RESUMO
Abstract The association between plasmacytomas and multiple myeloma (MM) is well-described, and in about one third of the cases of plasmacytoma the additional study will lead to the diagnosis of MM. The finding of plasmacytomas in the genital tract is extremely rare, with sparse cases described in the literature, and these cases pose a challenge regarding the optimal guidance and treatment. This paper describes a case of uterine extramedullary plasmacytoma in a 79-year-old woman with complaints of postmenopausal abnormal uterine bleeding. The complementary study led to the diagnosis of uterine plasmacytoma and, subsequently, of MM. Despite the unfavorable outcome of this case, we consider pertinent to report it because it constitutes a differential diagnosis to be taken into account in the approach of pelvic masses.
Resumo A associação entre plasmocitomas e mieloma múltiplo (MM) encontra-se bem demonstrada, e em cerca de um terço dos casos de plasmocitoma o estudo adicional conduzirá ao diagnóstico de MM. O achado de plasmocitomas no trato genital é extremamente raro, havendo um número muito limitado de casos descritos na literatura, o que dificulta concluir sobre a melhor forma de orientação e tratamento destes casos. O presente trabalho descreve um caso de plasmocitoma extramedular uterino em mulher de 79 anos estudada por queixas de hemorragia uterina anômala pós-menopáusica. O estudo complementar levou ao diagnóstico de plasmocitoma uterino e, posteriormente, de MM. Apesar do desfecho desfavorável do caso, consideramos pertinente o seu relato por se tratar de um diagnóstico diferencial a levar em consideração na abordagem de massas pélvicas.
Assuntos
Humanos , Feminino , Idoso , Mieloma Múltiplo/diagnóstico , Plasmocitoma/etiologia , Neoplasias Uterinas/etiologia , Mieloma Múltiplo/complicaçõesRESUMO
The association between plasmacytomas and multiple myeloma (MM) is well-described, and in about one third of the cases of plasmacytoma the additional study will lead to the diagnosis of MM. The finding of plasmacytomas in the genital tract is extremely rare, with sparse cases described in the literature, and these cases pose a challenge regarding the optimal guidance and treatment. This paper describes a case of uterine extramedullary plasmacytoma in a 79-year-old woman with complaints of postmenopausal abnormal uterine bleeding. The complementary study led to the diagnosis of uterine plasmacytoma and, subsequently, of MM. Despite the unfavorable outcome of this case, we consider pertinent to report it because it constitutes a differential diagnosis to be taken into account in the approach of pelvic masses.
A associação entre plasmocitomas e mieloma múltiplo (MM) encontra-se bem demonstrada, e em cerca de um terço dos casos de plasmocitoma o estudo adicional conduzirá ao diagnóstico de MM. O achado de plasmocitomas no trato genital é extremamente raro, havendo um número muito limitado de casos descritos na literatura, o que dificulta concluir sobre a melhor forma de orientação e tratamento destes casos. O presente trabalho descreve um caso de plasmocitoma extramedular uterino em mulher de 79 anos estudada por queixas de hemorragia uterina anômala pós-menopáusica. O estudo complementar levou ao diagnóstico de plasmocitoma uterino e, posteriormente, de MM. Apesar do desfecho desfavorável do caso, consideramos pertinente o seu relato por se tratar de um diagnóstico diferencial a levar em consideração na abordagem de massas pélvicas.
Assuntos
Mieloma Múltiplo/diagnóstico , Idoso , Feminino , Humanos , Mieloma Múltiplo/complicações , Plasmocitoma/etiologia , Neoplasias Uterinas/etiologiaRESUMO
In Yucatan, Mexico, chronic exposure of Mayan population to pesticides is expected as about 30 per cent are drinking polluted water. Residues of organochlorine pesticides (OCP) were monitored in 18 municipalities of Yucatan with high mortality rates due to uterine cervix cancer. 70 blood samples collected from Mayan women living in livestock, agricultural and metropolitan area were analyzed for OCP. Solid Phase Extraction was performed on C18 cartridges and analyzed by Gas Chromatography with Electron Capture Detector. The results showed that the highest OCP levels were detected in blood of women living in the livestock area. OCP detected were endosulfan I (7.35 µg/mL), aldrin (3.69 µg/mL), 4,4' DDD (2.33 µg/mL), 1.39 and 1.46 µg/mL of δ-HCH. Women from the agricultural area had high concentrations of OCP in their blood, particularly dieldrin (1.19 µg/mL), and 1.26 µg/mL of 4,4' DDE. In the metropolitan area, 0.080 µg/mL of γ-HCH and 0.064 µg/mL of heptachlore were detected. This monitoring study was also based on epidemiological data of uterine cervical cancer. It was found that environmental factors may have facilitated the infiltration of OCP to the aquifer used for potable water supply. These factors in addition to poverty can have impacts on public health. This first exploratory study suggests that monitoring of OCP in human is important for the establishment of health promotion programs. The integrative analysis of both, environmental and social factors would be helpful to characterize the bioaccumulation of pesticides in humans.
