Navegando por Palavras-chave "Endometriosis"

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    17 beta-Estradiol and steady-state concentrations of H2O2: antiapoptotic effect in endometrial cells from patients with endometriosis
    (Elsevier B.V., 2013-07-01) Andrade, Sheila Siqueira [UNIFESP]; Azevedo, Aline de Cássia [UNIFESP]; Monasterio, Izabel C. G. [UNIFESP]; Paredes-Gamero, Edgar Julian [UNIFESP]; Gonçalves, Giovana Aparecida [UNIFESP]; Bonetti, Tatiana Carvalho de Souza [UNIFESP]; Albertoni, Guilherme Ambrozio [UNIFESP]; Schor, Eduardo [UNIFESP]; Barreto, Jose A.; Oliva, Maria Luiza Vilela [UNIFESP]; Juliano, Luiz [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Silva, Ismael Dale Cotrim Guerreiro da [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Charitable Assoc Blood Collect
    Increased levels of hydrogen peroxide (H2O2) can initiate protective responses to limit or repair oxidative damage. However, H2O2 signals also fine-tune responses to growth factors and cytokines controlling cell division, differentiation, and proliferation. Because 17 beta-estradiol (E-2) also plays important roles in these processes, and is considered a major risk factor in the development and progression of endometriosis, this study evaluated whether E-2 has an antiapoptotic effect on oxidative stress in endometrial cells in combination with steady-state H2O2 levels ([H2O2]ss). Endometrial stromal cells were prepared from the eutopic endometrium of 18 women with and without endometriosis to produce primary cells. These cells were stimulated with E-2 for 20 h, exposed to [H2O2]ss, and examined for cell viability, proliferation, and apoptosis. the endometrial cells from women with endometriosis maintained the steady state for 120 min at high H2O2 concentrations. When they were pretreated with E-2 and exposed to [H2O2]ss, a decrease in apoptosis level was observed compared to the control cells (p < 0.01). the endometrial cells from patients with endometriosis subjected to both E-2 and [H2O2]ss showed increased ERK phosphorylation. These findings suggested that H2O2 is a signaling molecule that downregulates apoptosis in endometrial cells, supporting the fact that endometriosis, albeit a benign disease, shares some features with cancer such as decreased catalase levels. These results link the E-2 effects on [H2O2]ss to resistance to apoptosis and progression of endometriosis. (C) 2013 Elsevier Inc. All rights reserved.
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    Análise da expressão do TFDP1 no endométrio tópico de mulheres com endometriose
    (Universidade Federal de São Paulo (UNIFESP), 2016-05-04) Jibrim, Rodrigo Lopes Meime [UNIFESP]; Schor, Eduardo [UNIFESP]; http://lattes.cnpq.br/8854353153245040; http://lattes.cnpq.br/0752881495360444; Universidade Federal de São Paulo (UNIFESP)
    Introduction: one of the researches fields of the ethiopathogenesis of endometriosis aims to identify endometrial disorders as the origin of the disease. Changes in expression of proteins related to cell adhesion, collagenases, and mainly of the cell cycle regulators have been identified. Based on these previous studies we set out to analyze the expression of TFDP1 gene in the endometrium of women with endometriosis. This gene, member of the E2F family encodes several proteins responsible for the control of passage between the G1 and S phase of the cycle, key point of regulation of cell division. Proposition: to evaluate, using Real Time PCR, TFDP1 gene expression in endometrial cells in culture, of women with endometriosis. Methodology: five samples were studied from the endometrium of healthy patients (no pelvic disease determined by means of laparoscopy for tubal ligation) and six patients with diagnosis of deep endometriosis done during surgery. The samples, from the Bank of cells of Endometriosis Unit-UNIFESP, were subjected to PCR-Real Time processing. The results were expressed through the fold and Ct. Results: we observed higher expression of TFDP1 in the cells of women with endometriosis (ct 32,08) when compared with the control group (ct 29,019) (p < 0 .05). And a fold of -2.04674 in the control group compared to the endometriosis (t test 0.01059). Conclusion: We found a significantly higher expression of the TFDP1 gene in the endometrium of women with endometriosis when compared to the same tissue of healthy women.
