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Carcinoma ductal invasor : relação de características anatomopatológicas com a presença de metástases axilares em 220 casos

2017-07-06T15:59:03Z

Título: Carcinoma ductal invasor : relação de características anatomopatológicas com a presença de metástases axilares em 220 casos Autor(es): Aquino, Ranniere Gurgel Furtado de; Vasques, Paulo Henrique Diógenes; Cavalcante, Diane Isabelle Magno; Oliveira, Ayane Layne de Sousa; Oliveira, Bruno Masato Kitagawa de; Pinheiro, Luiz Gonzaga Porto Abstract: Objective: to analyze the relation of anatomopathological features and axillary involvement in cases of invasive ductal carcinoma. Methods: this is a cross-sectional study of 220 breast cancer patients submitted to radical mastectomy or quadrantectomy with axilar emptying, from the Mastology Service of the Assis Chateaubriand Maternity School, Ceará, Brazil. We submitted the tumors to histological processing and determined the histological (HG), tubular (TG) and nuclear (NG) grades, and the mitotic index (MI) by the classification of Scarff-Bloom-Richadson, verified the presence of angiolymphatic invasion (AI) and measured the largest tumor diameter (TD). We then correlated these variables with the presence of axillary metastases. Results: the mean patients'age was 56.81 years ± 13.28. Tumor size ranged from 0.13 to 22 cm, with an average of 2.23cm ± 2.79. HG3, TG3 and NG3 prevailed, respectively 107 (48.6%), 160 (72.7%) and 107 (48.6%). Mitotic indexes 1, 2 and 3 presented a homogeneous distribution, respectively 82 (37.2%), 68 (31%) and 70 (31.8%). We observed no relation between the HG, TG and NG with the occurrence of axillary metastases (p=0.07, p=0.22 and p=0.21, respectively). Mitotic indices 2 and 3 were related with the occurrence of axillary metastases (p=0.03). Tumors larger than 2cm and cases that presented angiolymphatic invasion had a higher index of axillary metastases (p=0.0003 and p<0.0001). Conclusion: elevated mitotic indexes, tumors with a diameter greater than 2cm and the presence of angiolymphatic invasion were individuallyassociatedwith the occurrence of axillary metastases. Descrição: AQUINO, Ranniere Gurgel Furtado de et al. Carcinoma ductal invasor: relação de características anatomopatológicas com a presença de metástases axilares em 220 casos. Revista do Colégio Brasileiro de Cirurgiões, Rio de Janeiro, v. 44, n. 2, p. 163-170, mar./apr. 2017.

Avaliação in vitro do efeito relaxante de inibidores de fosfodiesterases e agonista beta-adrenérgico em bexiga de camundongos utilizando modelo experimental de hiperatividade detrusora.

2017-06-28T11:40:59Z

Título: Avaliação in vitro do efeito relaxante de inibidores de fosfodiesterases e agonista beta-adrenérgico em bexiga de camundongos utilizando modelo experimental de hiperatividade detrusora. Autor(es): Linhares, Bruno Lima Abstract: Overactivity bladder syndrome has classically been treated with antimuscarinics. However, frequent adverse systemic effects have led to the search for new therapeutic options. β3- adrenoceptor (β3-AR) agonists relax the detrusor smooth muscle (DSM) by the adenylyl cyclase pathway, increasing cyclic adenosine monophosphate (cAMP). Rolipram, a selective type 4 phosphodiesterase inhibitor (IPDE4), elevates intracelular cAMP levels by supressing hydrolysis. Phosphodiesterase type 5 inhibitors (IPDE5), such as tadalafil, relax DSM by the nitric oxide/cyclic guanosine monophosphate pathway (NO/cGMP). It has been hypothesized that the inhibition of phophodiesterases could potentiate the relaxing effect of β3-AR agonists. The main objective of this study is to evaluate in vitro the effects of the combination of a β3-AR agonist with two different phosphodiesterase inhibitors (IPDE4 and IPDE5) in a experimental model of detrusor overactivity. The experiments were performed on bladder strips of mice and divided in two phases. The following drugs were used: BRL 37344 (β3-AR agonist), tadalafil (IPDE5) and rolipram (IPDE4). In the first phase, after potassium-induced contraction, strips isolated from naive mice were exposed to increasing concentrations of each study drug. In another series of experiments, prior to contraction, strips were incubated with either tadalafil or rolipram and then increasing concentrations of BRL 37344 were added. In the second phase, the same protocol was performed with animals treated with L-NAME for 30 days. Chronic L-NAME administration leads to detrusor overactivity by NO deprivation. Cumulative concentration-response curves were constructed. In the first phase, preincubation with tadalafil increased the relaxing response of BRL 37344 in two concentrations. Pretreatment with rolipram had no effect on the relaxation obtained with BRL 37344. In LNAME- treated mice, rolipram showed the best relaxation when compared to the other drugs. In these animals, rolipram increased the relaxing response of BRL 37344 in almost all concentrations, but no synergistic effect with tadalafil was observed. Phosphodiesterase inhibitors associated with the already proven effective β3-AR agonists may represent a new approach for patients with storage symptons. In our experimental model, the relaxing effect of the β3-AR agonist was potentiated by IPDE4 but not by IPDE5, suggesting cAMP plays an important role in DSM relaxation. Keywords: Detrusor smooth muscle. β3-adrenoceptor agonist. Phosphodiesterase inhibitors. Descrição: LINHARES, B.L Avaliação in vitro do efeito relaxante de inibidores de fosfodiesterases e agonista beta-adrenérgico em bexiga de camundongos utilizando modelo experimental de hiperatividade detrusora. 2016. 65 f. Dissertação (Mestrado Ciências Médico-Cirúrgicas) - Faculdade de Medicina, Universidade Federal do Ceará. Fortaleza, 2016.

