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Search Results: 1 - 10 of 24036 matches for " Mariano Tamura Vieira Gomes "
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Gene Expression Analysis of Extracellular Matrix and Cytokines after Uterine Artery Embolization  [PDF]
André Bernardo, Tatiana Carvalho de Souza Bonetti, Ismael Dale Cotrim Guerreiro da Silva, Mariano Tamura Vieira Gomes, Rodrigo Aquino Castro, Manoel Jo?o Batista Castello Gir?o, Claudio Emilio Bonduki
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.415132
Abstract: Arterial embolization of myomas (AEM) is an established option for the conservative treatment of uterine leio-myomas; it treats all present uterine nodules at once, is less invasive than other procedures and effective in controlling symptoms, and does not require long term hospitalizations. Nevertheless, the potential impact on endometrial morphological and functional outcomes after the procedure is still controversial based on reports of endometritis or eventual transient ischemia. This study evaluated endometrial reorganization in uterine leiomyoma patients, before and after AEM, through gene expression analyses of extracellular matrix and cytokines genes in theendometrial tissue. Eight patients with leiomyomas were evaluated before AEM and 6 months after. The examinations included transvaginal pelvic ultrasonography, dosing of the follicle-stimulating hormone, and endometrial biopsy during the second phase of the menstrual cycle. RNA was extracted from endometrial samples, cDNA was synthesized, and applied on PCR arrayTM plates to evaluate the expression of extracellular matrix (ECM) genes and cytokines and their receptors’ genes (CYT). The ECM overexpressed genes were MMP (1, 3, 10, 11, and 14), CTGF1, ICAM1, TBHS1, ITGA2, ITGA3, ITGB3, COL7A1, COL12A, SPP1, and TNC; ADAMTS8 was underexpressed. The CYT overexpressed genes were SPP1, BCL6, CXCL12, IL-8, and CEBPB; CXCL13 and CCL21 were underexpressed. The ECM results showed overexpression of proteases that are responsible for dysfunctions in the ECM, and of genes responsible for adhesion and membrane components. The CYT results showed overexpression of chemokines responsible for endometrial repair, and underexpression of cytokines involved in inflammatory processes in the endometrial tissue. AEM treatment did not negatively affect the endometrial function at 6 months after embolization. This study broadens the knowledge about using a procedure that is relevant to the treatment of leiomyomas and contributes to the establishment of future guidelines for the decision making process for physicians and patients.
Impacto da emboliza??o arterial do leiomioma uterino no volume uterino, diametro do mioma dominante e na fun??o ovariana
Bernardo, André;Gomes, Mariano Tamura Vieira;Castro, Rodrigo Aquino;Gir?o, Manoel Jo?o Batista Castello;Bonduki, Claudio Emilio;Yokoyama, Claudio Atsushi;
Revista Brasileira de Ginecologia e Obstetrícia , 2011, DOI: 10.1590/S0100-72032011000800006
Abstract: purpose: to evaluate the impact of uterine artery embolization (uae) on uterine volume (uv), greater myoma diameter (gmd) and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (tvpus) and by the determination of follicle-stimulating hormone (fsh). methods: thirty patients with leiomyomas were submitted to uae. tvpus and fsh determination were performed before and three months after uae. uv was determined in cm3, gmd in cm and fsh in iu/ml. data are reported as as mean standard deviation (sd) and were analyzed statistically by the nonparametric mann-whitney test. results: twenty-nine patients were analyzed. before uae, mean uv was 402.4 165.9 cm3 and gmd was 5.9 2.1 cm. after uae, mean uv was 258.9 118.6 cm3 and gmd was 4.6 1.8 cm. mean fsh concentration was 4.9 3.5 iu/ml before uae and 5.5 4.7 iu/ml after uae, with p=0.5. there was a 35% reduction of uv and a 22% reduction of gmd, with no changes in fsh values after three months. conclusion: the procedure significantly reduced uv and gmd but did not cause a significant increase in fsh levels, thus causing no changes in ovarian function.