Assuntos
Hidrocarbonetos Clorados/sangue , Hidrocarbonetos Clorados/toxicidade , Resíduos de Praguicidas/sangue , Resíduos de Praguicidas/toxicidade , Neoplasias Uterinas/etiologia , Poluentes Químicos da Água/sangue , Poluentes Químicos da Água/toxicidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Agricultura , Colo do Útero/fisiopatologia , Cromatografia Gasosa , Monitoramento Ambiental , Feminino , Água Subterrânea/química , Hexaclorocicloexano , Humanos , México , Pessoa de Meia-Idade , Neoplasias Uterinas/fisiopatologiaRESUMO
Hereditary Leiomyomatosis and Renal Cell Cancer Syndrome (HLRCC) is a rare disease and since the first report, it has been found in just over 200 families approximately, around the world (Smit et al. in Clin Genet 79:49-59, 2009). Patients in Colombia or in Latin America have not been described, as far as we know. HLRCC is inherited in an autosomal dominant manner, and it is caused by heterozygous germline mutations in the FH gene, which encodes the fumarate hydratase enzyme. It is characterized mainly by the appearance of cutaneous and uterine leiomyomas, and an early-onset, aggressive form of type 2- papillary renal cell carcinoma (Smit et al. in Clin Genet 79:49-59, 2009; Schmidt and Linehan in Int J Nephrol Renovasc Dis 7:253-260, 2014]. We report a Colombian family with HLRCC syndrome, with a novel mutation in FH gene (c.1349_1352delATGA) in which cutaneous leiomyomas have not been found, but other clinical manifestations such as type 2- papillary renal cell carcinoma, uterine leiomyomas and rare tumors were present. This investigation constitutes the first report of HLRCC syndrome in Colombia, and probably in Latin America.
Assuntos
Fumarato Hidratase/genética , Leiomiomatose/etiologia , Mutação , Síndromes Neoplásicas Hereditárias/etiologia , Neoplasias Cutâneas/etiologia , Neoplasias Uterinas/etiologia , Adulto , Idoso , Criança , Colômbia , Feminino , Humanos , Leiomiomatose/genética , Masculino , Pessoa de Meia-Idade , Síndromes Neoplásicas Hereditárias/genética , Linhagem , Neoplasias Cutâneas/genética , Neoplasias Uterinas/genética , Adulto JovemRESUMO
A correlação entre Trichomonas vaginalis (T. vaginalis) e o desenvolvimento do câncer cervical foi estabelecida. Uma revisão sistemática baseada em artigos originais (padrão ouro) foi conduzida a partir de duas importantes bases eletrônicas: PubMed e MEDLINE. A partir das bases de dados Medical Subject Headings (MeSH) e Descritores em Ciências da Saúde (DeCS) os seguintes termos "T. vaginalis & uterine cervical neoplasms" e "T. vaginalis & signal transduction" foram buscados. Critérios de inclusão e exclusão foram estabelecidos considerando as características específicas de cada artigo visando garantir a qualidade dos artigos selecionados (testes de relevância 1 e 2). Com relação aos efeitos patogênicos de T. vaginalis, o teste de relevância 1 selecionou 13 artigos de ambas as bases, PubMed e MEDLINE, enquanto o teste de relevância 2 finalizou com 8 artigos. Os estudos selecionados demonstraram correlação entre T. vaginalis e neoplasia cervical, apontando os efeitos citopatogênicos do parasito e enfatizando a importância das vias de sinalização, tais como as proteínas mitógenoativadas (MAPK).(AU)
A correlation between Trichomonas vaginalis (T. vaginalis) and the development of cervical cancerwas investigated. A systematic review based on original articles (the gold standard) was conducted by performing a search of two major electronic databases, PubMed and MEDLINE. The search was performed by using the exploded MeSH and DeCS terms "T. vaginalis & uterine cervical neoplasms" and "T. vaginalis & signal transduction". Inclusion and exclusion criteria were assessed using specific characteristics to determine whether the quality of each article was high enough to warrant selection (the first and second tests of relevance). With reference to the cytopathogenic effects of T. vaginalis, the first test of relevance selected13 articles from both databases, PubMed and MEDLINE, whereas the second test of relevance selected8 articles. The studies selected showed a correlation between T. vaginalis and cervical neoplasia, demonstrating the cytopathogenic effects of the parasite and highlighting the importance of cell signaling pathways such as the mitogen-activated protein kinase (MAPK) pathway.(AU)