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    Análise do papel do H2O2 na endometriose: regulação da apoptose e perfil de citocinas inflamatórias
    (Universidade Federal de São Paulo, 2011-11-30) Azevedo, Aline de Cassia [UNIFESP]; Silva, Ismael Dale Cotrim Guerreiro da [UNIFESP]; http://lattes.cnpq.br/7917312029683516; http://lattes.cnpq.br/5965982844300078
    Antecedentes: Aumentos nos níveis de peróxido de hidrogênio (H2O2) podem iniciar ações protetoras respostas para limitar ou reparar danos oxidativos. No entanto, os sinais de H2O2 também ajustam o respostas a fatores de crescimento e citocinas para controlar a divisão, diferenciação e proliferação. A análise desses processos requer condições que imitem o estado estacionário de H2O2 in vivo. O 17β-Estradiol (E2) desempenha um papel importante nestes processos e, portanto, o E2 é considerado um importante fator de risco no desenvolvimento e progressão da endometriose. Este estudo foi projetado para avaliar se o E2 tem um efeito citoprotetor no estresse oxidativo e concentrações estaduais de H2O2 ([H2O2]ss) nas células endometriais. Metodologia/Principais Resultados: As células estromais endometriais foram preparadas a partir do endométrio eutópico de 18 mulheres com e sem endometriose para produzir células primárias de cada paciente. As células foram estimuladas com E2 por 20 h, expostas a [H2O2]ss., e depois examinado quanto à viabilidade celular, proliferação e apoptose. As células endometriais com endometriose (em estágios variados) foram capazes de manter o estado estacionário por 120 minutos em alta concentrações de H2O2 (60 μM), seguidas por um aumento contínuo da concentração extracelular concentração de H2O2. Quando foram pré-tratados com E2 e expostos a [H2O2]ss, observaram uma diminuição nos níveis de apoptose em comparação com as células controle (p <0,01). Produção de espécies reativas de oxigênio e vias de desintoxicação foram avaliadas, e E2 teve um efeito protetor efeito sobre o estresse oxidativo, induzindo a produção de uma superóxido dismutase. Estresse oxidativo induz a ativação de ERK; em nosso estudo, células endometriais submetidas a E2 e [H2O2]ss mostrou aumento da fosforilação de ERK, como esperado. Conclusões/Significado: Estas descobertas sugerem que o H2O2 é uma molécula sinalizadora que regula a apoptose nas células endometriais. Nossos resultados vinculam os efeitos do E2 no [H2O2]ss à resistência à apoptose e progressão da endometriose.
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    Análise funcional da ativação e da expressão do receptor da progesterona em cultura primária de células endometriais de pacientes portadoras de endometriose profunda intestinal
    (Universidade Federal de São Paulo (UNIFESP), 2017-05-09) Kamergorodsky, Gil [UNIFESP]; Schor, Eduardo [UNIFESP]; http://lattes.cnpq.br/8854353153245040; http://lattes.cnpq.br/9374412922125900; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVES: To evaluate the activation and expression of the progesterone receptor in primary culture of endometrial cells, after exposure to estradiol and progesterone. DESIGN: In vitro experimental study for analysis of microphysiometry and real-time PCR PLACE OF DEVELOPMENT: Pelvic Algeal and Endometriosis Sector and Center for Cellular and Molecular Therapy of UNIFESP / Escola Paulista de Medicina PATIENTS AND METHODS: This study included 20 patients, 11 with radiological diagnosis of deep intestinal pelvic endometriosis, confirmed by laparoscopy, and 09 without endometriosis. Endometrial fragments were obtained by means of a Novak® curette, later processed for culture formation. The culture plates were treated with 17-E2 and progesterone, and then processed for microphysiometry and real-time PCR. RESULTS: There was a decrease in nuclear expression of progesterone receptor (PR) mRNA after hormone treatment; six times lower in the deep endometriosis group than in the control group. In the microphysiometry study, mean ECARs (56.19 ± 0.76 μV / second) were lower than the control group (114.3 ± 1.34 μV / second) ). (P <0.005) CONCLUSIONS: Lower extracellular acidification and lower progesterone receptor expression were observed in endometrial stromal cells in culture compared to women without the disease. These findings support the hypothesis that resistance to progesterone may be involved in the etiopathogenesis of endometriosis.