Avalia??o da propor??o de colágeno no tecido uterino antes e após tratamento do leiomioma uterino pela emboliza??o arterial
Bonduki, Cláudio Emílio;Dornelas Junior, Gilmar de Oliveira;Bernardo, André;Sim?es, Manuel de Jesus;Castro, Rodrigo de Aquino;Gomes, Mariano Tamura Vieira;Gir?o, Manoel Jo?o Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2009, DOI: 10.1590/S0100-72032009001200004
Abstract: purpose: to analyze histomorphometric consequences of the uterine arteries embolization (uae) in the uterine tissue, especially by collagen tissue quantification through uterine biopsy, before and after treatment of uterine leiomyoma. methods: 15 patients with symptomatic leyomioma and/or infertility, submitted to uae, participated in the study according to the study exclusion criteria, after having signed an informed consent. uterine biopsy was performed in the secretory phase of the menstrual cycle, before and three months after the procedure, to evaluate the collagen. after the histological processing of the material, 3 μ slices were prepared, some of them dyed with hematoxiline-eosin (he) and others with the specific dye for collagen fibers (picrosirius red). then, the slides were examined and interpreted, and the collagen quantified. the amount was calculated as the percent of the area composed by collagen, and the result expressed in mean±standard deviation (sd). data has then been submitted to statistical analysis by student's paired t test (p<0.05). results: the presence of smooth muscle cells was observed in the biopsies performed before the treatment, surrounded by a rich network of collagen fibers, which are part of the tumor, blood vessels and fibroblast nuclei. on the slides of biopsies performed after the treatment, it was observed the presence of widespread coagulation necrosis, vascular thrombosis, calcification and lymphoplasmocitary infiltration areas and clear reduction of the collagen component. the percentage of collagen fibers was higher in the pre-uae group (84.07±1.41), than in the post-uae (81.05±1.50) group, with p<0.0001, and 95% confidence interval (ci95%) from 2.080 to 3.827. conclusion: the quantitative and qualitative collagen reduction clearly shows that the proposed treatment is efficient in reducing the tumoral mass, composed mainly by collagen fibers intermingled with neoplasic smooth muscle cells. nevertheless, complementary studi
Rela??o entre polimorfismo do gene do receptor de progesterona, ra?a, paridade e ocorrência de leiomioma uterino
Gomes, Mariano Tamura Vieira;Castro, Rodrigo de Aquino;Villanova, Fabiola Elizabeth;Silva, Ismael Dale Cotrim Guerreiro da;Baracat, Edmund Chada;Lima, Geraldo Rodrigues de;Gir?o, Manoel Jo?o Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2006, DOI: 10.1590/S0100-72032006000500003
Abstract: purpose: to analyze race, parity and presence of the progesterone receptor polymorphism, named progins, as factors related to uterine leiomyoma occurrence in brazilian women. methods: we carried out a case-control study, composed of 122 patients with the diagnosis of uterine fibroid and 125 women without the disease. after recording the clinical data, we collected biological material for dna extraction, polymerase chain reaction and agarose gel electrophoresis in order to identify the presence of progins polymorphism. statistical analysis was performed using the non-parametric mann-whitney test or the c2 test, depending on the studied variable. the risk for the occurrence of the disease was calculated by the logistic regression model, providing the odds ratio (or). the adopted significance level was 5% (p<0.05) and the confidence interval was 95% (95% ci). results: we observed a higher prevalence of "non-white"women - mulatto and black - (50 vs 22.4%) and nulliparas (23.8 vs 11.2%) in the cases, while the progesterone receptor genotype was more often progins positive - heterozygous or mutant homozygous - among the controls (21.6 vs 10.7%). the or indicated an elevated risk for leiomyoma related to the "non-white"race (or=3.46; 95% ci: 2.0-6.0) and the nulliparity (or=3.30; 95% ci: 1.9-5.6), with reduction in the presence of progins-positive genotypes (or=0.43; 95% ci: 0.2-0.9). conclusions: the "non-white"race and nulliparity were considered risk factors for the occurrence of uterine fibroid in the studied population, while progins polymorphism showed to be a protective factor.
Polimorfismo do receptor de progesterona como fator de risco para o parto prematuro
Oliveira, Tenilson Amaral;Cunha, Danielle Renzoni da;Policastro, Adriana;Traina, évelyn;Gomes, Mariano Tamura;Cordioli, Eduardo;
Revista Brasileira de Ginecologia e Obstetrícia , 2011, DOI: 10.1590/S0100-72032011000600002
Abstract: purpose: to investigate the association between gene polymorphism of the progesterone receptor (progins) and the risk of premature birth. methods: in this case-control study, 57 women with previous premature delivery (case group) and 57 patients with delivery at term in the current pregnancy and no history of preterm delivery (control group) were selected. a 10 ml amount of peripheral blood was collected by venipuncture and genomic dna was extracted followed by the polymerase chain reaction (pcr) under specific conditions for this polymorphism and 2% agarose gel electrophoresis. the bands were visualized with an ultraviolet light transilluminator. genotype and allele progins frequencies were compared between the two groups by the χ2 test, with the level of significance set at value p<0.05. the odds ratio (or) was also used, with 95% confidence intervals. results: progins genotypic frequencies were 75.4% t1/t1, 22.8% t1/t2 and 1.8% t2/t2 in the group with preterm delivery and 80.7% t1/t1, 19.3% t1/t2 and 0% t2/t2 in the term delivery group. there were no differences between groups when genotype and allele frequencies were analyzed: p=0.4 (or=0.7) and p=0.4 (or=0.7). conclusions: the present study suggests that the presence of progins polymorphism in our population does not constitute a risk factor for premature birth.