Assuntos
Humanos , Feminino , Trichomonas vaginalis/patogenicidade , Vaginite por Trichomonas/diagnóstico , Neoplasias Uterinas/etiologia , Transdução de Sinais , Bases de Dados Bibliográficas , Técnicas Histológicas , Teste de PapanicolaouRESUMO
BACKGROUND: Isoflavones and lignans are phytoestrogens, and therefore, are able to bind to and activate estrogen receptors. The resultant estrogenic or antiestrogenic effect is dependent on the concentration of these phytoestrogens relative to endogenous estrogens and the site of their action, among others. Thus, isoflavones and lignans act as selective estrogen receptor modulators; having a beneficial effect in some tissues while simultaneously causing deleterious changes in others. OBJECTIVE: This case-control study investigates the relationship between urinary concentrations of genistein, daidzein, equol, and enterolactone, and the presence of uterine leiomyomas (fibroids) in Jamaican women. DESIGN: Phytoestrogen concentration in spot urine samples from 157 uterine fibroid cases and 171 fibroid-free controls diagnosed by ultrasonography, were assessed by Time-resolved Fluoroimmnoassay. Statistical evaluations were performed using SPSS 12.0. RESULTS: The median concentration of urinary enterolactone was significantly different between uterine fibroid cases and controls (p=0.029). However, this was not observed to affect risk of uterine fibroid, as trends across quartiles of urine enterolactone did not differ significantly between cases and controls. Median urinary genistein (p=0.510), daidzein (p=0.838), equol (p=0.621), total isoflavones (0.510) and total phytoestrogens (p=0.084) were similar for both groups. Binary logistic regression analysis of quartiles of urine genistein, daidzein, equol, enterolactone, total isoflavones, and total phytoestrogens showed no association with uterine fibroid. CONCLUSIONS: Uterine fibroid cases had a higher median urine concentration of enterolactone compared with controls. However, this was not observed to affect ones risk of fibroid. Neither was urine genistein, daidzein, equol total isoflavones, and total phytoestrogens observed to be associated with risk of uterine fibroid.
Assuntos
Isoflavonas/urina , Leiomioma/epidemiologia , Fitoestrógenos/urina , Neoplasias Uterinas/epidemiologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Jamaica/epidemiologia , Leiomioma/etiologia , Leiomioma/urina , Fatores de Risco , Neoplasias Uterinas/etiologia , Neoplasias Uterinas/urina , Saúde da MulherRESUMO
Los tumores müllerianos mixtos malignos o carcinosarcomas son neoplasias poco frecuentes y altamente agresivas que suelen presentarse en pacientes mayores de 60 años, generalmente en forma de metrorragia posmenopáusica y/o presencia de masas uterinas. Entre los factores de riesgo reconocidos está descrita la historia de irradiación previa del área pélvica. Presentamos 3 casos clínicos de pacientes diagnosticadas y tratadas de tumores müllerianos mixtos uterinos malignos, existiendo en todos ellos el antecedente de neoplasias que habían precisado radioterapia pélvica como parte de su tratamiento.
The malignant Mullerian mixed tumors are rare and highly aggressive, these tumors usually occur in women over 60 years and the most common clinical appearance is that of postmenopausal vaginal bleeding or the presence of uterine mass. As a risk factor is described the history of prior irradiation of the pelvic area. We reported the case of three patients with mullerian mixed tumors, in all these cases the patients have a history of cancer who required pelvic radiation as part of their treatment.
