Navegando por Palavras-chave "Mioma"
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- ItemSomente MetadadadosAspectos histopatologicos do endometrio em pacientes portadoras de mioma do utero e ciclos hipermenorragicos(Universidade Federal de São Paulo (UNIFESP), 1988) Santos, Lindinalva Batista [UNIFESP]
- ItemAcesso aberto (Open Access)Avaliação da contratilidade uterina por ressonância magnética em mulheres submetidas a embolização de miomas uterinos(Universidade Federal de São Paulo (UNIFESP), 2018-09-06) Fornazari, Vinicius Adami Vayego [UNIFESP]; Goldman, Suzan Menasce [UNIFESP]; Szejnfeld, Denis; Bonduki, Claudio Emilio; http://lattes.cnpq.br/7384818983129643; http://lattes.cnpq.br/5784659077054234; http://lattes.cnpq.br/4903816455277036; http://lattes.cnpq.br/9458061365748156; http://lattes.cnpq.br/9458061365748156; Universidade Federal de São Paulo (UNIFESP)Purpose: To evaluate the impact of uterine fibroid embolization (UFE) on uterine contractility using ultrafast magnetic resonance (cineMR) sequences. Method: This prospective study included 26 patients, aged between 30 and 41 years (mean age: 36 years), with symptomatic uterine fibroids undergoing UFE. Patients underwent cineRM sequences before and 6 months after EMUT. Contractility was classified as absent, ordered or disordered. Patients were divided into three patterns of evolution of contractility after UFE: unchanged (group A), favorable modification (group B) and loss of contractility (group C). The following variables were also evaluated: uterine volume, dominant localization of fibroids, fibroidmyometrial index (predominance of myometrium versus predominance of fibroids) and pattern of necrosis of the dominant myometrial nodule after the procedure. Results: Of the 26 patients, eight (30.7%) had no contractility before the procedure, 18 (69.2%) presented with some type of contractility, 11 (61%) were classified as ordered and seven (39%) as disordered. After UFE, the eight patients without contractility presented with contractions, five ordered and three disordered. Of the 11 patients who initially showed ordered contractility, nine remained ordered and two showed loss of contractility. Of the seven patients who initially presented with disordered contractility, one remained disordered, five began to have ordered contractions and one showed loss of contractility. Regarding the evolution of the contractility pattern, 10 (38%) patients had no change in the pattern (group A), 13 (50%) had a positive change in contractility (group B) and three had loss of contractility (group C). Uterine volume, dominant location of fibroids, fibroidmyometrial index and pattern of myometrial nodule necrosis were not statistically significant when comparing the evolution pattern groups. Conclusion: UFE may be related to an improvement in uterine contractility pattern. Uterine volume, fibroid location, fibroidmyometrial index and pattern of fibroid necrosis do not seem to be related to the evolution of the uterine contractility pattern.
- ItemAcesso aberto (Open Access)Expressões gênicas da matriz extracelular e citocinas em tecido endometrial antes e após embolização das artérias uterinas para tratamento do leiomioma uterino(Universidade Federal de São Paulo (UNIFESP), 2013) Bernardo, Andre [UNIFESP]; Bonduki, Claudio Emilio [UNIFESP]; Castro, Rodrigo Aquino de [UNIFESP]; http://lattes.cnpq.br/6590913930590292; http://lattes.cnpq.br/7384818983129643; http://lattes.cnpq.br/6533669023972906Introdução: Embolizar as arterias uterinas e manipular o sistema circulatorio uterino e isto gera preocupacoes quanto as modificacoes da biologia molecular do endometrio. Destacam-se as expressoes de genes da matriz extracelular (MEC) e citocinas (CIT) endometriais e sua analise na fase lutea merece atencao pois sao importantes no processo reprodutivo, sendo pouco descrito na literatura. Casuistica e Metodos: Foram avaliadas oito mulheres com leiomiomas do ambulatorio de ginecologia da UNIFESP. O termo de consentimento foi assinado e estas mulheres se submeteram ao exame de ultrasonografia pelvica transvaginal (USPTV), mensuracao de FSH na fase folicular e biopsia de endometrio na segunda fase do ciclo menstrual pre-EAM e 6 meses pos-EAM. As amostras obtidas foram aplicadas em placas de PCR arrayO para genes de matriz extracelular e citocinas inflamatorias e receptores. Valor p: O p valor foi calculado baseado no test-t Student do valor da replicacao de cada gene escolhido. Resultados: Em nossos resultados, os genes da MEC super-expressos pos 6m pos-EAM foram MMP(1,3,10,11,14), CTGF1, ICAM1, TBHS1, ITGA2, ITGA3, ITGB3, COL7A1, COL12A, SPP1 e TNC. O gene ADAMTS8 ficou sub-expresso 6m pos-EAM. Nas citocinas, ficaram super-expressos 6m pos-EAM os genes SPP1, BCL6, CXCL12, IL-8 e CEBPB. Observamos que CCL21 e CXCL13, ficaram sub-expressos 6m pos-EAM, sendo significativo do ponto de vista estatistico. Conclusoes: Matriz extracelular (MEC) em mulheres submetidas a EAM, durante a segunda fase do ciclo menstrual, mostrou: a) Subexpressao 6 meses pos-EAM de protease responsavel por disfuncoes da MEC; b) Super-expressoes 6 meses pos-EAM de genes responsaveis pela adesividade e componentes de membrana. Citocinas (CIT) de mulheres submetidas a EAM, durante a segunda fase do ciclo menstrual, mostrou: a) Superexpressao 6 meses pos-EAM de quimiocinas responsaveis pelo reparo endometrial; b) Citocinas sub-expressas 6 meses pos-EAM no endometrio envolvidas no processo inflamatorio
- ItemAcesso aberto (Open Access)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 VascularPURPOSE: 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.