Pólipos endometriais: aspectos clínicos, epidemiológicos e pesquisa de polimorfismos
Miranda, Simone Madeira Nunes;Gomes, Mariano Tamura;Silva, Ismael Dale Cotrim Guerreiro da;Gir?o, Manoel Jo?o Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2010, DOI: 10.1590/S0100-72032010000700004
Abstract: purpose: to evaluate the clinical and epidemiological risk factors for endometrial cancer in postmenopausal women with endometrial polyps, as well as the genetic polymorphism of the progesterone receptor (progins). methods: a case-control study was designed with 160 postmenopausal women with endometrial polyps, compared to a normal control group of 400 postmenopausal women. the genotyping of progins polymorphism was determined by the polymerase chain reaction. clinical and epidemiological data were compared between benign endometrial polyps and 118 of the control subjects. variables were also compared with regard to benign and malignant endometrial polyps. results: comparison of the epidemiological variables between groups showed a significant difference for age, ethnicity, time since menopause, parity, tamoxifen use, hypertension and breast cancer, all of them more prevalent in the polyp group. after adjustment for age, statistical significance remained only for parity (or=1.1), hypertension (or=2.2) and breast cancer (or=14.4). there were six cases of malignant polyps (3.7%). the frequency of bleeding was 23.4% for benign polyps and 100% for malignant polyps, with large polyps being detected in 54.6% of the benign cases and in 100 of the malignnat ones. the frequency of arterial hypertension was 54.5% for benign polyps and 83.3% for the malignant ones. the frequency of progins t1/t1, t1/t2 and t2/t2 polymorphism was 79.9%, 19.5% and 0.6%, respectively, for the polyp group, and 78.8%, 20.8% and 0.5% for the control group. conclusions: elderly age, hypertension, and breast cancer were significantly associated with endometrial polyps. the presence of progins polymorphism was not significantly associated with endometrial polyps. the incidence of malignant polyps was low and strongly associated with bleeding, large-sized polyp and arterial hypertension.
Fratura de mandíbula: análise de 293 pacientes tratados no Hospital de Clínicas da Universidade Federal de Uberlandia
Patrocínio, Lucas Gomes;Patrocínio, José A.;Borba, Bruno Henrique Carrijo;Bonatti, Bruno De Santi;Pinto, Lauro Figueira;Vieira, Juliana Villela;Costa, José Mariano Carvalho;
Revista Brasileira de Otorrinolaringologia , 2005, DOI: 10.1590/S0034-72992005000500003
Abstract: mandibular fracture is the second most common facial fracture and there has been a significant increase in number of cases in the last years. misidentification and inadequate treatment can take to permanent aesthetic or functional deformity. aim: evaluate cases of mandibular fracture reduction in the hospital of clinics of the federal university of uberlandia, from january of 1974 to december of 2002. study design: historical cohort. patient and method: two hundred and ninety-three cases of reduction of mandibular fractures were retrospectively analyzed according to factors related to: patient, trauma, signs and symptoms, and surgical treatment. results: there has been a clear tendency of increase of the number of mandibular fractures along the years. there was higher prevalence in male (4:1), with occurrence peak between 20 to 29 years old. the principal causes of fracture in this study were traffic accidents and violence, representing 72.4%. one hundred and thirty-five patients presented only one fracture. the most injured sites were, in decreasing order, symphysis, condyle, angle, body, ramus, and coronoid. we performed closed reduction (28), open reduction (213) and association of the two (11 patients); 56.8% of the patients were treated within the first 3 days; and, 50.4% were discharged from the hospital until the first postoperative day. about 10% of the patients presented complications, being osteomyelitis the most frequent one. conclusion: the incidence of mandibular fractures was remarkably larger in the male sex, during the third decade of life. the most common cause was traffic accident, and symphysis and condyle were the most injured sites. isolated fractures occurred in over half of the cases. most of the patients were treated in the first three days and were discharged until the first postoperative visit. closed reduction was the treatment most commonly employed. the most frequent complication was osteomyelitis.