Assuntos
Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Neoplasias Uterinas/cirurgia , Neoplasias Uterinas/diagnóstico , Radioterapia Adjuvante/efeitos adversos , Tumor Mulleriano Misto/cirurgia , Tumor Mulleriano Misto/diagnóstico , Histerectomia , Metrorragia/etiologia , Neoplasias Uterinas/etiologia , Pós-Menopausa , Tumor Mulleriano Misto/etiologiaRESUMO
OBJETIVO: Verificar a mudança na qualidade de vida de pacientes portadoras de miomatose uterina sintomática submetidas a tratamento por embolização. MATERIAIS E MÉTODOS: Quarenta mulheres portadoras de miomatose uterina sintomática que foram tratadas com a técnica de embolização responderam a um questionário de qualidade de vida antes e 12 semanas após o procedimento. RESULTADOS: Verificou-se que o escore médio relacionado com a gravidade dos sintomas nas 40 pacientes antes da embolização foi de 62,07 ± 6,34 e se modificou, com significância estatística após o tratamento, quando se verificou escore médio de 20,42 ± 3,81. Da mesma forma, comprovou-se a melhora na qualidade de vida pela modificação dos escores antes e depois do tratamento, o que também apresentou significância estatística, passando de 40,26 ± 2,98 para 85,06 ± 2,57. CONCLUSÃO: A embolização uterina provoca alívio evidente dos sintomas relacionados com a miomatose e proporciona melhora substancial da qualidade de vida das pacientes.
OBJECTIVE: To determine the impact on the quality of life in patients with symptomatic uterine fibroids submitted to uterine artery embolization. MATERIALS AND METHODS: Forty patients with symptomatic fibroids submitted to embolization have answered a quality-of-life questionnaire before and 12 weeks after the procedure. RESULTS: Mean score for symptoms severity before the procedure was 62.07 ± 6.34 and decreased with statistical significance to 20.42 ± 3.81 after the procedure. Similarly, scores for quality of life have improved from 40.26 ± 2.98 before the procedure to 85.06 ± 2.57 after the procedure, which again was statistically significant. CONCLUSION: Uterine embolization results in evident symptoms relief and significant improvement in the quality of life of patients with symptomatic fibroids.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Embolização Terapêutica , Leiomioma , Leiomioma/diagnóstico , Leiomioma/terapia , Neoplasias Uterinas/etiologia , Qualidade de Vida , Neoplasias Uterinas , Embolização Terapêutica/tendências , Inquéritos e Questionários , Radiologia IntervencionistaRESUMO
OBJECTIVE: To establish the association between high-grade intraepithelial lesions and cervical-uterine-cancer, and the infection by human papillomavirus, genetic antecedents, socioeconomics, sexual behavior and gynecology and obstetrics factors in women of the State of Nayarit, Mexico. MATERIALS AND METHODS: With a case-control design were studied 66 cases of high-grade intraepithelial lesions and cervical-uterine-cancer, and 132 controls. The information upon the risk factors was obtained by the application of a structured questionnaire. Polymerase Chain Reaction executed the virus identification. In the statistical analysis the association was obtained by odds ratio. The statistical significance was evaluated by the chi-square-Fisher and Student t tests, and multivariate logistic regression was used to explain the factors' influence. RESULTS: In women with high-risk squamous intraepithelial lesions and cervical-uterine-cancer, the most frequently high-risk human papillomavirus found were: 18, 35, 58, 16, 31, 33 and 51. CONCLUSIONS: Familial data of cervical-uterine-cancer, socioeconomic level, number of sexual partners, data of sexual transmitted diseases, and infection due to human papillomavirus 18 and 35 are the factors related to high-risk squamous intraepithelial lesions and cervical-uterine-cancer.
Assuntos
Papiloma/epidemiologia , Papiloma/etiologia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/etiologia , Neoplasias Uterinas/epidemiologia , Neoplasias Uterinas/etiologia , Adulto , Idoso , Área Programática de Saúde , Feminino , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
OBJECTIVE: To describe 6 cases of gestational trophoblastic disease (GTD) in ectopic pregnancy admitted to Hospital Universitario de Caracas (HUC). STUDY DESIGN: Medical records of 6 patients admitted to the Obstetrics and Gynecology Department, HUC, from 1996 to 2004 were reviewed. They underwent surgery with a diagnosis of ectopic pregnancy, and histologic analysis revealed GTD. Clinical trends were analyzed. RESULTS: The prevalence of GTD in ectopic pregnancy was 0.16:1,000 deliveries. The mean patient age was 29 years. The preceding gestation was a term delivery in 4 and abortion in 2. The mean gestational age at admission was 8 weeks. All patients complained of abdominal pain, and 3 of them also had vaginal bleeding. Ultrasound revealed an adnexal tumor in 5 cases; this tumor and hemoperitoneum (6 cases) were the most frequent surgical findings. Histopathologic diagnosis was partial mole in 5 and choriocarcinoma in 1. Four patients were lost to follow-up. CONCLUSION: In this series the prevalence of ectopic GTD was high. The condition can mimic the usual symptoms of ectopic pregnancy, especially when a hemoperitoneum is present. It is important to apply strict histologic criteria for GTD when a sample of ectopic pregnancy is analyzed and to monitor those patients with careful human chorionic gonadotropin follow-up.
