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OBJECTIVE: The objectives of this study were to evaluate the vascularization pattern of uterine myoma (UM) by ultrasonography using Superb Microvascular Imaging (SMI) and tissue stiffness elastography. METHOD: A prospective and cross-sectional study was carried out between March 2020 and December 2022 among women with clinical and ultrasound diagnosis of UM who would subsequently undergo radiofrequency ablation. Ultrasound examination was performed using both transvaginal and transabdominal routes. UM vascularization pattern was assessed by power Doppler (PD) and SMI, while elastographic pattern was assessed by shear wave (SWE) and strain (STE). FIGO classification, location, and measurement of the largest UM were also described. RESULTS: A total of 21 women diagnosed with UM were evaluated. There was a predominance of nulliparous women and 20 women (95.2%) reported desire for pregnancy. Of the 18 women with abnormal uterine bleeding, 15 (83.3%) had abdominal cramping. As far as previous treatment, 7 (33.3%) had undergone myomectomy for other UM. The mean uterine and UM volumes were 341.9 cm3 (90-730) and 126.52 cm3 (6.0-430), respectively. There was a predominance of hypoechogenic lesions (90.5%). There was also preponderance of UM in the FIGO 2-5 classification (n = 9; 42.9%). Vascularization patter was mostly moderate (score 2) in 9 cases (42.9%). The majority of UM were considered to have intermediate stiffness (n = 10; 47.6%). CONCLUSION: The majority of UM showed vascularization and moderate stiffness. A relationship was observed between the stiffness of the UM assessed by elastography and its FIGO classification.
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OBJECTIVE: The study aimed to evaluate the impact of CE on the expression of HOXA10 and HOXA11 during the late proliferative phase in the endometrium of infertile women. METHODS: A prospective, translational cohort study was conducted in partnership with the Hospital Universitário Antônio Pedro in Niterói and the Clínica Ginendo in Rio de Janeiro after approval by the Ethics Committee. The patients were selected to participate in the study after showing an indication for hysteroscopy. All participants were divided into three groups: infertile women with endometritis (n=10), infertile women without endometritis (n=17) and fertile women without endometritis (n=10). At hysteroscopy, two endometrial samples were obtaneid, with one sent for histopathological examination per the gynecologist's request and the other used for immunohistochemistry procedures to evaluate the expression of CD138, HOXA10 and HOXA11. CD138 was used to confirm the diagnosis of CE. The analysis of HOXA10 and HOXA11 was performed using the HScoring method for immunohistochemistry with polyclonal antibodies. RESULTS: Women with and without endometritis had lower HOXA10 and HOXA11 expression values than women in the control group (fertile women without endometritis). CONCLUSIONS: The expression of HOXA10 and HOXA11 during the proliferative phase is not significantly different between infertile women with endometritis and infertile women without endometritis. Translational studies with a larger number of patients should be performed.
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Abstract Humans are exposed to natural compounds such as phytoestrogens primarily through diet and supplements. These compounds promote health by alleviating the symptoms and illnesses associated with menopause and arthritis. Diosgenin (DSG) occurs naturally in plants such as Dioscorea villosa (DV) and binds to estrogen receptors, so it may have similar effects to this hormone, including against arthritis. Thus, we investigated the effect of chronic treatment with dry extract of DV and its phytoestrogen DSG on ovariectomized mice with arthritis. We found that dry extract of Dioscorea villosa (DV) contains the phytoestrogen diosgenin (DSG) in its composition. Furthermore, arthritic mice treated with DV and DSG showed reduced neutrophil accumulation in the articular cartilage. Also, the dry extract of DV administered orally (v.o) did not alter the leukocyte count in the joints or promote changes in the reproductive tract. However, DSG altered these parameters, with possible beneficial effects by reducing symptoms related to reproductive aging. Thus, oral treatment with dry extract of DV and subcutaneous (s.c) treatment with DSG showed promise by acting against inflammation caused by arthritis and reducing symptoms in the reproductive tract due to menopause.