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    Análise histomorfométrica no endométrio em modelo ectópico e eutópicos de endometriose em camundongas
    (Universidade Federal de São Paulo, 2021-08-26) Silva, Felipe Rosendo da [UNIFESP]; Bertoncini, Clélia Rejane Antônio [UNIFESP]; http://lattes.cnpq.br/6913838606609313; http://lattes.cnpq.br/3495431664934359
    Objetivo: Realizar um modelo de endometriose em camundongos isogênicos Balb/c, implantando tecido endometrial ectópico. Avaliar a histomorfometria dos tecidos endometriais ectópico e eutópicos de camundongo controles e receptores. Método: Foram utilizados21 camundongos Balb/c fêmea entre 7 a 8 semanas, que foram divididos em 4 grupos, sendo que primeiro grupo contém 3 camundongos doadores e o restante possuiu6 camundongos por grupos. Grupo 1- Controle, são animais saudáveis não tiveram nenhum procedimento; Grupo 2-Sham, são animais que tiveram os mesmos procedimentos do animal modelo de endometriose, porém não receberam o implante endometrial ectópico em seu lugar receberam solução salina; Grupo 3- endometriose, os animais tiverem intervenções com implante endometrial ectópico. Os camundongos do G1 e G3 foram tratados com 17 β estradiol diluídos em óleo de rícino e tratados 1 vez por semana durante 4 semanas consecutivas. A administração do 17 β estradiol foi utilizada para sincronizar a fase do ciclo estral. Após os tratamentos aguardamos 2 semanas e no final realizamos a eutanásia dos camundongos doadores, retiramos os cornos uterinos e o endométrio, para ser inoculado no grupo G3. Para tal procedimento utilizamos cloridrato cetamina e xilazina como anestésico. Após este procedimento de indução à endometriose, todos os animais foram eutanasiados para remoção dos cornos uterinos e o endométrio que foram imersos em paraformaldeído a 4% para realização de processamento histológico e coloração com H.E para obtenção das análises histomorfometricas e obtenção de dados estatísticos. Resultado: Analisamos a área de superfície dos implantes e evidenciamos importantes sítios de implantação de tecido endometrial na parede abdominal das camundongas, com crescimento local de tecido, mostrando importantes lesões e aderências, além de cistos escuros. Notamos que no grupo endometriose ocorreu um aumento no número de vasos sanguíneos GIII e glandulares GIII (GIII ≥GI e GIII. P>0,001). Além do evidente espessamento do epitelial endometrial GIII, quando comparados com o controle GI e Sham GII (GIII ≥GI e GIII. P>0,001). Notamos também um aumento no número de eosinófilos(GIII (GIII ≥GI e GIII. P>0,001). Conclusão: O modelo empregado é de fácil execução e boa reprodutibilidade, capaz de reproduzir as características morfológicas da endometriose, além de possibilitar a obtenção de análises histomorfométricas do endométrio, mostrando que o modelo reproduzido está relacionado a patogênese da endometriose.
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    Análises histoquímica e morfométrica de lesões endometrióticas induzidas em ratas e tratadas com dexametasona
    (Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, 2009-04-01) Batista, Ana Paula Castor; Medeiros, Paloma Lys De; Teixeira, Álvaro Aguiar Coelho [UNIFESP]; Teixeira, Valéria Wanderley; Universidade Federal de Pernambuco; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
    INTRODUCTION: The literature reports that endometrial implants have receptors for steroid hormones primarily stimulated by estrogen and that some treatment strategies have been proposed in experimental models such as the use of synthetic glucocorticoids, for example, dexamethasone. OBJECTIVE: to analyze histochemically and morphometrically endometriotic lesions induced in rats and treated with dexamethasone (0.8 mg/kg/day). MATERIAL AND METHODS: Forty albino female rats (Wistar strain), with 90 days of age, weighing approximately 150 g, were induced with endometriosis and divided into groups: I - rats with endometriosis and evaluated after 34 days, II - rats with endometriosis and evaluated after 47 days, III - rats with endometriosis and 21 days post-surgery treated with dexamethasone for 13 days and IV - rats with endometriosis and 21 days post-surgery treated with dexamethasone for 13 days and euthanized after a period of 13 days starting from the end of treatment. The fragments of endometrial implants were fixed in Bouin, embedded in Paraplast and stained with hematoxylin-eosin and Mallory trichrome. The mean number of glands was compared through nonparametric Tukey-Kramer test (p < 0,05). RESULTS: Dexamethasone reduced inflammation in the endometrial implants, the collagen content in the stroma and decreased significantly the area occupied by glands (GI - 123.25 ± 6.44ª; IGI - 113 ± 6.27ª; GIII - 81.66 ± 3.05b and GIV - 94 ± 6.24b). CONCLUSION: The applied dexamethasone dosage reduces estrogenic effects in endometrial implants in rats.
