Navegando por Palavras-chave "Leiomioma"

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    Analise de polimorfismos de nucleotideo unico (SNP) no receptor de estrogenio alfa em pacientes com leiomioma uterino
    (Universidade Federal de São Paulo (UNIFESP), 2005) Villanova, Fabiola Elizabeth [UNIFESP]
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    Análise do polimorfismo do gene CYP 17 como fator relacionado ao desenvolvimento do leiomioma uterino
    (Universidade Federal de São Paulo (UNIFESP), 2009-09-24) Vieira, Lucinda Coelho Esperança [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: Uterine leiomyoma is the most common pelvic tumor in women of reproductive age. It has been well established that endogenous sex hormones are involved in the pathogenesis of the disease, and polymorphisms in genes encoding for enzymes that act in the steroid hormones metabolism, as the CYP17, may therefore play a role in the genesis of fibroids. Variations in this gene have been thought to be candidates influencing the susceptibility to hormone-related diseases. A single nucleotide polymorphism (T→C) [rs1042386] in the promoter region of CYP17 is speculated to alter its transcription. The present study was conducted to investigate the association between this polymorphism and the presence of uterine leiomyoma in Brazilian women. Methods: Genotyping of the CYP17 was performed in 121 uterine fibroid patients and 120 unaffected women using polymerase chain reaction and restriction fragment length polymorphism analysis. Results: No significant difference in the CYP17 genotype distribution was noted between cases and controls (p=0.165) Conclusion: These findings suggest that the CYP17 gene polymorphism studied is unlikely to be associated with risk for uterine leiomyoma in Brazilian women.
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    Aspectos histopatologicos do endometrio em pacientes portadoras de mioma do utero e ciclos hipermenorragicos
    (Universidade Federal de São Paulo (UNIFESP), 1988) Santos, Lindinalva Batista [UNIFESP]
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    Avaliação da proporção de colágeno no tecido uterino antes e após tratamento do leiomioma uterino pela embolização arterial
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2009-12-01) Bonduki, Claudio Emílio [UNIFESP]; Dornelas Junior, Gilmar de Oliveira [UNIFESP]; Bernardo, Andre [UNIFESP]; Simões, Manuel de Jesus [UNIFESP]; Castro, Rodrigo de Aquino [UNIFESP]; Gomes, Mariano Tamura Vieira [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: to analyze histomorphometric consequences of the uterine arteries embolization (UAE) in the uterine tissue, especially by collagen tissue quantification through uterine biopsy, before and after treatment of uterine leiomyoma. METHODS: 15 patients with symptomatic leyomioma and/or infertility, submitted to UAE, participated in the study according to the study exclusion criteria, after having signed an informed consent. Uterine biopsy was performed in the secretory phase of the menstrual cycle, before and three months after the procedure, to evaluate the collagen. After the histological processing of the material, 3 µ slices were prepared, some of them dyed with hematoxiline-eosin (HE) and others with the specific dye for collagen fibers (Picrosirius red). Then, the slides were examined and interpreted, and the collagen quantified. The amount was calculated as the percent of the area composed by collagen, and the result expressed in mean±standard deviation (SD). Data has then been submitted to statistical analysis by Student's paired t test (p<0.05). RESULTS: the presence of smooth muscle cells was observed in the biopsies performed before the treatment, surrounded by a rich network of collagen fibers, which are part of the tumor, blood vessels and fibroblast nuclei. On the slides of biopsies performed after the treatment, it was observed the presence of widespread coagulation necrosis, vascular thrombosis, calcification and lymphoplasmocitary infiltration areas and clear reduction of the collagen component. The percentage of collagen fibers was higher in the pre-UAE group (84.07±1.41), than in the post-UAE (81.05±1.50) group, with p<0.0001, and 95% confidence interval (CI95%) from 2.080 to 3.827. CONCLUSION: the quantitative and qualitative collagen reduction clearly shows that the proposed treatment is efficient in reducing the tumoral mass, composed mainly by collagen fibers intermingled with neoplasic smooth muscle cells. Nevertheless, complementary studies are needed to investigate the functional and biological consequences of these histological changes.
