the high prevalence of contraindicated herbs among the pregnant population in Brazil, it is crucial to examine the use of HM and evaluate its safety based on the current scientific literature to ensure that women are using HM appropriately.Methods: A cross-sectional study was conducted from October 2022 to January 2023 at a public teaching hospital in Sao Paulo, Brazil. A total of 333 postpartum women in the postnatal wards and postnatal clinic were interviewed using a semi-structured questionnaire. The survey instrument consisted of 51 items covering the use of HM during pregnancy, sociodemographic and health-related characteristics, COVID-19 experiences, and pregnancy outcomes. For data analysis, chi-square and multivariate logistic regression were conducted using SPSS ver. 26.0.Results: Approximately 20% of respondents reported using HM during their most recent pregnancy, with a higher use observed among women from ethnic minority groups and those with prior HM experience. Among the 20 medicinal herbs identified, 40% were found to be contraindicated or recommended for use with caution during pregnancy. However, only half of the women discussed their HM use with obstetric care providers.Conclusion: This study emphasizes the continued public health concern regarding the use of contraindicated or potentially harmful HM among pregnant women in Brazil, highlighting the need for sustained efforts to reduce the risk of inappropriate HM use. By updating antenatal care guidelines based on the latest scientific evidence, healthcare providers can make informed clinical decisions and effectively monitor pregnant women's HM use, ultimately promoting safer and more effective healthcare practices.
- Exercise training and experimental myocardial ischemia and reperfusion: A systematic review and meta-analysis(2023) VEIGA, Eduardo Carvalho de Arruda; LEVY, Rozeli Ferreira; BOCALINI, Danilo Sales; JR, Jose Maria Soares; BARACAT, Edmund Chada; CAVALLI, Ricardo Carvalho; SANTOS, Leonardo dosBackground: Despite the success of interventional coronary reperfusion strategies, morbidity and mortality from acute myocardial infarction are still substantial. Physical exercise is a well-recognized effective nonpharmacological therapy for cardiovascular diseases. Therefore, the objective of this systematic review was to analyze studies in animal models of ischemia-reperfusion in association with physical exercise protocols.Search strategy: Articles published on the topic over a 13-year period (2010-2022) were searched in two databases (PubMed and Google Scholar) using the keywords exercise training, ischemia/reperfusion or ischemia reperfusion injury. Meta-analysis and quality assessment of the studies were performed using the Review Manager 5.3 program.Results: From the 238 articles retrieved from PubMed and 200 from Google Scholar, after screening and eligibility assessment, 26 articles were included in the systematic review and meta-analysis. For meta-analysis comparing the group of previously exercised animals with the non-exercised animals and then submitted to ischemia-reperfusion, the infarct size was significantly decreased by exercise (p < 0.00001). In addition, the group exercised had increased heart-to-body weight ratio (p < 0.00001) and improved ejection fraction as measured by echocardiography (p < 0.0004) in comparison to non-exercised animals.Conclusion: We concluded that the animal models of ischemia-reperfusion indicates that exercise reduce infarct size and preserve ejection fraction, associated with beneficial myocardial remodeling.