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    Analysis of Gene Expression in the Endocervical Epithelium of Women With Deep Endometriosis
    (Sage Publications Inc, 2016) Kopelman, Alexander [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Bonetti, Tatiana Carvalho de Souza [UNIFESP]; Carvalho, Cristina Valletta de [UNIFESP]; Silva, Ismael Dale Cotrim Guerreiro da [UNIFESP]; Schor, Eduardo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Endometriosis affects approximately 12% of reproductive-age women and is currently diagnosed using invasive laparoscopic surgery. Differences in gene expression in the eutopic endometrium between women with and without endometriosis have been reported, and determining the reproducibility of these genetic differences in the endocervical epithelium would represent an important step toward developing novel diagnostic strategies. In this study, we analyzed gene expression in the endocervical epithelium in women with and without moderate or severe endometriosis. Using RT2 Profiler PCR Arrays, we analyzed gene expression in endocervical epithelial cells from women with deep endometriosis (n = 4) and healthy women (n =6). Nine genes were identified as being upregulated: 5 cell cycle genes (cyclin B1 [CCNB1], cyclin G1 [CCNG1], cullin 1 [CUL1], general transcription factor IIH, polypeptide 1 [GTF2H1], and proliferating cell nuclear antigen [PCNA]), 3 cytokine genes (C3, chemokine (C-C motif) ligand 21 [CCL21], and chemokine (C-X-C motif) ligand 14 [CXCL14]) and 1 gene related to dendritic cell pathways (ICAM2), showing that differential gene expression is present in the endocervical epithelium of women with deep endometriosis.
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    Analysis of polymorphisms in codons 11, 72 and 248 of tp53 in brazilian women with breast cancer
    (Funpec-editora, 2016) Almeida, B. C. [UNIFESP]; Kleine, J. P. F. O. [UNIFESP]; Camargo-Kosugi, C. M. [UNIFESP]; Lisboa, M. R. [UNIFESP]; Franca, C. N. [UNIFESP]; Franca, J. P.; Silva, I. D. C. G. [UNIFESP]
    The association between TP53 gene polymorphisms and breast cancer (BC) in Brazilian women is a controversial topic. In this cross-sectional study, we evaluated the association between clinical pathological variables and three polymorphisms (TP53(star)11, TP53(star)72, and TP53(star)248) in BC patients and controls. Genomic DNA was extracted from the blood cells of 393 participants
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    Avaliação de genes relacionados a motilidade celular em mulheres com endometriose profunda
    (Universidade Federal de São Paulo (UNIFESP), 2019-11-28) Zanni, Pamela Cristina Mastellaro Delvas [UNIFESP]; Girao, Manoel Joao Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Endometriosis is a common, benign, estrogen-dependent inflammatory disease and is a chronic gynecological disorder. The pathology affects approximately 10% of women in reproductive age and 35-50% of women who presents pelvic pain and infertility. The histological origin of endometriosis aims to explain the ability of endometrial tissue to develop ectopically. However, no consensus has been reached with regard to a single theory is able to explaining such capability. The retrograde menstruation is the oldest and accepted theory, but it does not explain how some women develop endometriosis and others do not, since all women have some degree of retrograde flow. Cell migration plays a central role in a wide variety of biological phenomena and contributes to the progression of most human diseases. In the adult organism the migration remains remarkable being essential for adequate immune response, wound repair and tissue homeostasis, nonetheless, in several pathologies it appears abnormally. However, little is known on the role of cellular motility mechanisms for the establishment and progression of endometriosis implants. The aim of this study was to evaluate, using RT-PCR, the expression of genes related to the cellular motility processes in primary cells derived from the endometrium of women with deep infiltrating endometriosis and women without the disease. For this, endometrial samples were obtained from volunteers of Pain Unit Pelvic and Endometriosis Department of Gynecology, Paulista Medical School of the Federal University of São Paulo (EPM-UNIFESP). Women between 29 and 35 years were recruited. For endometriosis group, women undergoing for surgery of IV stage endometriosis and the control group were composed of women submitted to laparoscopy for tubal ligation. The samples were cultured and stored for the RT-PCR realization in order to analyze the possible genes involved in the cellular motility process in primary cells derived from the endometrium of women with deep endometriosis. It was possible to observe that endometrial cells from women with deep endometriosis showed the gene CAV1 downregulated, a gene related to a tumor suppression; RHOB and PLD1 were upregulated, which are involved in cell migration and progression. In this sense, it is suggested that these genes may play an important role in the establishment and progression of endometriosis.
