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São José do Rio Preto, Brazil

Perez-Lopez F.R.,University of Zaragoza | Cuadros-Lopez J.L.,University of Granada | Fernandez-Alonso A.M.,Obstetrics and Gynecology Service | Cuadros-Celorrio A.M.,University of Granada | And 2 more authors.
Gynecological Endocrinology | Year: 2010

Objective.To assess fatal cardiovascular disease (FCD) risk among women in early post-menopausal years, as evaluated with the Systematic Coronary Risk Evaluation (SCORE) scale. Design.This was a retrospective study of parallel cohorts. Two hundred seventy-three healthy post-menopausal women. Participants received one of the following hormone treatment (HT) regimens: transdermal estradiol (50μg) (n=99), sequential cyclic HT with transdermal estradiol (50μg/day) plus 200mg/day natural micronised oral progesterone (cycle days 1225) (n=63) and combined HT using transdermal estradiol (50μg) plus 100mg/day of micronised oral progesterone (n=61). A group of women who elected not to use HT served as control group (n=50). SCORE values were assessed before HT or follow up. Results.Only one woman displayed a high-risk SCORE value both before and after 10 years of HT, the remaining had low risk values (<5) for FCD. After 10 years, SCORE values increased significantly as compared to baseline among HT users (all three regimens) and controls. Although post-treatment SCORE values significantly differed among groups, values were all below the high risk cut-off (5). There were no FCD events during the 10 year observation period. Conclusion.As assessed with the SCORE scale, FCD risk in young post-menopausal women (HT users and controls) had a slight significant increase after 10 years, being values in the low risk range. © 2010 Informa UK Ltd.

Marco A.,Servicio de Endocrinologia y Nutricion | Vicente A.,Servicio de Endocrinologia y Nutricion | Castro E.,Servicio de Endocrinologia y Nutricion | Eva Perez C.,Institute of Health science | And 7 more authors.
Thyroid | Year: 2010

Background: Appropriate maternal intake of iodine during pregnancy is essential for maternal thyroxine production and thyroid status of the fetus. It should be possible to enhance iodine intake during pregnancy by using iodine fortified salt or taking iodine supplements. In the present report we determined the status of iodine nutrition in pregnant women who were stratified on the basis of their history of taking or not taking iodized salt or iodine supplements. The study was performed in Toledo (Spain), a region in which prior studies have noted borderline iodine sufficiency. Iodine nutrition was assessed by measuring urinary iodine concentration (UIC) and neonatal thyrotropin (TSH). Methods: UIC was measured in 525 pregnant women. They were grouped according to their history of iodine intake. Diet Group 1 patients (n=69) did not take iodized salt or iodine supplements during pregnancy. Diet Group 2 patients (n=75) took iodized salt but not iodine supplements during pregnancy. Diet Group 3 patients (n=381) took iodine supplements during pregnancy. Plasma determinations included TSH, free thyroxine, thyroid peroxidase antibody, and thyroglobulin antibody. UIC was measured in a single urine sample from all the pregnant women. Neonatal TSH was measured in capillary spot blood from all the neonates as part of a screening for congenital metabolic abnormalities. Results: The median UIC in all subjects was 164μg/L (interquartile range [IR]: 116-245). The median UICs in Diet Groups 1, 2, and 3 were 134.5 (IR: 90-196), 146 (IR: 103-205), and 183 (IR: 124-261) μg/L, respectively (p=not significant [NS] for Diet Group 1 vs. 2; p<0.01 for Diet Group 2 vs. 3; all other comparisons NS). The median (IR) TSH of the neonates in all Diet Groups was 1.0 (IR: 0.7-1.6) μU/mL. Only 2 neonates had blood TSH concentrations >5mU/L. Neonatal blood TSH concentrations were similar in all Diet Groups. Conclusions: In a region with a history of borderline iodine deficiency the UICs were below 150μg/L in a substantial percentage of pregnant women who did not take iodine supplements, regardless of whether or not they took iodized salt. Our results support the use of iodine supplements from the start of the pregnancy, or even before pregnancy in women who live in regions with a history of even small degrees of iodine deficiency. In addition, neonate TSH screening is not the best tool to assess whether the iodine status in populations is ideal. © Copyright 2010, Mary Ann Liebert, Inc.