- Correspondence: Interpreting live birth rates following preimplantation genetic testing for aneuploidy: per embryo transferred or initiated cycle*Re: ""Live birth per embryo transfer with next generation sequencing preimplantation genetic testing: an analysis of 26,107 cycles""(2023) MONTELEONE, Pedro Augusto Araujo; BONETTI, Tatiana Carvalho de Souza
- Breast cancer survivals and horetone therapy: estrogen and melatonin(2023) SOARES JUNIOR, Jose Maria; MOTA, Bruna Salani; NOBREGA, Gabriela Bezerra; FILASSI, Jose Roberto; SORPRESO, Isabel Cristina Esposito; BARACAT, Edmund Chada
- Granulosa cells and follicular development: a brief review ( vol 69 , e20230175 , 2023)(2023) CAVALCANTI, Giovanna Santos; CARVALHO, Katia Candido; FERREIRA, Cecilia da Silva; CHEDRAUI, Peter; MONTELEONE, Pedro Augusto Araujo; BARACAT, Edmund Chada; SOARES JUNIOR, Jose Maria
- Chronic endometritis and assisted reproduction: a systematic review and meta-analysis(2023) VEIGA, Eduardo Carvalho de Arruda; SOARES JUNIOR, Jose Maria; SAMAMA, Marise; IKEDA, Fabio; FRANCISCO, Luciana Semiao; SARTOR, Amanda; URBANETZ, Lorena Ana Mercedes Lara; BARACAT, Edmund Chada; UENO, Joji
- Pathological macroscopic evaluation of breast density versus mammographic breast density in breast cancer conserving surgery(2023) REIS, Yedda Nunes; MOTA, Bruna Salani; MOTA, Rosa Maria Salani; SHIMIZU, Carlos; RICCI, Marcos Desiderio; AGUIAR, Fernando Nalesso; SOARES-JR, Jose Maria; BARACAT, Edmund Chada; FILASSI, Jose RobertoCorrelation between imaging and anatomopathological breast density has been superficially explored and is heterogeneous in current medical literature. It is possible that mammographic and pathological findings are divergent. The aim of this study is to evaluate the association between breast density classified by mammography and breast density of pathological macroscopic examination in specimens of breast cancer conservative surgeries. Post-hoc, exploratory analysis of a prospective randomized clinical trial of patients with breast cancer candidates for breast conservative surgery. Breast mammographic density (MD) was analyzed according to ACR BI-RADS (R) criteria, and pathologic macroscopic evaluation of breast density (PMBD) was estimated by visually calculating the ratio between stromal and fatty tissue. From 412 patients, MD was A in 291 (70,6%), B in 80 (19,4%) B, C in 35 (8,5%), and D in 6 (1,5%). Ninety-nine percent (201/203) of patients classified as A+B in MD were correspondently classified in PMBD. Conversely, only 18.7% (39/209) of patients with MD C+D were classified correspondently in PMBD (p < 0.001). Binary logistic regression showed age (OR 1.06, 1.01-1.12 95% CI, p 0.013) and nulliparity (OR 0.39, 0.17-0.96 95% CI, p 0.039) as predictors of A+B PMBD.Conclusion: Mammographic and pathologic macroscopic breast density showed no association in our study for breast C or D in breast image. The fatty breast was associated with older patients and the nulliparity decreases the chance of fatty breasts nearby 60%.
- Association between torquetenovirus in vaginal secretions and infertility: An exploratory metagenomic analysis(2023) COSTA, A. Charlys Da; BORTOLETTO, Pietro; SPANDORFER, Steven D.; TOZETTO-MENDOZA, Tania Regina; LINHARES, Iara M.; MENDES-CORREA, Maria Cassia; WITKIN, Steven S.ProblemThe association of viruses with infertility remains incompletely evaluated.Method of studyVaginal secretions from 46 women seeking treatment in the Center for Reproductive Medicine and Infertility at Weill Cornell Medicine were tested for viruses by metagenomic analysis by lab personnel blinded to all clinical data.ResultsTorquetenovirus (TTV) was identified in 16 women, alphapapillomavirus in seven women and most were positive for bacteriophages. Twelve of the subjects were fertile and sought to freeze their oocytes for future implantation. These women were all negative for TTV. In contrast, 16 of the 34 women (47.1%) being treated for infertility were TTV-positive (p = .0035). Evaluating the women by cause of infertility, five of nine women (55.6%) whose male partner had inadequate sperm parameters and six of 14 women (42.9%) with defective ovulation were TTV positive (p = .0062 and p = .0171, respectively, vs. the fertile women). Alphapapillomavirus was identified in one (8.3%) fertile woman, five (35.7%) women with ovulation deficiency, and one (11.1%) woman with male factor infertility. These differences were not statistically significant. There were no differences in bacteriophage families or the presence of Lactobacillus phages between fertile or infertile women or between different causes of infertility. There was a negative association between TTV detection and Lactobacillus crispatus dominance in the vaginal microbiota (p = .0184), but no association between TTV detection and the presence of alphapapillomavirus or Candida species.ConclusionDetection of TTV in the vagina might be a biomarker for specific causes of infertility.