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    Caracterização molecular e funcional das células do endométrio de mulheres com endometriose pélvica
    (Universidade Federal de São Paulo (UNIFESP), 2016-04-27) Nogueira, Adriana Luckow Invitti [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; http://lattes.cnpq.br/0973903299568770; http://lattes.cnpq.br/2547404412649527; Universidade Federal de São Paulo (UNIFESP)
    The endometrium contains stem cells that possibly contribute to the regeneration of the functional layer during the mensal cycling. Different kinds of stem cells were isolated from endometrium and endometriotic implants. The monoclonal origin of endometriotic implants indicates that stem cells may have a role in the endometriosis pathogenesis. We isolated a mixed cells pool containing at least one stem cells population from healthy and endometriosis endometrium. These cells presented the markers CD90, CD73, CD105, CD44 and CD146, being able to differentiate into adipogenic, osteogenic and chondrogenic lineages and not responding to progesterone stimulus. The endometriosis stem cells expressed the CD34 naïve stem cells marker, presented higher proliferative rates than healthy ones and were able to form long lasting cells aggregates (spheroids) in tridimensional cultures. The endometrium with endometriosis had a unique stem cell population, reinforcing the hypothesis that stem cells play a key role in the endometriosis pathogenesis. 2. INTRODUCTION Stem cells are undifferentiated cells defined by their functional ability to self-renew and to differentiate into multiple cell lineages, as well as by plasticity and clonogenic potential. They were found abundantly in embryonic and fetal tissues and are also present in small amounts in the majority of the adult tissues; differing between each other only in the clonogenic and differentiation potential. Adult stem cells occur in niches that balance self-renewal with lineage selection and progression during tissue homeostasis
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    Caracterização morfológica e molecular das endometriosferas formadas por células derivadas do endométrio de mulheres com endometriose profunda
    (Universidade Federal de São Paulo, 2024-02-05) Nogueira, Pollyana Telles [UNIFESP]; Nogueira, Adriana Luckow Invitti [UNIFESP]; Schor, Eduardo [UNIFESP]; http://lattes.cnpq.br/8854353153245040; http://lattes.cnpq.br/2547404412649527; http://lattes.cnpq.br/8492689839290665
    Endometriose é uma doença ginecológica crônica e benigna que se caracteriza pela presença de tecido semelhante ao endométrio fora da cavidade uterina. Estima-se que 10-15% das mulheres em idade reprodutiva apresentam a doença e a maioria experimenta grande diminuição na qualidade de vida. Dentre os sintomas, destacam-se a dismenorreia, a dispareunia e a infertilidade. Inúmeras teorias tentam explicar a fisiopatologia da doença, porém nenhuma é capaz de explicar todas as suas apresentações. O início da doença está diretamente relacionado à capacidade de sobrevivência e proliferação das células regurgitadas pelas tubas uterinas na cavidade peritoneal. Neste trabalho, avaliamos o papel das células endometriais estromais (eSCs) e epiteliais (eECs) na formação de esferoides em um modelo in vitro sem matriz de suporte mimetizando as células endometriais regurgitadas no fluido peritoneal. eSCs e eECs primárias foram isoladas do endométrio eutópico de mulheres com endometriose rASRM estágio IV e co-cultivadas em diferentes proporções desses tipos celulares. A morfologia dos esferoides e a participação de cada tipo celular foram avaliadas por microscopia. As eSCs são o principal componente dos esferoides em todas as proporções testadas e estão localizados na parte interna das esferas. O aumento das proporções de eSCs é diretamente proporcional ao aumento do tamanho dos esferoides. As células foram polarizadas, ficando as eSCs na parte interna do esferoide e as eECs revestindo a superfície. O marcador de células-tronco mesenquimais CD146 foi identificado até mesmo nas células da superfície do esferoide. Em conclusão, tanto as eECs como as eSCs contribuíram ativamente para a formação de esferoides endometriais. As interações entre eSCs e eECs são necessárias para a formação de esferoides estáveis e reforçam o possível papel do das interações entre eECs e eSCs para a sobrevivência de células endometriais
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    Contraceptive effect of Uncaria tomentosa (cat's claw) in rats with experimental endometriosis
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2011-01-01) Nogueira Neto, João; Cavalcante, Frederico Lucas Lima Paiva; Carvalho, Rafael Antonio Freire; Rodrigues, Taciana Gabrielle Pinheiro De Moura; Xavier, Mariana Santana; Furtado, Pablo Gustavo Ribeiro; Schor, Eduardo [UNIFESP]; Federal University of Maranhao; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: Evaluate the histological changes in parenchyma´s epithelial layer of the uterus and ovarian of rats with induced endometriosis, treated with Uncaria tomentosa extract. METHODS: 29 rats with experimental endometriosis, were selected and divided in three groups: The uncaria group received 32mg/ml of Uncaria tomentosa extract, 1ml administered daily and the placebo group received 1ml of saline 0.9% per day, during for 14 days (both groups); the leuprolide group received leuprolide acetate 1mg/kg body weight applied single subcutaneous dose. In the 15th day of treatment the uterine horn and ovaries were removed for histopathological analysis. RESULTS: The uncaria group presented nine samples (90%) with immature ovarian follicles, whereas the placebo group did not present any case and in the leuprolide group there were eight rats (88%) with the same change. The placebo group showed mature corpus luteum in all animals, occurring less frequent in uncaria (10%) and leuprolide (22%) groups. The uterine epithelium showed weak proliferative in nine (90%) samples of the uncaria group, in two (20%) animals in the placebo group and seven (77.8%) rats in the leuprolide group. CONCLUSIONS: The findings suggest that Uncaria tomentosa has contraceptive effect.