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    Avaliação do polimorfismo do gene da cetecol-orto-metiltransferase(COMT) como fator relacionado ao desenvolvimento do leiomioma do útero
    (Universidade Federal de São Paulo (UNIFESP), 2008) Oliveira, Emerson de [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]
    Objetivos: avaliar o polimorfismo da catecol-orto-metiltransferase como possível fator relacionado ao desenvolvimento de leiomioma do útero. Métodos: Foram comparadas, em estudo caso-controle, 124 mulheres com leiomioma uterino sintomático, que se submeteram a tratamento cirúrgico (casos) e 193 mulheres na pós- menopausa sem diagnóstico prévio ou atual dessa afecção (controles). Os grupos foram analisados quanto à presença do polimorfismo do gene da COMT. A genotipagem foi realizada por meio de reação em cadeia da polimerase (PCR), com DNA proveniente de punção venosa periférica no grupo controle, ou de fragmento de leiomioma retirado durante a histerectomia no grupo caso. Os grupos foram estratificados por raça e, a seguir, para cálculo da razão de chances, ou odds ratio (OR), para a ocorrência da doença, aplicou-se o modelo de regressão logística. O nível de significância adotado foi de 5 por cento (p < 0,05) e o intervalo de confiança foi de 95 por cento (95 por cento IC). Resultados: O polimorfismo da COMT foi mais prevalente nas mulheres da raça branca (p = 0,013). Após a estratificação pelo volume uterino, o modelo de regressão logística demonstrou que o polimorfismo da COMT, nas pacientes com leiomioma do útero, correlacionou-se com tumores maiores (OR = 4,35; 95 por cento IC = 1,58 – 12; p = 0,004). Conclusões: A presença do polimorfismo do gene da COMT correlacionou-se com tumores maiores nas mulheres com leiomioma do útero..
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    Estudo de assinaturas metabólicas em leiomiomas uterinos
    (Universidade Federal de São Paulo, 2022-07-12) Barison, Gustavo Anderman Silva [UNIFESP]; Gomes, Mariano Tamura Vieira [UNIFESP]; Bonduki, Claudio [UNIFESP]; Castro, Rodrigo de Aquino [UNIFESP]; http://lattes.cnpq.br/6590913930590292; http://lattes.cnpq.br/7384818983129643; http://lattes.cnpq.br/6319329004052486; http://lattes.cnpq.br/7168607477194335
    Objective: The present study evaluated circulating metabolites in the plasma of patients with and without leiomyomas, to define a metabolomic profile of these patients and compare them according to leiomyomas' presence and uterine size. Methods: Cross-sectional observational study, including women divided into three groups: 37 with leiomyomas and uterus over 500 cm3, 17 with leiomyomas and uterus up to 150 cm3, and 21 leiomyoma-free women. Patients underwent peripheral blood collection that was further evaluated using untargeted metabolic assessment by gas chromatography coupled to mass spectrometer. Results: There was no statistical difference between patients’ anthropometric and demographic features and general laboratory tests. Groups were statistically different for uterus volume (p<0.0001). Forty six metabolites were identified in all samples (35% were amino acids and derivatives, 22% were fatty acids and 18% were carbohydrates). Statistically significant metabolic distinction (p<0.05 and FDR<0.05) was observed for 14 metabolites. Amino acids, except for L-glutamine, were significantly reduced in plasma levels of patients with large leiomyomas. Fatty acids and carbohydrates were progressively reduced in patients with leiomyomas and even more reduced in plasma levels of patients with large leiomyomas, except for an increase in alpha- linolenic acid. Conclusion: There are differences in plasma metabolites levels of amino acids, fatty acids, and carbohydrates among patients with leiomyomas and large leiomyomas compared to leiomyoma-free patients. These metabolites are especially reduced in patients presenting large leiomyomas. This metabolic panel is an initial step for the definition of possible biomarkers and metabolic signatures of the uterine fibroid. Keywords: Leiomyoma, Metabolomics, Mass spectrometry, Lipidomics, Gas chromatography, Omic.