Assuntos
Doença Trofoblástica Gestacional/epidemiologia , Neoplasias Uterinas/epidemiologia , Adulto , Feminino , Doença Trofoblástica Gestacional/diagnóstico , Doença Trofoblástica Gestacional/etiologia , Doença Trofoblástica Gestacional/patologia , Humanos , Prontuários Médicos , Gravidez , Resultado da Gravidez , Diagnóstico Pré-Natal , Prevalência , Estudos Retrospectivos , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/etiologia , Venezuela/epidemiologiaRESUMO
OBJECTIVE: To review the prenatal complications, management, and perinatal outcome in pregnancies complicated by placental chorioangioma. METHODS: Cases of placental chorioangioma diagnosed prenatally as part of a prospective, multicentric program for fetal diagnosis and therapy were identified. All cases were evaluated with color flow imaging. In the latter part of the study, three-dimensional power Doppler angiography was also used to study the vascular pattern of the tumor. Information on maternal demographics, prenatal sonographic findings, pregnancy complications, antenatal intervention, and perinatal outcome was obtained by reviewing the medical records or contacting the referring obstetricians. RESULTS: In the 5-year period from January 1997 to December 2001, 11 cases of placental chorioangioma were diagnosed prenatally. Nine cases were diagnosed in singleton and two in twin pregnancies. Among the nine cases occurring in singletons, five (56%) were associated with pregnancy complications, including polyhydramnios (n = 3), oligohydramnios (n = 2), fetal growth restriction (n = 2), and nonimmune hydrops (n = 1). Amniodrainage was required in one of these cases, allowing prolongation of pregnancy until term. Four (44%) singletons delivered before 35 weeks. Overall, two fetuses died, including one twin due to complications of twin-twin transfusion syndrome and another with hydrops after alcohol injection into the chorioangioma. In four pregnancies, no prenatal complications were detected in spite of continuous growth and vascularity of the placental mass in three of them. CONCLUSION: Placental chorioangioma is associated with an increased risk of pregnancy complications, the most common being polyhydramnios and preterm delivery. In selected cases, amniodrainage allows continuation of the pregnancy with improving perinatal outcome. Fetuses who develop hydrops are at the highest risk for perinatal death, with limited therapeutic options being available. Close follow-up is advised, even in those cases with no associated findings at the time of the diagnosis.
Assuntos
Hemangioma/epidemiologia , Doenças Placentárias/epidemiologia , Resultado da Gravidez , Diagnóstico Pré-Natal , Neoplasias Uterinas/epidemiologia , Adulto , Angiografia , Chile/epidemiologia , Feminino , Hemangioma/diagnóstico , Hemangioma/diagnóstico por imagem , Hemangioma/etiologia , Humanos , Prontuários Médicos , Doenças Placentárias/diagnóstico , Doenças Placentárias/diagnóstico por imagem , Doenças Placentárias/etiologia , Gravidez , Estudos Prospectivos , Estudos Retrospectivos , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/etiologiaRESUMO
OBJETIVO: Apresentar os resultados da experiência clínica inicial de 100 casos de mulheres portadoras de miomatose sintomática que foram submetidas a embolização das artérias uterinas como forma de tratamento principal. Apresenta-se, também, extensa revisão bibliográfica sobre o tema, para determinar as indicações e contra-indicações, bem como as eventuais complicações do método. MATERIAL E MÉTODO: Cem pacientes com miomatose sintomática foram submetidas a embolização das artérias uterinas como única forma de tratamento. O principal sintoma que indicou a intervenção foi o aumento do fluxo menstrual em 79 pacientes e dor associada à miomatose em 21. O diagnóstico de miomatose foi realizado por meio de ultra-sonografia em 75 pacientes, e pela associação de ultra-sonografia e ressonância magnética em 25 pacientes. O volume uterino médio avaliado por esses métodos de imagem resultou em 487 cm³. Os procedimentos foram realizados em duas instituições hospitalares: uma pública, onde foram atendidas 56 pacientes dependentes do Sistema Unico da Saúde (SUS), e outra particular, onde foram atendidas 46 pacientes com plano de assistência médica. Setenta e seis pacientes foram avaliadas clinicamente após 12 semanas da realização da embolização uterina. RESULTADOS: O procedimento foi completado com sucesso em 97 por cento dos casos, utilizando-se técnica convencional. O acompanhamento e a avaliação clínica após 12 semanas evidenciou que houve melhora dos sintomas em mais de 90 por cento das pacientes. Verificou-se, ainda, redução de volume uterino de 52 por cento. Não foram observadas complicações técnicas ou clínicas relevantes. CONCLUSÃO: A técnica de embolização uterina para tratamento da miomatose sintomática é um método simples, eficiente e seguro