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    Deep Infiltrating Colorectal Endometriosis Treated With Robotic-Assisted Rectosigmoidectomy
    (Soc Laparoendoscopic Surgeons, 2013-04-01) Neme, Rosa Maria; Schraibman, Vladimir [UNIFESP]; Okazaki, Samuel [UNIFESP]; Maccapani, Gabriel [UNIFESP]; Chen, Winston Jenning; Domit, Cassia Danielle; Kaufmann, Oskar Grau [UNIFESP]; Advincula, Arnold P.; Universidade de São Paulo (USP); Ctr Endometriose São Paulo; Albert Einstein Hosp; Universidade Federal de São Paulo (UNIFESP); Digimagem Med Diagnost; Univ Cent Florida; Florida Hosp Celebrat Hlth
    Background and Objective: Deep infiltrating pelvic endometriosis with bowel involvement is one of the most aggressive forms of endometriosis. Nowadays, robotic technology and telemanipulation systems represent the latest developments in minimally invasive surgery. the aim of this study is to present our preliminary results and evaluate the feasibility of robotic-assisted laparoscopic colorectal resection for severe endometriosis.Methods: Between September 2009 and December 2011, 10 women with colorectal endometriosis underwent surgery with the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, CA, USA). We evaluated the following parameters: short-term complications, clinical outcomes and long-term follow-up, pain relief recurrence rate, and fertility outcomes.Results: Extensive ureterolysis was required in 8 women (80%). Ovarian cystectomy with removal of the cystic wall was performed in 7 women (70%). Torus resection was performed in all women, with unilateral and bilateral uterosacral ligament resection in 1 woman (10%) and 8 women (80%), respectively. in addition to segmental colorectal resection in all cases, partial vaginal resection was necessary in 2 women (20%). An appendectomy was performed in 2 patients (20%). the mean operative time with the robot was 157 minutes (range, 90-190 minutes). the mean hospital stay was 3 days. Six patients had infertility before surgery, with a mean infertility time of 2 years. After a 12-month follow-up period, 4 women (67%) conceived naturally and 2 (33%) underwent in vitro fertilization.Conclusion: We show that robotic-assisted laparoscopic surgery for the treatment of deep infiltrating bowel endometriosis is feasible, effective, and safe.