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Animais , Feminino , Camundongos , Artrite/induzido quimicamente , Zimosan/administração & dosagem , Dioscorea/efeitos adversos , Diosgenina/efeitos adversos , Osteoartrite/induzido quimicamente , Extratos Vegetais/agonistasRESUMO
Viral infections have been the cause of high mortality rates throughout different periods in history. Over the last two decades, outbreaks caused by zoonotic diseases and transmitted by arboviruses have had a significant impact on human health. The emergence of viral infections in different parts of the world encourages the search for new inputs to fight pathologies of viral origin. Antibodies represent the predominant class of new drugs developed in recent years and approved for the treatment of various human diseases, including cancer, autoimmune and infectious diseases. A promising group of antibodies are single-domain antibodies derived from camelid heavy chain immunoglobulins, or VHHs, are biomolecules with nanometric dimensions and unique pharmaceutical and biophysical properties that can be used in the diagnosis and immunotherapy of viral infections. For viral neutralization to occur, VHHs can act in different stages of the viral cycle, including the actual inhibition of infection, to hindering viral replication or assembly. This review article addresses advances involving the use of VHHs in therapeutic propositions aimed to battle different viruses that affect human health.
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Antivirais , Anticorpos de Domínio Único , Viroses , Anticorpos de Domínio Único/uso terapêutico , Animais , Camelidae/metabolismo , Antivirais/uso terapêutico , Terapia de Alvo Molecular , Viroses/tratamento farmacológico , Viroses/virologia , Humanos , Vírus/classificaçãoRESUMO
The recent emergence of Zika virus (ZIKV) has affected many countries, with severe clinical manifestations such as fetal microcephaly and Guillain-Barré syndrome. However, even though it is a major public health concern, there is no approved treatment available. Structural knowledge of the main neutralization regions of the envelope (E) protein of ZIKV and its interactions with neutralizing antibodies (nAbs) are crucial for the rational development of subunit vaccines and establishment of antibody-based interventions. In this study we screened from public data hot spot epitopes in conserved regions of ZIKV E protein that are nAbs targets. The result points to a conserved epitope located at domain II of the ZIKV E protein, namely adjacent dimer epitope, which is the ZIKV-117 and Z20 nAbs target. Although these two nAbs have been isolated from different donors, we have demonstrated, from structural and energetic details obtained by molecular dynamics of native and mutants, that hot spots residues of the epitope are the same for these nAbs, thereby indicating that they may share similar binding and neutralization mechanism. This convergence of information between these nAbs is important because both are potential targets for the development of therapies against ZIKV and only Z20 has its sequence and its complex structure with ZIKV E protein determined. Finally, these findings also contribute to existing knowledge, by fine mapping of the epitope/paratope residue pairs that are important for biotechnological development of therapies such as epitope mimetics for subunit vaccines and the rational design for antibody-based interventions against ZIKV. Communicated by Ramaswamy H. Sarma.
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Infecção por Zika virus , Zika virus , Anticorpos Neutralizantes , Anticorpos Antivirais , Epitopos , Humanos , Proteínas do Envelope ViralRESUMO
OBJECTIVE: To evaluate and reconstruct three-dimensional images of vascularization along the fallopian tube (FT), as well as to determine its relationship with the ovary and ovarian fimbria, and to quantify the blood vessels along the FT according to its anatomical segments, using confocal microtomography (micro-CT). MATERIALS AND METHODS: Nine specimens (six FTs and three FTs with ovaries) were fixed in a solution of 10% formalin for > 24 h at room temperature. Iodine staining was performed by soaking the specimens in 10% Lugol's solution for 24 h. All specimens were evaluated using micro-CT. A morphometric analysis was performed on the reconstructed images to quantify the vascular distribution along the FT. RESULTS: In the FTs evaluated, the density of blood vessels was significantly greater in the fimbrial segments than in the isthmic segments (p < 0.05). The ovarian fimbria was clearly identified, demonstrating the important relationship between these vessels and the FT fimbriae. CONCLUSION: We believe that the vascularization in the fimbriae is greater than and disproportional that in the other segments of FT, and that the ovarian fimbria plays an important role in the development of that difference.
