Trans-abdominal cervical cerclage revisited
Published on: 18th June, 2019
OCLC Number/Unique Identifier: 8165593316
Changes in contemporary obstetric and gynaecological practice in relation to ultrasound cervical screening during pregnancy, the treatment of intra-epithelial cervical neoplasia and laparoscopic surgery have resulted in an increased utilization of trans-abdominal cervico-isthmic cerclage in an attempt to reduce the incidence of mid-trimester and early preterm birth in women with repeated pregnancy loss.
Anal cytology in immunocompetent patients with high-grade intraepithelial neoplasia (CIN II and CIN III)
Published on: 13th February, 2020
OCLC Number/Unique Identifier: 8550959427
Introduction: Anal cancer is directly related to the presence of high-grade HPV. Immunocompromised patients have defined conducts, something which is not observed in immunocompetent patients.
Objective: To study the anal cytology of patients with high-grade intraepithelial neoplasia (CINII and III) in order to propose a protocol to be followed by the Oncology Gynaecology Service at the Samuel Libânio Clinical Hospital (HCSL).
Methods: Clinical, prospective, transversal and single-centered study. Sampling was by convenience within one year. A total of 150 patients were studied. Out of these, 76 were patients with high-grade cervical intraepithelial lesions diagnosed through histopathological examination of the uterine cervix (Study Group) and 74 without high-grade intraepithelial lesions and with cervical cytology negative for neoplasia (Control Group). The following variables were analyzed: age, sexarc, tobacco use, alcohol consumption, STD history (not HPV), menopause, Hormone Replacement Therapy, anal sex practice, parity, number of sexual partners and contraceptive use.
Results: There was no significant difference between the number of cases in altered anal cancer oncology in the study group, in comparison with the control group.
Conclusion: There were changes in the anal cytology of the study group and these should be evaluated due to the risk of dealing with pre-neoplastic anal lesion. Clinical Trials: NCT03241680.
A case report on Meigs’ syndrome and elevated serum CA-125: A rare case report
Published on: 24th March, 2021
OCLC Number/Unique Identifier: 9038781665
Meigs syndrome is an uncommon presentation, where a benign ovarian neoplasia presents along with ascites and pleural effusion. About 1% of ovarian neoplasia can present as Meigs syndrome. Patients with Meigs’ syndrome and elevated serum CA-125 are not frequently reported. We report a case of a 50-year-old women who presented with shortness of breath, cough, weight loss of one and half month duration. Chest radiograph of the patient with clinical examination of patient confirms pleural effusion as cause of progressive shortness of breath. The presence of a pelvic mass and elevated serum CA-125, which raised the possibility of malignancy. After complete resection of tumor, the pathologic reports confirmed a benign ovarian neoplasia. We highlight the importance of suspicion, careful general examination, radiological assessment and histological tests to confirm the diagnosis of Meigs’ syndrome.
Evaluation of Uranium in Organs of Residents from an Uranium-Rich Region using Teeth as Bioindicators
Published on: 26th March, 2020
OCLC Number/Unique Identifier: 8588716918
The Uranium extraction and processing plant of INB (Brazilian Nuclear Industries) is in Caetité, a city located in a region hosting the largest Uranium reserve of the country. The degree of Uranium contamination in the Caetité population was investigated before using teeth as bioindicator, where a quite high Uranium concentration was measured in this region, about 160 times higher than the world-wide average. Radiobiological risks are here evaluated from Uranium burdens in organs as skeleton, kidneys, liver, tissues and blood, which were estimated from transfer coefficients and effective internal doses. This was accomplished by means of calculations with the use of the STATFLUX/ICRP approach, plus a set of Uranium transfer rate parameters as function of individual’s age assuming an uninterrupted exposure over a period of 60 years. It was found that U ingestion rates by residents of Caetité are three orders of magnitude higher than worldwide average, indicating that food and water would exhibit high levels of contamination. Calculated effective internal doses range from a minimum of one to a maximum of three orders of magnitude higher than background doses, for blood and bones respectively. The likelihood that this circumstance could lead to serious health problems as e.g. neoplasia is addressed. The methodology presented in this work offers subsidies for further studies on environmental pollution by radionuclides.
Age as a Predictor of Time to Response for Patients Undergoing Medical Management of Endometrial Cancer
Published on: 4th October, 2023
Objective: To explore the pathologic response rate to primary progesterone treatment in patients with Endometrial Intraepithelial Neoplasia (EIN) and early-stage endometrioid-type Endometrial Adenocarcinoma (EAC).Methods: Retrospective chart data were collected for patients with either EIN or EAC receiving primary progesterone treatment between 2015 and 2022. The presence of complete or partial response, time to response, and other demographic and treatment factors were recorded to determine independent predictors of response to progestin treatment.Results: In total, 112 women who were diagnosed with EIN or EAC were treated with upfront progestin therapy, of whom 79 had sufficient follow-up to assess response. Fifty patients (63%) responded, of whom 10 (20%) ultimately relapsed. Response was more robust among patients with EIN (79%, n = 33) compared with patients who had cancer (46%, n = 17). The median time to respond was 5.8 months overall. Diagnosis of EIN, younger age at diagnosis, and any pathologic evidence of progesterone effect were all predictors of treatment response. Younger patients had a significantly shorter time to partial or complete response with a median time to response of 5.9 months in patients ≤ 45 and 13.8 months in patients > 45. Conclusion: Our study demonstrated a lower overall response rate (63%) than reported in previous studies, especially for patients with cancer (46%). Younger patients had a significantly shorter time to respond than older patients. Pathologic progesterone effect observed at any time during treatment was a significant predictor of treatment response regardless of diagnosis and could serve as an early predictor of response to therapy.
Primary Diffuse Leptomeningeal Melanocytosis: A Rare and Challenging Diagnosis
Published on: 17th April, 2024
Primary melanocytic neoplasms of the central nervous system are rare entities and can present in different clinical forms with mild and non-specific symptoms (such as headache and tinnitus) to severe and limiting symptoms (focal deficits and intracranial hypertension), mimicking the most diverse pathologies. In addition to the peculiar changes in imaging tests, diagnosis is always a challenge given the multitude of possible differential diagnoses, including aseptic meningitis. Given this, we bring here the case of a 59-year-old patient who attended care due to headache and vertigo followed by involvement of the cranial nerves and spinal cord, corroborated by physical examination and imaging study suggesting diffuse involvement of the meninges, which was subsequently confirmed by anatomopathological examination as a primary melanocytic neoplasm of the central nervous system but ended up dying due to complications resulting from late diagnosis. The objective of this work is to raise awareness about the possibility of this pathology as a differential diagnosis in these cases where there are often frustrating clinical manifestations but with changes in imaging tests, to enable an early diagnosis and consequently the possibility of a better therapeutic result, in addition to a brief review of the propaedeutic findings of this pathology.
Hepatic Pseudolymphoma Mimicking Neoplasia in Primary Biliary Cholangitis: A Case Report
Published on: 19th December, 2024
Visualizing a nodule in the liver parenchyma of a patient with chronic liver disease raises the suspicion of hepatic malignancy. We report here the case of a 63-year-old female with primary biliary cholangitis (PBC) in whom a hepatic pseudolymphoma (HPL) was incidentally detected. This fairly rare lesion mimics primary liver cancer, has no specific radiological features, and requires histology for a definite diagnosis. This tumor-like lymphoid liver proliferation has been reported in clinical situations with immune-mediated inflammation including PBC. It can be observed in many organs but very rarely in the liver. The diagnosis of HPL should be considered when detecting a liver nodule in a patient with this particular chronic cholestatic liver disease.
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