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    Gravidez e parto após embolização arterial para tratamento de leiomioma uterino
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2006-10-01) Bonduki, Cláudio Emilio [UNIFESP]; Gonçalves, Patrícia; Yokohama, Cláudio [UNIFESP]; Costa, Odon Ferreira Da; Baracat, Edmund Chada [UNIFESP]; Lima, Geraldo Rodrigues De; Girão, Manoel João Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Sírio Libanês; Hospital Sírio Libanês Departamento de Radiologia Vascular
    PURPOSE: To analyze gestation evolution and deliveries after myoma treatment by embolization of the uterine arteries. METHODS: In the initial evaluation, 112 patients submitted to embolization of uterine arteries were included for treatment of myoma. From those, only nine wanted to be submitted to conservative treatment in order to keep their reproductive capacity. This procedure was indicated to the nine patients, since they were not susceptible to a conservative surgical treatment. They were submitted to embolization of the uterine arteries with particles of polyvinyl alcohol or embospheres with diameters ranging from 500 to 700 µm, and they have evolved without intercurrence. RESULTS: During the follow-up of these patients, there was a good clinical response with significant reduction in the uterus and myoma volumes. Four of them got pregnant, two had an early abortion and two evolved normally till the end of gestation with a term delivery. One of these had twins. CONCLUSION: Embolization of the uterine arteries is an option for the treatment of uterine myoma, and presents good clinical and anatomical results, allowing patients to preserve their reproductive capacity.
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    Impacto da embolização arterial do leiomioma uterino no volume uterino, diâmetro do mioma dominante e na função ovariana
    (Universidade Federal de São Paulo (UNIFESP), 2011-05-25) Bernardo, Andre [UNIFESP]; Bonduki, Claudio Emilio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate the impact of the mioma arterial embolization (EAM) by uterine volume, mioma diameter greater and in the ovarian function, was carried through before and after three months of the procedure, pelvic ultrasonography for the transvaginal way (USPTV) and dosages of FSH (follicle-stimulating hormone). METHODS: Thirty patients carrying of symptomatic leiomyomas had participated of the study that they had been submitted to the EAM after science and signature of the term of free and clarified assent, obeying the criteria of inclusion of the study. Examinations of USPTV for the same professional had been carried through, in the same device before and after three months of the EAM. The uterus volume was express in cm³ e mioma diameter greater in cm. Had been made dosages of FSH before and after three months of the EAM in the central laboratory of the Hospital São Paulo. The values had been quantified in UI/ml, analyzed and express for medium+/-shunting line standard. The data then had been submitted the statistics analysis for the test distribution free of Mann-Whitney. RESULTS: It had the exclusion of a patient due to lack of data after EAM. The average before EAM uterine volume was 402,4±165,9cm³, before-EAM mioma diameter greater 5,928±2,126cm. The observed result was after-EAM uterine volume was 258,9±118,6cm³ and after-EAM mioma diameter greater 4,607±1,858cm. The average of the dosage before-EAM FSH was 4,997 (±3,520) UI/ml and after-EAM FSH was 5,500 (±4,759) UI/ml with p=0,581*. In hormone dosages, 29 cases had been evaluated. One case, that is equivalent 3.4% of the total, attended a course with definitive increase of FSH. It had reduction of 35% of the uterus volume, of 22% in the size of the mioma diameter greater and the EAM did not modify the FSH values significantly after 3 months. CONCLUSION: The procedure causes reduction of the uterine volume and leiomyomas preserving the uterus and, does not provoke ovarian function alterations.