OBJETIVO: Avaliar e reconstruir imagens tridimensionais da vascularização ao longo da trompa de Falópio (TF) e sua relação com o ovário e fímbria do ovário, além de quantificar os vasos sanguíneos ao longo da TF de acordo com seus segmentos anatômicos usando microtomografia confocal (micro-TC). MATERIAIS E MÉTODOS: Nove espécimes (seis com TFs e três com TFs e ovários) foram fixados em solução de formol a 10% por mais de 24 h à temperatura ambiente. A coloração com iodo foi realizada usando solução de Lugol a 10% durante 24 h. Todos os espécimes foram avaliados usando micro-TC. Uma análise morfométrica foi realizada nas imagens reconstruídas para quantificar a distribuição vascular ao longo da TF. RESULTADOS: A densidade dos vasos sanguíneos nas fímbrias foi significativamente aumentada em comparação ao segmento ístmico da TF (p < 0,05). A fímbria ovariana foi claramente identificada, demonstrando importante relação entre esses vasos e as fímbrias da TF. CONCLUSÃO: Acreditamos que as fímbrias apresentam vascularização aumentada e desproporcional em comparação com os demais segmentos da TF e que a fímbria ovariana desempenha importante papel nessa diferença.
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Abstract Objective: To evaluate and reconstruct three-dimensional images of vascularization along the fallopian tube (FT), as well as to determine its relationship with the ovary and ovarian fimbria, and to quantify the blood vessels along the FT according to its anatomical segments, using confocal microtomography (micro-CT). Materials and Methods: Nine specimens (six FTs and three FTs with ovaries) were fixed in a solution of 10% formalin for > 24 h at room temperature. Iodine staining was performed by soaking the specimens in 10% Lugol's solution for 24 h. All specimens were evaluated using micro-CT. A morphometric analysis was performed on the reconstructed images to quantify the vascular distribution along the FT. Results: In the FTs evaluated, the density of blood vessels was significantly greater in the fimbrial segments than in the isthmic segments (p < 0.05). The ovarian fimbria was clearly identified, demonstrating the important relationship between these vessels and the FT fimbriae. Conclusion: We believe that the vascularization in the fimbriae is greater than and disproportional that in the other segments of FT, and that the ovarian fimbria plays an important role in the development of that difference.
Resumo Objetivo: Avaliar e reconstruir imagens tridimensionais da vascularização ao longo da trompa de Falópio (TF) e sua relação com o ovário e fímbria do ovário, além de quantificar os vasos sanguíneos ao longo da TF de acordo com seus segmentos anatômicos usando microtomografia confocal (micro-TC). Materiais e Métodos: Nove espécimes (seis com TFs e três com TFs e ovários) foram fixados em solução de formol a 10% por mais de 24 h à temperatura ambiente. A coloração com iodo foi realizada usando solução de Lugol a 10% durante 24 h. Todos os espécimes foram avaliados usando micro-TC. Uma análise morfométrica foi realizada nas imagens reconstruídas para quantificar a distribuição vascular ao longo da TF. Resultados: A densidade dos vasos sanguíneos nas fímbrias foi significativamente aumentada em comparação ao segmento ístmico da TF (p < 0,05). A fímbria ovariana foi claramente identificada, demonstrando importante relação entre esses vasos e as fímbrias da TF. Conclusão: Acreditamos que as fímbrias apresentam vascularização aumentada e desproporcional em comparação com os demais segmentos da TF e que a fímbria ovariana desempenha importante papel nessa diferença.
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PURPOSE: To evaluate in three dimensions (3D) the human endosalpinx and reconstruct its surface along its different anatomical segments, without the injection or insertion of luminal contrasts, using confocal microtomography (micro-CT). MATERIAL AND METHODS: 15 fallopian tubes (FT) from 14 women in reproductive age from procedures for benign disease or sterilization were selected. The specimens were fixed in formalin and stained with Lugol solution. Micro-CT studies were conducted on the specimens using protocols adapted from biological studies, to acquire images to reconstruct in 3D the endosalpinx surface. RESULTS: From these specimens, 6 presented the intra-mural segment, 14 presented the isthmus and 15 presented the ampulla and fimbria segment of the FT. The specimen presented tissue definition, and contrast sufficient for FT endosalpinx morphological analysis and lumen definition. The intramural portion presented initially a mucosal projection toward the lumen, bending on its own axis, and increased numbers of projections towards the isthmic portion, where the projections become longer more numerous. The endosalpinx becomes more tortuous, the lumen diameter increases and the mucosal projections become more bulky in the ampullary portion, with the projections less present on the antimesenteric side. The infundibular portion is marked with the organized and predictable endosalpinx, the abdominal ostium is cleared demonstrated, with the reduction of the endosalpinx volume. The fimbria demonstrated a small relation between fringes and intratubal endosalpinx. CONCLUSIONS: Microscopic anatomy of different segments of the human FT mucosa can be analyzed and reconstructed in 3D with histological correlation using micro-CT.