Endometriosis and ovarian cancer : an integrative review (Endometriosis and Ovarian Cancer)

2017-06-09T14:13:50Z

Título: Endometriosis and ovarian cancer : an integrative review (Endometriosis and Ovarian Cancer) Autor(es): Brilhante, Aline Veras Morais; Augusto, Kathiane Lustosa; Portela, Manuela Cavalcante; Sucupira, Luiz Carlos Gabriele; Oliveira, Luiz Adriano Freitas; Pouchaim, Ana Juariana Magalhães Veríssimo; Nóbrega, Lívia Rocha Mesquita; Magalhães, Thaís Fontes de; Sobreira, Leonardo Robson Pinheiro Abstract: Despite being initially considered a benign disease, it is widely thought nowadays that endometriosis and especially ovarian endometriomas are neoplastic conditions with the potential to become malignant. This review was conducted to summarize, in a concise and systematic manner, the available scientific data relating endometriosis to ovarian cancer, published in the past five years. After reading abstracts and applying our predefined inclusion and exclusion criteria, a final list of 11 scientific papers was obtained and subjected to review. Endometriosis is associated with an increased risk of developing epithelial ovarian cancer (EOC), mainly of endometrioid and clear cell subtypes. This might be by virtue of the high estrogen concentration with the disease, which leads to malignant proliferation of endometriotic cysts, or be due to mutations in the ARID1A gene and consequent loss of BAF250a expression. The iron produced in the fluid of endometriotic cysts promotes oxidative stress, which in turn may cause genetic mutations and malignant progression of ovarian cysts. Descrição: BRILHANTE, Aline Veras Morais. et al. Endometriosis and ovarian cancer : an Integrative Review (Endometriosis and Ovarian Cancer). Asian Pacific Journal of Cancer Prevention, Bangkok, v. 18, n. 1, p. 11-16, jan. 2017

Defecatory dysfunction and fecal incontinence in women with or without posterior vaginal wall prolapse as measured by pelvic organ prolapse quantification (POP-Q)

2017-06-09T12:23:33Z

Título: Defecatory dysfunction and fecal incontinence in women with or without posterior vaginal wall prolapse as measured by pelvic organ prolapse quantification (POP-Q) Autor(es): Augusto, Kathiane Lustosa; Bezerra, Leonardo Robson Pinheiro Sobreira; Murad-Regadas, Sthela Maria; Vasconcelos Neto, José Ananias; Vasconcelos, Camila Teixeira Moreira; Bilhar, Andreisa Paiva Monteiro; Karbage, Sara Arcanjo Lino; Regadas, Francisco Sérgio Pinheiro Abstract: Introduction and hypothesis: Pelvic Floor Dysfunction is a complex condition that may be asymptomatic or may involve a loto f symptoms. This study evaluates defecatory dysfunction, fecal incontinence, and quality of life in relation to presence of posterior vaginal prolapse. Methods: 265 patients were divided into two groups according to posterior POP-Q stage: posterior POP-Q stage 2 and posterior POP-Q stage <2. The two groups were compared regarding demographic and clinical data; overall POP-Q stage, percentage of patients with defecatory dysfunction, percentage of patients with fecal incontinence, pelvic floor muscle strength, and quality of life scores. The correlation between severity of the prolapse and severity of constipation was calculated using r de Spearman (rho). Results: Women with Bp stage 2 were significantly older and had significantly higher BMI, numbers of pregnancies and births, and overall POP-Q stage than women with stage <2. No significant differences between the groups were observed regarding proportion of patients with defecatory dysfunction or incontinence, pelvic floor muscle strength, quality of life (ICIQ-SF), or sexual impact (PISQ-12). POP-Q stage did not correlate with severity of constipation and incontinence. General quality of life perception on the SF-36 was significantly worse in patients with POP-Q stage 2 than in those with POP-Q stage <2. Conclusions: The lack of a clinically important association between the presence of posterior vaginal prolapse and symptoms of constipation or anal incontinence leads us to agree with the conclusion that posterior vaginal prolapse probably is not an independent cause defecatory dysfunction or fecal incontinence. Descrição: AUGUSTO, Kathiane Lustosa et al. Defecatory dysfunction and fecal incontinence in women with or without posterior vaginal wall prolapse as measured by pelvic organ prolapse quantification (POP-Q). European Journal of Obstetrics & Gynecology and Reproductive Biology, v. 214, p. 50-55, jul. 2017.