- Chlamydia trachomatis, Neisseria gonorrhoeae and human papillomavirus infections of lower genital tract of Indigenous women from Xingu Indigenous Park(2023) PORTO, Claudia Regina Cinti Correa; LONGATTO-FILHO, Adhemar; ALMEIDA, Bruna Cristine De; BONETTI, Tatiana C. S.; KAMAIURA, Sula Fernanda A.; DIAZ, Ricardo Sobhie; HEINKE, Thais; CURY, Fernanda de Paula; SANTANA, Iara Viana Vidigal; QUEIROZ, Mariana M.; RODRIGUES, Douglas Antonio; SPECK, Neila Maria De GoisIntroduction: Xingu Indigenous Park (XIP) currently protects 16 ethnic Indigenous groups and is located in the central area of Brazil. XIP is the first and the largest Indigenous land to be recognized in the country. Community access is limited and restricted for the non-Indigenous population, and the Indigenous women are constantly dealing with shortages of medical care. High-risk human papillomavirus (HR-HPV) is the most common cause of cervical cancer and is detected in 99% of cervical precancers. HPV infections may be associated with bacterial agents such as Chlamydia trachomatis and Neisseria gonorrhoeae, which are also important causative agents of sexually transmitted infections and are responsible for the most frequent bacterial infections in the world. The present study evaluated the frequency and potential impact of Chlamydia trachomatis, Neisseria gonorrhoeae, and HR-HPV in the Indigenous women of XIP. Methods: In this cross-sectional study, 992 cervical-vaginal samples were collected from Indigenous women, using a CervexBrush, and were immediately placed in a SurePath medium. All samples were submitted to the cobas & REG; 4800 detection system for the identification of 14 different types of HR-HPV, and the multiplex Abbott RealTime CT/NG assay for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae. Results: HR-HPV was detected in 18.2% of women; 6% were positive for HPV16, 5% for HPV18, and 81% for other types of HRHPV. Co-infections of HPV16 and other types was observed in 5% of women, and 3% had co-infections of HPV18 and other types. Moreover, 1.8% of women were positive for Chlamydia trachomatis, while Neisseria gonorrhoeae was not detected. In women with HR-HPV, 33% had Chlamydia trachomatis infections, 28% were positive for HR-HPV other than HPV16 or HPV18, and 5% had co-infections of HPV16 and the other types of HPV. Younger women were found to be more susceptible to HPV infections. Conclusion: The findings indicate a high frequency of HR-HPV and a considerable frequency of Chlamydia trachomatis in the Indigenous women of XIP. The detection of Chlamydia trachomatis, Neisseria gonorrhoeae, and/or HR-HPV does not present evidence of a potential interrelationship for a combined pathogenic action in these women.
- Interventions towards barriers to the practice of physical activity in adolescence: A systematic review protocol(2023) TERRA, Lauryane Fonseca; COSTA, Woska Pires da; SILVA, Regina Marcia Ferreira; REZENDE, Leonardo Mateus Teixeira de; NOLL, Matias; NOLL, Priscilla Rayanne E. SilvaIntroductionLack of regular physical activity is recognized as a global public health issue. Three out of every four adolescents do not adhere to physical activity recommendations. Thus, this systematic review will evaluate interventions employed to minimize barriers to physical activity among adolescents. Herein, we present the study protocol. To the best of our knowledge, this will be the first systematic review to assess the interventions implemented to minimize barriers to the practice of physical activity among adolescents. A systematic understanding of the most effective interventions to reduce the barriers to physical activity is essential.Method and analysisWe will search five databases: two multidisciplinary (Scopus and Web of Science) and three other health-related databases (Embase, SPORTDiscus, and PubMed). The search will be limited to original peer-reviewed articles published in English, with no time restrictions. The search strategy will use MeSH terms and their variations to maximize the search strategy. Two reviewers will independently read the included articles, extract the data, and evaluate the methodological quality using the Grading of Recommendations, Assessment, Development, and Evaluation scale and the risk of bias using the Critical Appraisal Skills Programme checklist and Downs and Black scale. Discrepancies will be resolved by a third reviewer. This systematic review will follow the guidelines outlined in the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses.DiscussionThe outcomes of this study are expected to enhance the current understanding of the obstacles to physical activity among adolescents and aid in the development or modification of programs to combat physical inactivity in this population. Consequently, these findings should have a positive impact on current and future adolescent health outcomes.Ethics and disclosureEthical approval will not be required for this study as it is an analysis of previously published articles (i.e., secondary data). The results will be published in a peer-reviewed journal.PROSPERO registration: .