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OBJECTIVE: Most lung transplants are obtained from brain-dead donors. The physiopathology of brain death involves hemodynamics, the sympathetic nervous system, and inflammatory mechanisms. Administering methylprednisolone 60 min after inducing brain death in rats has been shown to modulate pulmonary inflammatory activity. Our objective was to evaluate the effects of methylprednisolone on transplanted rat lungs from donors treated 60 min after brain death. METHODS: Twelve Wistar rats were anesthetized, and brain death was induced. They were randomly divided into two groups (n=6), namely a control group, which was administered saline solution, and a methylprednisolone group, which received the drug 60 min after the induction of brain death. All of the animals were observed and ventilated for 2 h prior to being submitted to lung transplantation. We evaluated the hemodynamic and blood gas parameters, histological score, lung tissue levels of thiobarbituric acid-reactive substances, level of superoxide dismutase, level of tumor necrosis factor-alpha, and level of interleukin-1 beta. RESULTS: After transplantation, a significant reduction in the levels of tumor necrosis factor-alpha and IL-1ß was observed in the group that received methylprednisolone (p=0.0084 and p=0.0155, respectively). There were no significant differences in tumor necrosis factor-alpha and superoxide dismutase levels between the control and methylprednisolone groups (p=0.2644 and p=0.7461, respectively). There were no significant differences in the blood gas parameters, hemodynamics, and histological alterations between the groups. CONCLUSION: The administration of methylprednisolone after brain death in donor rats reduces inflammatory activity in transplanted lungs but has no influence on parameters related to oxidative stress.
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Anti-Inflamatórios/administração & dosagem , Morte Encefálica/fisiopatologia , Transplante de Pulmão/métodos , Pulmão/efeitos dos fármacos , Metilprednisolona/administração & dosagem , Animais , Gasometria , Hemodinâmica , Interleucina-1beta/análise , Masculino , Distribuição Aleatória , Ratos , Ratos Wistar , Valores de Referência , Reprodutibilidade dos Testes , Superóxido Dismutase/análise , Substâncias Reativas com Ácido Tiobarbitúrico/análise , Fatores de Tempo , Fator de Necrose Tumoral alfa/análiseRESUMO
OBJECTIVE: Most lung transplants are obtained from brain-dead donors. The physiopathology of brain death involves hemodynamics, the sympathetic nervous system, and inflammatory mechanisms. Administering methylprednisolone 60 min after inducing brain death in rats has been shown to modulate pulmonary inflammatory activity. Our objective was to evaluate the effects of methylprednisolone on transplanted rat lungs from donors treated 60 min after brain death. METHODS: Twelve Wistar rats were anesthetized, and brain death was induced. They were randomly divided into two groups (n = 6), namely a control group, which was administered saline solution, and a methylprednisolone group, which received the drug 60 min after the induction of brain death. All of the animals were observed and ventilated for 2 h prior to being submitted to lung transplantation. We evaluated the hemodynamic and blood gas parameters, histological score, lung tissue levels of thiobarbituric acid-reactive substances, level of superoxide dismutase, level of tumor necrosis factor-alpha, and level of interleukin-1 beta. RESULTS: After transplantation, a significant reduction in the levels of tumor necrosis factor-alpha and IL-1β was observed in the group that received methylprednisolone (p = 0.0084 and p = 0.0155, respectively). There were no significant differences in tumor necrosis factor-alpha and superoxide dismutase levels between the control and methylprednisolone groups (p = 0.2644 and p = 0.7461, respectively). There were no significant differences in the blood gas parameters, hemodynamics, and histological alterations between the groups. CONCLUSION: The administration of methylprednisolone after brain death in donor rats reduces inflammatory activity in transplanted lungs but has no influence on parameters related to oxidative stress. .