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    Efeito do fluido peritoneal de pacientes inférteis com endometriose e inférteis de causa desconhecida na reação acrossômica de espermatozóides capacitados
    (Universidade Federal de São Paulo (UNIFESP), 1996) Passos, Eduardo Pandolfi [UNIFESP]; Lima, Geraldo Rodrigues de [UNIFESP]
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    Efetividade do tratamento clínico em mulheres com diagnóstico de endometriose e dor pélvica crônica
    (Universidade Federal de São Paulo (UNIFESP), 2021) Mello, Thais Farias Koch [UNIFESP]; Schor, Eduardo [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Endometriosis is a chronic disease that preferentially affects young women and at reproductive age, whose delay in diagnosis and, consequently, in treatment, can significantly affect patients' quality of life. Clinical treatment of symptoms related to endometriosis is a valid option as a first line of therapeutic approach, with good results on pain symptoms relief and as an alternative for when the surgical approach is not possible immediately. Objective: To evaluate the effectiveness of clinical treatment in relieving the symptoms of with chronic pelvic pain and endometriosis. Methods: Retrospective study with review of the medical records of patients with clinical and radiological diagnosis of endometriosis, with symptoms for more than six months and followed up at the Pelvic Pain and Endometriosis outpatient clinic (UNIFESP), with care beginning between January 2010 and December 2012. Patients were divided according to the classification of endometriosis by imaging exams; aspects of the clinical treatment used (type of drug treatment, number of medications, length of follow-up) were evaluated in relation to its effectiveness (improvement in the symptoms reported by the patients). Data on the care and follow-up of these patients were extracted until 12/31/2016. Results: Among the 316 patients seen during the study period, 169 were considered eligible. Significant improvement of symptoms was observed in 69,8% of women who underwent through clinical treatment, of which 87% used hormonal medication and 13% non-hormonal medication. Conclusion: Our study demonstrated that clinical treatment in patients with endometriosis, for a maximum period of six years of follow-up, is effective, with improvement in the symptoms reported by the patients and with rates similar to those described in the literature.
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    Endometriose pélvica: comparação entre imagens por ressonância magnética de baixo campo (0,2 T) e alto campo (1,5 T)
    (Colégio Brasileiro de Radiologia e Diagnóstico por Imagem, 2008-12-01) Minaif, Karine [UNIFESP]; Shigueoka, David Carlos [UNIFESP]; Minami, Cintia Cristina Satie [UNIFESP]; Sales, Danilo Moulin [UNIFESP]; Ruano, José Maria Cordeiro [UNIFESP]; Noguti, Alberto Sinhiti [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Szejnfeld, Jacob [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To compare low-field (0.2 T) with high-field (1.5 T) magnetic resonance imaging in the assessment of pelvic endometriosis and adenomyosis. MATERIALS AND METHODS: Twenty-seven female patients with clinically suspected endometriosis were prospectively evaluated by means of high-field and low-field magnetic resonance imaging. The reading of the images was performed by a single radiologist, initiating by the low-field, followed by the high-field images. High-field magnetic resonance imaging was utilized as the golden-standard. RESULTS: Among the 27 patients included in the present study, 18 (66.7%) had some type of lesion suggesting the presence of endometriosis demonstrated at high-field images. In 14 of these patients the diagnosis was correctly established by low-field magnetic resonance imaging. Endometriomas, tubal lesions, and endometriotic foci > 7 mm identified at the high-field images were also identified at low-field images with 100% accuracy, sensitivity and specificity. Among the nine patients diagnosed with adenomyosis by high-field images, eight were correctly diagnosed by low-field images with 88.9% accuracy, specificity and sensitivity. CONCLUSION: Low-field magnetic resonance imaging demonstrated a low sensitivity in the detection of small endometriotic foci, high sensitivity in the detection of endometriomas and large endometriotic foci, and high accuracy in the detection of adenomyosis when compared with high-field magnetic resonance imaging.
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    Endometriose: modelo experimental em ratas
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 1999-06-01) Schor, Eduardo [UNIFESP]; Freitas, Vilmon de [UNIFESP]; Soares Júnior, José Maria [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Purpose: to demonstrate the experimental endometriosis induction in animals. Method: we used adult female Wistar rats weighing 200 - 250 g anesthetized with ethyl ether to open the abdominal cavity. After identifying the uterine horns, we removed an approximately 4 cm fragment from the right uterine horn. This fragment was placed in physiological saline and, with the aid of a stereoscopic magnifying glass, the endometrium was separated from the myometrium and cut into rectangles of approximately 4 x 5 mm. These rectangles were fastened to the lateral abdominal wall near great blood vessels, taking care that the free portion of the endometrium was directed towards the lumen of the abdominal cavity. After 21 days the animals were again operated to observe the size of the implants and to remove the ectopic endometrium for microscopic analysis. Results: we macroscopically observed a significant growth of the endometrial implants. Microscopic examination showed presence of glandular epithelium and stroma similar to topic epithelium. Conclusion: this model reproduces endometriosis in the female rat allowing a better study of this pathology, mainly the action of drugs on these implants.