PURPOSE: To report the initial clinical experience after the treatment of 100 women suffering of symptomatic fibroids who were submitted to uterine artery embolization as the main form of treatment. We also present an extensive review of literature on the subject in order to determine the indications and contra-indications, and the possible complications of this method. MATERIAL AND METHOD: One hundred patients with symptomatic fibroids were submitted to uterine artery embolization as the main form of treatment. The main symptoms that justified the intervention were increased menstrual flow in 79 patients and pain related to the fibroids in 21 patients. Diagnosis was made using ultrasound alone in 75 patients and ultrasound and magnetic resonance imaging in 25 patients. The mean uterine volume measured using these imaging methods was 487cm³. The procedure was performed in two Institutions: 56 procedures in a public Institution in patients attended by the public health system, and 46 patients with health insurance treated in a private clinic. Seventy-six patients were followed clinically during 12 weeks after uterine embolization. RESULTS: The procedure was done with success in 97% of cases using a conventional technique. Clinical follow-up after 12 weeks showed symptomatic improvement in over 90% of the patients. Reductions of the uterine volume of up to 52% were also observed. No relevant technical and/or clinical complications were seen. CONCLUSION: Uterine artery embolization for the treatment of symptomatic fibroids is a simple, efficient and safe procedure.
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Menorragia/complicações , Menorragia/diagnóstico , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/etiologia , Neoplasias Uterinas/terapia , Embolização da Artéria Uterina , Embolização Terapêutica/métodos , Hospitais PúblicosRESUMO
OBJECTIVE: The purpose of this study was to compare gestational trophoblastic disease incidence rates with the use of population-based data. STUDY DESIGN: All incident cases between 1973 and 1997 and live birth, pregnancy, and women at risk were tabulated with the use of data that were derived from the New Mexico Tumor Registry and Vital Records and Health Statistics Annual Reports. Statistical methods included trends analyses, odds ratios, and Poisson regression. RESULTS: Of 939 total cases, 312 non-Hispanic white women, 399 Hispanic white women, 201 American Indian women, and 27 other women were affected. Age-adjusted incidence rates were significantly higher for American Indian women (11.16%) compared with non-Hispanic (3.57%) or Hispanic white women (5.32%); the probability value was <.001. When live birth (1:438 women) and pregnancy (1:486 women) denominators were considered, American Indian women alone were at increased risk, and the ratio increased by 56% over 25 years. American Indian women were also at increased risk for partial mole (relative risk, 4.03; 95% CI, 2.57-6.31), invasive mole (relative risk, 26.7; 95% CI, 7.81-93.14), and choriocarcinoma (relative risk, 6.29; 95% CI, 1.81-22.66) variants. CONCLUSION: American Indians are at increased risk relative to the other predominant ethnic groups in New Mexico. Age-adjusted standardization provided a reproducible measurement that may be applicable across other registries.
Assuntos
Doença Trofoblástica Gestacional/etnologia , Doença Trofoblástica Gestacional/etiologia , Hispânico ou Latino/estatística & dados numéricos , Indígenas Norte-Americanos/estatística & dados numéricos , População Branca/estatística & dados numéricos , Adolescente , Adulto , Criança , Coriocarcinoma/etnologia , Coriocarcinoma/etiologia , Feminino , Humanos , Mola Hidatiforme/etnologia , Mola Hidatiforme/etiologia , Mola Hidatiforme Invasiva/etnologia , Mola Hidatiforme Invasiva/etiologia , New Mexico/epidemiologia , Gravidez , Medição de Risco , Fatores de Risco , Neoplasias Uterinas/etnologia , Neoplasias Uterinas/etiologiaRESUMO
BACKGROUND: Epidemiological studies have suggested that smoking, nutrition and sexual patterns are major risk factors for cervical cancer. AIM: To study the association between food consumption patterns, smoking and sexual behavior and the risk of cervical cancer. MATERIAL AND METHODS: A matched case control study of 170 cases and 340 controls. Food and nutrient intakes were assessed by a food frequency questionnaire considering 58 antioxidant rich food items. Median daily intake of vegetables, fruits, antioxidant vitamins and fiber was calculated. A conditional logistic regression model was used to determine odds ratios associated with variations in nutritional intake and no nutritional factors (age at first delivery, parity, body mass index, family history of cancer and smoking). RESULTS: High intakes of vegetables, fruits, beta carotene, vitamin C, E and fiber were associated with a lower risk of cervical cancer (Odds ratios ranging from 0.56 to 0.78). The risk for cancer was inversely associated with the age at first delivery and directly associated with the total number of pregnancies and smoking. Multivariate analysis model showed a protective effect for vegetable and vitamin E consumption (odds ratio of 0.6 with confidence intervals of 0.5 to 0.8 p < 0.001) and a higher risk associated to smoking (odds ratio 2.8, confidence intervals 1.5-5.5 p < 0.002) and a younger age at the first delivery (odds ratio 3.37 confidence intervals 2-5.3 p < 0.001). CONCLUSIONS: Cervical cancer is associated with reproductive and food consumption behaviors. A higher intake of vegetables and foods rich in vitamin E can reduce its risk.