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Animais , Masculino , Ratos , Anti-Inflamatórios/administração & dosagem , Morte Encefálica/fisiopatologia , Transplante de Pulmão/métodos , Pulmão/efeitos dos fármacos , Metilprednisolona/administração & dosagem , Gasometria , Hemodinâmica , Interleucina-1beta/análise , Distribuição Aleatória , Ratos Wistar , Valores de Referência , Reprodutibilidade dos Testes , Superóxido Dismutase/análise , Fatores de Tempo , Substâncias Reativas com Ácido Tiobarbitúrico/análise , Fator de Necrose Tumoral alfa/análiseRESUMO
A osteoporose é uma doença que pode acarretar um enorme prejuízo na qualidade de vida dos pacientes em função das alterações no tecido ósseo, levando à fragilidade mecânica e consequente predisposição a fraturas e dor. Hoje, dispomos de medidas preventivas, do uso de suplementos e de várias drogas aprovadas para terapia farmacológica da osteoporose, no período pós-menopausa, revisadas neste artigo. Essas drogas apresentam características antirreabsortivas (bisfosfonatos, terapia estrogênica, agonistas seletivos dos receptores de estrogênio - SERM -, calcitonina e denozumabe), anabólicas (teriparatida - PTH) ou ambas, simultaneamente (ranelato de estrôncio). A terapia estrogênica (TE) e a terapia com os bisfosfonatos compreendem as primeiras linhas de medicamentos utilizadas para prevenção e tratamento da osteoporose no climatério. Os medicamentos de segunda linha ficam reservados aos casos com evolução desfavorável com uso de TE e/ou bisfosfonatos, ou quando essas pacientes apresentem alguma enfermidade óssea associada (osteoporose secundária), necessitando de tratamento específico. Na falha ou impossibilidade da utilização dos medicamentos de segunda linha podemos utilizar o ranelato de estrôncio ou o denozumabe, pesando que os riscos dessas drogas precisam ser mais bem estudados
Osteoporosis is a disease that can cause a great loss of quality of life of patients according to the changes in bone tissue leading to mechanical fragility and consequent susceptibility to fractures and pain. Today, we offer preventive measures, the use of supplements and several drugs approved for pharmacologic therapy for osteoporosis in postmenopausal, reviewed in this article. These drugs have anti resorptive characteristics (bisphosphonates, estrogen, selective estrogen receptor modulators - SERM -, calcitonin and denozumab), anabolic (teriparatide - PTH) or both, simultaneously (strontium ranelate). Estrogen therapy (ET) and therapy with bisphosphonates comprise the first line drugs used for prevention and treatment of osteoporosis in the climacteric. The second-line drugs are reserved to cases with unfavorable outcome with the use of TE and/or bisphosphonates, or when these patients have a disease associated with bone (secondary osteoporosis), requiring specific treatment. In the failure or inability of use of second-line drugs, we can use the strontium ranelate or denozumab, weighing the risks of these drugs that need to be further studied
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Humanos , Feminino , Fraturas por Osteoporose/prevenção & controle , Osteoporose Pós-Menopausa/prevenção & controle , Osteoporose Pós-Menopausa/terapia , Alcoolismo/complicações , Cálcio da Dieta/administração & dosagem , Difosfonatos/uso terapêutico , Fumar/efeitos adversos , Moduladores de Receptor Estrogênico/administração & dosagem , Osteoporose/prevenção & controle , Cloridrato de Raloxifeno/administração & dosagem , Terapia de Reposição de Estrogênios , Vitamina D/administração & dosagemRESUMO
A osteoporose é um distúrbio osteometabólico caracterizado pela diminuição da densidade mineral óssea (DMO), com deterioração da microarquitetura óssea, levando a um aumento da fragilidade esquelética e do risco de fraturas, pelo comprometimento da resistência e/ou da qualidade óssea. Sua incidência pode variar de 14 a 29% em mulheres acima de 50 anos e chegar até 73% em mulheres acima de 80 anos. O objetivo do nosso artigo é estudar a osteoporose relacionada ao período pós-menopausa, mas vale ressaltar que os riscos de fraturas em algumas condições independem da quantidade de massa óssea mensurada, e sim da qualidade óssea. Atualmente dispomos de uma ferramenta muito útil, denominada FRAXtm (Fracture Risk Assessement tool), para avaliação do risco de fraturas; por meio dela, é possível calcular a probabilidadede, em dez anos, ocorrer fratura no quadril e em outros sítios, não somente pela quantidade de massa óssea, mas pela associação de outros fatores clínicos de risco. Isso poderá nos ajudar a tomar decisões clínicas quanto à prevenção e tratamento da osteoporose na mulher na pós-menopausa, na nossa prática diária, quando validada para uso no Brasil