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    Evaluation of Quality of Life and Sexual Satisfaction in Women Suffering from Chronic Pelvic Pain With or Without Endometriosis
    (Wiley-Blackwell, 2011-02-01) Tripoli, Tatiana M. [UNIFESP]; Sato, Helio; Sartori, Marair G.; Araujo, Fabio Fernando de; Girao, Manoel J. B. C.; Schor, Eduardo; Universidade Federal de São Paulo (UNIFESP)
    Introduction.Chronic pelvic pain (CPP) is one of the most frequent symptoms in women of reproductive age. This is an enigmatic clinical condition that results from the complex interactions of physiological and psychological factors with direct impact on the social, marital, and professional lives of women.Aim.To evaluate the quality of life and sexual satisfaction of women who suffer from CPP with or without endometriosis.Method.Forty-nine patients who had been diagnosed with endometriosis and 35 patients with CPP diagnosed with another gynecological condition, all 84 of whom were treated at the Chronic Pelvic Pain and Endometriosis Clinic at Universidade Federal de São Paulo (UNIFESP) from January to July of 2008. the controls were 50 healthy women from the Family Planning Clinic at UNIFESP.Main Outcome Measures.World Health Organization Quality of Life Assessment-Bref (WHOQOL-BREF) quality of life questionnaire and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS).Results.No statistically significant differences were observed between the groups with CPP symptoms, in either the results from the WHOQOL-BREF or in the GRISS questionnaire. in both questionnaires, differences were observed when the two groups of symptomatic women were compared with the group of healthy women.Conclusion.CPP caused by endometriosis or other gynecological conditions leads to a significant reduction of quality of life and sexual satisfaction. Tripoli TM, Sato H, Sartori MG, de Araujo FF, Girao MJBC, and Schor E. Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis. J Sex Med 2011;8:497-503.
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    Follicular fluid lipid peroxidation levels in women with endometriosis during controlled ovarian hyperstimulation
    (Taylor & Francis Ltd, 2017) Lima, Camila Bruna de [UNIFESP]; Cordeiro, Fernanda Bertuccez [UNIFESP]; Camargo, Mariana [UNIFESP]; Zylbersztejn, Daniel Suslik [UNIFESP]; Cedenho, Agnaldo Pereira [UNIFESP]; Bertolla, Ricardo Pimenta [UNIFESP]; Lo Turco, Edson Guimaraes [UNIFESP]
    This observational study aimed to establishing a relationship between lipid peroxidation and endometriosis in women undergoing controlled ovarian hyperstimulation. A total of 79 women were divided into two groups: (i) controls (tubal or male factor)
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    Frequency of endometriotic lesions in peritoneum samples from asymptomatic fertile women and correlation with CA125 values
    (Associação Paulista de Medicina - APM, 2009-11-01) Barbosa, Caio Parente [UNIFESP]; Souza, Ângela Mara Bentes de; Bianco, Bianca Alves Vieira [UNIFESP]; Christofolini, Denise Maria [UNIFESP]; Bach, Fernanda Abani Mafra; Lima, Geraldo Rodrigues de [UNIFESP]; Faculdade de Medicina do ABC Department of Gynecology and Obstetrics Division of Pathological Gynecology; Universidade Federal de São Paulo (UNIFESP)
    CONTEXT AND OBJECTIVE: Serological testing for CA125 has been widely used to detect endometriosis and to monitor its progression. However, controversy still exists regarding the usefulness of the plasma CA125 assay for diagnosing endometriosis. Furthermore, some authors have described superficial endometriosis as a cyclical and normal phenomenon in women's lives, and have indicated that development and progression of this disease would only occur in some women as a result of immunological changes. This study aimed to determine the frequency of endometriosis and the correlation between serum CA125 levels and the presence of endometriotic lesions in the peritoneum of asymptomatic fertile patients. DESIGN AND SETTING: Cross-sectional study at the Family Planning outpatient clinic of Faculdade de Medicina do ABC. METHODS: Eighty asymptomatic fertile patients who underwent tubal sterilization surgery were studied. Blood and peritoneum samples were collected. CA125 levels were measured from blood samples, and peritoneum biopsies were studied using histopathological tests. RESULTS: Histopathological evaluation of the peritoneum revealed that 16.25% of the patients had minimal or mild endometriosis. There was no statistically significant difference in CA125 levels between patients with and without endometriosis. CONCLUSION: The presence of endometriotic lesions in the peritoneum of fertile patients supports the hypothesis that incidental findings of minimal or mild endometriosis may not be of clinical significance, and that the progression of the disease probably occurs as a result of immunological and genetic abnormalities. Serum CA125 levels did not show any diagnostic significance with regard to detecting the disease.