A prática complexa do psicólogo clínico: cotidiano e cultura na atua??o em circuito de rede institucional
Vieira Filho, Nilson Gomes;
Estudos de Psicologia (Campinas) , 2005, DOI: 10.1590/S0103-166X2005000300008
Abstract: the main objective of this article is to clarify basic theoretical constructs about lhe complexity of clinical psychologist practice in the context of psychiatric reform, with an emphasis on lhe influence of everyday life and culture in therapeutic interventions involving community networks. this practice implies interdisciplinary collaboration and continuous interactions with lhe community. the psychosocial approach adopted highlights lhe dynamic of social networks and the cooperation between professionals and patients. the aspects discussed in this article are: cultural experience; the interactions involving mental health services, the demand of patients, and the dialogue in therapeutic relations; psychological suffering, whose understanding takes into account lhe patients' world vision and cultural myths. it was emphasized here that informal and interpersonal rules tend to influence lhe professionals' daily practice, and interfere with institutional decisions and changes. the dialogical communication in therapeutic interaction supposes patients' psychic suffering and world vision, which would require reinvention of cultural myths of social exclusion regarding madness. as final considerations, importance is given to de-institutionalization mental institutions as a process of social inclusion.
Vida familiar e trabalho de crian?as e de jovens pobres
Gomes, Jerusa Vieira;
Paidéia (Ribeir?o Preto) , 1998, DOI: 10.1590/S0103-863X1998000100005
Abstract: this article discuss children and adolescents work mainly in poor classes in brazilian society. the relationships between family, socialization and work are emphasized. the discussion is based first of all in a brief historical review of the subject: the work in childhood and youth, till the last law proposed in brazilian society- eca; second in pointing the real gains and the conflictual ideas behind the fights against the work of children and adolescents, specially when it is considered the physical, psychological and social development of them.
A clínica psicossocial e a aten o de cuidados religiosos ao sofrimento psíquico no contexto da reforma psiquiátrica brasileira Psychosocial clinical approach and religious care in psychological suffering in the context of the Brazilian psychiatric reform
Nilson Gomes Vieira Filho
Psicologia: Ciência e Profiss?o , 2005, DOI: 10.1590/s1414-98932005000200006
Abstract: O processo de desinstitucionaliza o prioriza a aten o em saúde mental nos servi os comunitários e o trabalho terapêutico em rede social. A partir da demanda do usuário e/ou família, é possível construir, nessa prática complexa, uma rede social de apoio articulada ao processo terapêutico, incluindo cuidados religiosos, e que funcione como sistema de amparo social em situa o de sofrimento. O objetivo deste artigo é refletir sobre essa constru o e suas implica es para a clínica da aten o psicossocial. Percursos terapêuticos em diferentes países demonstram que existem, em diversos contextos culturais, pacientes que circulam entre os servi os oficiais de saúde e os cuidados religiosos. Essa situa o se repete em usuários de uma clínica-escola pública brasileira onde se observa que eles parecem orientar-se por um pensamento sincrético que seria capaz de dar uma certa coerência tanto a múltiplos aspectos do sofrimento quanto à busca de diversos cuidados à saúde mental. A OMS tem adotado, nestas últimas décadas, uma postura de tendência inclusiva relativa aos servi os culturais de saúde. Esse fato refor a que é fundamental a amplia o de pesquisas sobre sistemas terapêuticos (oficial e cultural), como prop e Tobie Nathan. Numa rede de apoio, esses dois sistemas n o est o em concorrência, mas em coopera o, e com a inten o de auxiliar, proteger e socorrer o usuário e/ou família que sofre. Essas intera es podem estar ligadas à psicoterapia (complexa e dialógica), exigindo, assim, tanto uma aten o preventiva quanto uma certa margem de risco interativo. In the deinstitutionalization process the priority is mental health care in community healthcare clinics and the use of the network therapeutic approach. In order to respond to patients' (and/or their families') needs, this complex practice enables the building of a social support network concomitantly with the therapeutic process, including religious care, to operate as a system of social relations that offers protection for people in suffering situations. The objective of this paper is to discuss the construction of such support network and its implications for a psychosocial clinical approach. Therapeutic itineraries in different countries evidence the existence of patients who resort to public healthcare services and religious care in various cultural contexts. This situation is reproduced in one public university clinic in Brazil where it was observed that clients are apparently guided by a logic of religious syncretism that seem to render some coherence to multiple aspects of suffering as well as to t
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