Osteoporosis is a metabolic disorder characterized by decreased bone mineral density (BMD), with deterioration of bone microarchitecture. It leads to an increase in skeletal fragility and fracture risk, by compromising the strength and/or quality of bone. Its incidence varies from 14 to 29% in women over 50 years and reaches 73% in women over 80 years. The objective of our paper is to study osteoporosis related to post-menopause. But, it is noteworthy that the risk of fractures in some conditions depends on the bone quality. Currently, we have a very useful tool called FRAXtm (Fracture Risk Assessment tool), to evaluate the risk of fractures. The probability to occur hip fracture, or another bone fracture, in ten years is calculated, not only by the amount of bone mass, but by the association of other clinical risk factors. This may help us make clinical decisions about prevention and treatment of osteoporosis in postmenopausal women in our daily practice, when validated for use in Brazil
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Humanos , Masculino , Feminino , Idoso , Climatério/metabolismo , Fraturas por Osteoporose , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/prevenção & controle , Absorciometria de Fóton/métodos , Densidade Óssea , Fraturas Ósseas/fisiopatologia , Fraturas do Quadril , Programas de Rastreamento , Medição de Risco/métodos , Fatores de RiscoRESUMO
BACKGROUND: Estrogen promotes the growth of thyroid cells. Therefore, we analyzed the influence of estrogen and selective estrogen receptor modulators (SERMs) on the expression of vascular endothelial growth factor (VEGF) and nitric oxide synthase III (NOS III) in the thyroid gland of ovariectomized (Ovx) rats. METHODS: Wistar rats were divided into five groups, and bilateral ovariectomies were performed, except on the Sham-operated controls (Sham). Rats were grouped as follows: Sham; Ovx; and Ovx rats treated with daily subcutaneous injections of estradiol benzoate 3.5 microg/kg, tamoxifen 2.5 mg/kg, or raloxifene 2.5 mg/kg for 50 consecutive days. Control animals received vehicle (propyleneglycol), and at the end of the treatment, rats were sacrificed. The thyroid glands were excised, weighed, and processed for analysis of the expression of VEGF or NOS III by immunohistochemistry. The mean vascular areas were evaluated by immunodetection of alpha-smooth muscle actin. RESULTS: Thyroid weight and mean vascular area were lower in Ovx as compared with Sham, Ovx + estradiol benzoate, Ovx + Tam, or Ovx + Ral (p < 0.01). VEGF (p < 0.01) and NOS III expressions (p < 0.05) were significantly lower in the Ovx group, as compared with Sham, Ovx + estradiol benzoate, Ovx + Tam, and Ovx + Ral. Immunoreactivity for both VEGF and NOS III was mainly detected in the cytoplasm of the follicular epithelial cells. CONCLUSIONS: Our data suggest that estrogen and SERMs regulate the thyroid gland vascularization and that tamoxifen and raloxifene behave like estrogen does. Estrogen and SERMs upregulate VEGF and NOS III in such a way as to reverse the effects detected on the thyroid microvasculature of the Ovx rats.
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Estradiol/análogos & derivados , Estrogênios/farmacologia , Óxido Nítrico Sintase Tipo III/metabolismo , Moduladores Seletivos de Receptor Estrogênico/farmacologia , Glândula Tireoide/metabolismo , Regulação para Cima/efeitos dos fármacos , Fatores de Crescimento do Endotélio Vascular/metabolismo , Actinas/metabolismo , Animais , Estradiol/farmacologia , Feminino , Imuno-Histoquímica , Microvasos/efeitos dos fármacos , Tamanho do Órgão , Ovariectomia , Cloridrato de Raloxifeno/farmacologia , Distribuição Aleatória , Ratos , Ratos Wistar , Tamoxifeno/farmacologia , Glândula Tireoide/irrigação sanguínea , Glândula Tireoide/citologia , Glândula Tireoide/efeitos dos fármacos , Útero/anatomia & histologia , Útero/efeitos dos fármacosRESUMO
Chylothorax as a complication of the surgical treatment of thoracic outlet syndrome is a quite rare event. We report a case of right-sided chylothorax and present a brief review on the treatment of postoperative chylothorax.