Assuntos
Dieta/efeitos adversos , História Reprodutiva , Fumar/efeitos adversos , Neoplasias Uterinas/etiologia , Adulto , Estudos de Casos e Controles , Chile/epidemiologia , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Paridade , Fatores de Risco , Neoplasias Uterinas/epidemiologia , Vitamina E/administração & dosagemRESUMO
In this case-control study, the authors analyzed associations of uterine leiomyoma with atherogenic risk factors and potential sources of uterine irritation. The study included 318 case women with uterine leiomyoma that was first confirmed between 1990 and 1993 in the Baltimore, Maryland, area and 394 controls selected from women visiting the same gynecologists' offices for routine reasons. Telephone interviews were conducted with 77.8% of eligible cases and 78.0% of eligible controls. Compared with participants with no hypertension history, increased risks were observed among participants with any history of hypertension (odds ratio (OR) = 1.7; 95% confidence interval (CI): 1.0, 2.8), hypertension requiring medication (OR = 2.1; 95% CI: 1.1, 4.1), hypertension diagnosed at ages less than 35 years (for hypertension requiring medication, OR = 2.7; 95% CI: 1.0, 7.6), and hypertension of 5 or more years' duration (for hypertension requiring medication, OR = 3.1; 95% CI: 1.2, 8.2). Estimates of associations with diabetes history were very imprecise but followed similar patterns. Adjusted associations were observed with pelvic inflammatory disease (three or more episodes vs. none: OR = 3.7; 95% CI: 0.9, 15.9), chlamydial infection (history vs. no history: OR = 3.2; 95% CI: 0.8, 13.7), and use of an intrauterine device when it caused infectious complications (use vs. no use: OR = 5.3; 95% CI: 1.8, 16.3). Risk of uterine leiomyoma was also associated in a graded fashion with frequency of perineal talc use (daily use vs. no use: OR = 2.2; 95% CI: 1.4, 3.1). The authors conclude that nonhormonal factors may influence risk of uterine leiomyoma.
Assuntos
Complicações do Diabetes , Hipertensão/complicações , Leiomioma/epidemiologia , Leiomioma/etiologia , Neoplasias Uterinas/epidemiologia , Neoplasias Uterinas/etiologia , Adolescente , Adulto , Baltimore/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Irritantes , Prontuários Médicos , Pessoa de Meia-Idade , Pré-Menopausa , Estudos Retrospectivos , Fatores de Risco , Infecções Sexualmente Transmissíveis/complicações , TalcoRESUMO
OBJECTIVE: To determine whether further follow-up of a cohort of Chilean women would demonstrate an increased risk of invasive cancer associated with quinacrine sterilization. DESIGN: Cohort study. Cancer cases were evaluated using cohort analyses. SETTING: Santiago and Valdivia, Chile. SUBJECT(S): Fourteen hundred ninety-two women who received transcervical quinacrine pellets for contraceptive sterilization between 1977 and 1989. METHOD(S): Interviews and reviews of medical records. MAIN OUTCOME MEASURE(S): Age- and site-specific incidence of invasive cancers. RESULT(S): During 13,444 person-years of follow-up, 25 invasive cancers were identified, including 8 new cases. This compares with 21.9 expected cancers, based on age-specific rates from the Cali, Colombia, cancer registry. Eight cases of cervical cancer were observed, compared with the 6.3 expected. Since the initial study's confirmation of a single case of leiomyosarcoma, no other noncervical uterine cancers have been diagnosed. The number of observed person-years gives an expectation of 0.62 noncervical uterine cancers. One case of ovarian cancer was diagnosed, compared with the 0.99 expected. CONCLUSION(S): Rates of cancer among women exposed to intrauterine quinacrine are not significantly different from population-based rates.