Fochi M.M.L.,Immunogenetics Laboratory | Fochi M.M.L.,FAMERP Toxoplasma Research Group | Baring S.,Obstetrics and Gynecology Service | Spegiorin L.C.J.F.,Obstetrics and Gynecology Service | And 7 more authors.
PLoS ONE | Year: 2015

Gestational Toxoplasma gondii infection is considered a major risk factor for miscarriage, prematurity and low birth weight in animals. However, studies focusing on this topic in humans are scarce. The objective of this study is to determine whether anti-Toxoplasma gondii maternal serum profiles correlate prematurity and low birth weight in humans. The study examined 213 pregnant women seen at the High-Risk Pregnancy Hospital de Base, São José do Rio Preto, São Paulo, Brazil. All serological profiles (IgM-/IgG+; IgM-/IgG-; IgM +/IgG+) were determined by ELISA commercial kits. Maternal age, gestational age and weight of the newborn at birth were collected and recorded in the Statement of Live Birth. Prematurity was defined as gestational age <37 weeks and low birth weight ≤ 2499 grams. The t-test was used to compare values (p < 0.05). The mean maternal age was 27.6±6.6 years. Overall, 56.3% (120/213) of the women studied were IgM-/IgG+, 36.2% (77/213) were IgM-/IgG- and 7.5% (16/213) were IgM+/IgG+. The average age of the women with serological profile IgM+/IgG+ (22.3±3.9 years) was different from women with the profile IgM-/IgG+ (27.9±6.7 years, p = 0.0011) and IgM-/IgG- (27.9±6.4 years, p = 0.0012). There was no statistically significant difference between the different serological profiles in relation to prematurity (p = 0.6742) and low birth weight (p = 0.7186). The results showed that prematurity and low birth weight did not correlate with anti-Toxoplasma gondii maternal serum profiles. Copyright: © 2015 Fochi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Arnau B.,Obstetrics and Gynecology Service | Jovell E.,Epidemiology Service | Redon S.,Obstetrics and Gynecology Service | Canals M.,Obstetrics and Gynecology Service | And 2 more authors.
Acta Obstetricia et Gynecologica Scandinavica | Year: 2013

We investigated the efficacy of 5% lidocaine 25 mg-prilocaine 25 mg/g cream (EMLA®) applied to the uterine cervix for reducing pain during diagnostic or operative hysteroscopy, using a visual analogue scale (VAS) for pain in a prospective randomized, non-blinded, controlled study in 92 successive patients. Patients were randomized to either 3 mL of EMLA cream or 3 mL of ultrasound gel (placebo), placed endocervically and exocervically, 10 min before hysteroscopy. Intensity of pain was evaluated immediately after the procedure using a 10-cm VAS. No differences were found between the two groups (p = 0.07). The number of women who wished to stop the procedure was significantly lower in the EMLA group compared with the control group (p = 0.013). We concluded that topical instillation of EMLA does not decrease pain during hysteroscopy, but does reduce a desire to abandon the procedure. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Solares C.,Obstetrics and Gynecology Service | Velasco J.,Pathology Service | Alvarez-Ruiz E.,Obstetrics and Gynecology Service | Gonzalez-Fernandez L.,Obstetrics and Gynecology Service | And 3 more authors.
Anticancer Research | Year: 2015

Aim: To determine if positive dual staining of p16/Ki-67 in cytology samples from women with atypical squamous cells of undetermined significance (ASC-US), lowgrade squamous intraepithelial lesion (LSIL) or normal cytological reports with presence of high-risk human papillomavirus (HPV), helps in predicting the risk of developing high-grade cervical lesions during one-year of follow-up after a normal initial colposcopy. Materials and Methods: One-hundred and sixty women with ASC-US, LSIL or otherwise normal cytology, but with the presence of high-risk HPV, were referred to the colposcopy Unit of our Hospital. Cytology and HPV testing were repeated and dual staining of p16/Ki-67 performed on a new cytological specimen, and subsequently patients were colposcopically assessed and prospectively followed-up for one year, after which the colposcopy was repeated. An optional intermediate colposcopical assessment after six months was also offered. Results: Out of 143/160 women with a normal initial colposcopy, 13 were ultimately lost to follow-up. Out of the remaining 130, nine developed histologically verified cervical intraepithelial neoplasia or higher grade (CIN2+) lesions during the one-year follow-up period. Two thirds of them (6/9) were initially p16/Ki-67-positive. Conclusion: Biomarker detection may identify women at higher risk of CIN2+, and these women may benefit from early colposcopic assessment. Women who test negatively for the biomarkers could eventually follow a less aggressive protocol.

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