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Quilotórax/etiologia , Complicações Pós-Operatórias , Síndrome do Desfiladeiro Torácico/cirurgia , Cirurgia Torácica Vídeoassistida/efeitos adversos , Adulto , Quilotórax/diagnóstico por imagem , Feminino , Humanos , Complicações Pós-Operatórias/diagnóstico por imagem , RadiografiaRESUMO
A fístula linfática como complicação de correção de síndrome do desfiladeiro torácico é um evento muito raro. Relatamos um caso de fístula linfática à direita e apresentamos uma breve revisão do tratamento de quilotórax pós-cirúrgico.
Chylothorax as a complication of the surgical treatment of thoracic outlet syndrome is a quite rare event. We report a case of right-sided chylothorax and present a brief review on the treatment of postoperative chylothorax.
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Adulto , Feminino , Humanos , Quilotórax/etiologia , Complicações Pós-Operatórias , Síndrome do Desfiladeiro Torácico/cirurgia , Cirurgia Torácica Vídeoassistida/efeitos adversos , Quilotórax , Complicações Pós-OperatóriasRESUMO
A relação entre as funções hormonais do ovário e da tireoide vem sendo motivo de interesse da comunidade científica mundial desde o século 19. Ao longo do tempo, diversos estudos objetivaram esclarecer fatos relacionados à interdependência funcional desses sistemas orgânicos. De fato, há evidências da ação direta e indireta do estrogênio na tireoide. Mulheres climatéricas em estado de hipoestrogenismo podem apresentar alterações na função tireoidea. Foram demonstrados efeitos da gonadectomia e da administração de estrogênio na tireoide de animais e de humanos. Por outro lado, alterações da função tireoidea podem causar distúrbios da função reprodutiva feminina. Mulheres portadoras de doenças da tireoide podem apresentar distúrbios menstruais, infertilidade e complicações do ciclo grávido-puerperal. Sendo assim, indicam-se procedimentos para a detecção de distúrbios tireoideos em diversas situações clínicas relacionadas à função reprodutiva feminina. Além disso, a função tireoidea deve ser cuidadosamente avaliada em mulheres com hipotireoidismo durante a gestação ou quando submetidas à estrogenioterapia. Dessa maneira, a função e as doenças da tireoide são assuntos de interesse para o ginecologista. É fundamental a conscientização do profissional que presta assistência à saúde da mulher em relação aos diversos aspectos relacionados às interações entre a tireoide e a função reprodutiva feminina.
Since the 19th century the interrelation between thyroid and sex organs function is recognized. In fact, there are evidences that estrogens act indirectly on the thyroid gland. Postmenopausal women can show altered thyroid function tests. It has been shown in animals and in humans that gonadectomy and estrogens treatment exert effects on thyroid gland. Also, thyroid dysfunction is associated with reproductive dysfunction in women. Both hyper and hypothyroidism may result in menstrual disturbances, infertility, abortion and complicated pregnancy. Tests for detection of thyroid disorders should be performed in women in many situations related to reproductive function. Patients with hypothyroidism should be strictly monitored during pregnancy and hormone replacement therapy with estrogens. Thus, thyroid dysfunction should be a point of interest for gynecologists. Practitioners providing health care for women should be aware of the consequences related to the interactions between these two endocrine systems .
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Feminino , Distúrbios Menstruais/etiologia , Doenças da Glândula Tireoide/epidemiologia , Estrogênios/uso terapêutico , Glândula Tireoide , Glândula Tireoide/fisiopatologia , Hormônios Tireóideos/fisiologia , Saúde da MulherRESUMO
We aimed to analyze the effects of raloxifene and estrogen on thyroid gland morphology of ovariectomized rats. Raloxifene treatment led to effects similar to those of estrogen on thyroid glands from ovariectomized rats, so that both were able to normalize the changes detected after ovariectomy.