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    O papel da vitamina D na fisiopatologia dos miomas uterinos: revisão sistemática em modelos animais, estudos in vitro e observações clínicas
    (Universidade Federal de São Paulo (UNIFESP), 2020-08-27) Barillari, Priscila Cristina Souza Giolo [UNIFESP]; Silva, Ivaldo Da [UNIFESP]; Universidade Federal de São Paulo
    Fibroids are benign tumors in women of reproductive age and although associated with hormonal, genetic and molecular factors, the exact factor leading to its development is unknown. About 50% of patients are asymptomatic, but the other 50% may have symptoms such as abnormal uterine bleeding, pelvic pressure or pain, compressive symptoms, causing significant morbidity and affecting their quality of life, as well as infertility. Treatment of this condition should be individualized depending on various factors such as number, size and location of the tumor. In most cases, the treatment is performed surgically, either by myomectomy or hysterectomy. Over the years, a search for less aggressive treatments in the medical area using medications that can prevent growth and problems caused by fibroids are on course. Within the pharmacological options there are several therapeutic classes of medications such as steroid synthesis inhibitors and steroid receptor modulators that control the symptoms and decrease the volume of the fibroid. However, surgical treatment remains the most effective and definitive treatment when pharmacological therapy is not sufficient to control symptoms. Several studies have now shown the role of vitamin D in the development of fibroids and studies are demonstrating the reduction in fibroid size when myomatous cells are brought into contact with high doses of vitamin D. The presence of vitamin D was able to prevent and decrease the proliferation of fibroids and their cells. The mechanisms by which vitamin D influences the development of fibroids are not yet fully known. This systematic review suggests that the hormone (1,25 (OH)2 D3) plays an important role in controlling cell growth, programmed cell death, damage to DNA, and low levels of vitamin D appears to be a critical factor for the etiopathogenesis of uterine fibroids. Currently, there are several attempts to create a drug that is safe, effective and inexpensive for the treatment and prevention of fibroids and the identification of modifiable risk factors, such as 1,25 (OH)2 D3 deficiency is promising. In addition, it is assumed that vitamin D can regulate the excess of specific proteins present in tumor cells, proteins that would be at high levels compared to uterine cells without fibroids. These proteins are known as metalloproteinases and are enzymes that degrade extracellular material, leading to tumor growth, when in excess.
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    Relação entre polimorfismo do gene do receptor de progesterona, raça, paridade e ocorrência de leiomioma uterino
    (Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2006-05-01) Gomes, Mariano Tamura Vieira [UNIFESP]; Castro, Rodrigo de Aquino [UNIFESP]; Villanova, Fabiola Elizabeth [UNIFESP]; Silva, Ismael Dale Cotrim Guerreiro da [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Lima, Geraldo Rodrigues de [UNIFESP]; Girão, Manoel João Batista Castello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: to analyze race, parity and presence of the progesterone receptor polymorphism, named PROGINS, as factors related to uterine leiomyoma occurrence in Brazilian women. METHODS: we carried out a case-control study, composed of 122 patients with the diagnosis of uterine fibroid and 125 women without the disease. After recording the clinical data, we collected biological material for DNA extraction, polymerase chain reaction and agarose gel electrophoresis in order to identify the presence of PROGINS polymorphism. Statistical analysis was performed using the non-parametric Mann-Whitney test or the chi2 test, depending on the studied variable. The risk for the occurrence of the disease was calculated by the logistic regression model, providing the odds ratio (OR). The adopted significance level was 5% (p<0.05) and the confidence interval was 95% (95% CI). RESULTS: we observed a higher prevalence of non-whitewomen - mulatto and black - (50 vs 22.4%) and nulliparas (23.8 vs 11.2%) in the cases, while the progesterone receptor genotype was more often PROGINS positive - heterozygous or mutant homozygous - among the controls (21.6 vs 10.7%). The OR indicated an elevated risk for leiomyoma related to the non-whiterace (OR=3.46; 95% CI: 2.0-6.0) and the nulliparity (OR=3.30; 95% CI: 1.9-5.6), with reduction in the presence of PROGINS-positive genotypes (OR=0.43; 95% CI: 0.2-0.9). CONCLUSIONS: the non-whiterace and nulliparity were considered risk factors for the occurrence of uterine fibroid in the studied population, while PROGINS polymorphism showed to be a protective factor.