Assuntos
Neoplasias/etiologia , Quinacrina , Esterilização Reprodutiva/efeitos adversos , Adulto , Neoplasias da Mama/etiologia , Colo do Útero , Estudos de Coortes , Feminino , Seguimentos , Humanos , Neoplasias Ovarianas/etiologia , Quinacrina/administração & dosagem , Sistema de Registros , Fatores de Risco , Esterilização Reprodutiva/métodos , Neoplasias Uterinas/etiologiaRESUMO
Se realizó estudio de tipo descriptivo, de corte transversal, realizado en el servicio de Gineco-Obstetricia del Hospital Escuela "Dr. Oscar Danilo Rosales A" en el período comprendido de julio 1998- junio19 99 a todas las pacientes con diagnostico de masa anexial ingresadas en el servicio de Gineco-Obstetricia. Se estudiarón un total de 39 pacientes que ingresarón al departamento de gineco-obstetricia con diagnóstico de Masa Anexial, el promedio de edad de las mujeres fue de 20-29 años 46.2 porciento, seguido del grupo de 30-39 años con 20.5 porciento y de 15-19 años 12.8 los sintomas más frecuentes fueron: dolor abdominal y sensación de peso en el 97.4 porciento, dismenorrea y dispareunía 82 porciento y malestar general y disuría. En la totalidad de las pacientes se encontró masa pélvica, sangrado transvaginal, fiebre y amenorrea, anemía, hirsutismo, perdida de peso. El medio diagnóstico utilizado fue el USG pelvico, radiografía de abdomen, pielografía intravenosa y colon por enema pero cabe destacar que el diagnóstico definitivo se obtiene con el apoyo del laboratorio anatomopatológico. Los quistes de ovario y embarazo ectópico fuerón los diagnosticos clínicos más frecuentes al igual que los principales hallazgos transoperatorios: La salpingo-oxforectomía
Assuntos
Dissertações Acadêmicas como Assunto , Mioma , Neoplasias Uterinas/classificação , Neoplasias Uterinas/etiologia , Neoplasias Uterinas/fisiopatologiaRESUMO
A miomatose uterina é um problema de saúde comum que traz diversas complicações, como infertilidade, sangramento, compressão de estruturas. Neste estudo, apresentamos uma revisão dessa patologia tão frequente nos consultórios ginecológicos
Assuntos
Humanos , Feminino , Leiomioma/complicações , Infertilidade Feminina/etiologia , Mioma/cirurgia , Neoplasias Uterinas/etiologiaRESUMO
Se tomaron 200 muestras de estudio, frotis cérvico vaginal, en pacientes con vida sexual activa que acudieron a consultorios externos de Ginecoobstetricia del Hospital Goyoneche; de las cuales en 100 pacientes se tomó la muestra de acuerdo al Método de Espátula de Ayre (grupo 1) y en 100 se utilizó el método de tampón vaginal (grupo 2). Se encontró que el 37 por ciento de muestras del grupo 1 fueron satisfactorias, y 2 por ciento del grupo 2. Las muestras satisfactorias pero con lectura limitada predominaron en ambos grupos con 58 por ciento y 92 por ciento para el grupo 1 y 2 respectivamente; la causa de esta limitación en ambos grupos fue la ausecia de componente endocervical en 86,2 por ciento y 100 por ciento para ambos grupos. La Gardnerella fue el microorganismo asociado a cambios relacionados a infección en 20 (95.23 por ciento) y 22 (91.6 por ciento) de muestras positivas. La inflamación es el único cambio reactivo para ambos grupos 80 (80 por ciento) y 50 (50 por ciento) casos. En el grupo 1 se encontró 95 (95 por ciento) muestras sin lesión escamosa intraepitelial (normal) el 5 por ciento restante, 3 por ciento correspondieron a LIE de bajo grado y 2 por ciento a LIE de alto grado. En el grupo 2; 1 (1 por ciento) muestra corresponde a LIE de bajo grado y 1 (1 por ciento) a LIE de alto grado. El nivel de experiencia y el sexo no influyen en la calidad de la toma de muestra, al utilizar el método de Espátula de Ayre en nuestro estudio.