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Search Results: 1 - 10 of 25159 matches for " Rodrigo Aquino Castro "
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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.
Correla o entre a press o de perda à manobra de Valsalva e a press o máxima de fechamento uretral com a história clínica em mulheres com incontinência urinária de esfor o
Feldner Jr Paulo Cezar,Bezerra Leonardo Robson Pinheiro Sobreira,Gir?o Manoel Jo?o Bastista Castelo,Castro Rodrigo Aquino de
Revista Brasileira de Ginecologia e Obstetrícia , 2002,
Abstract: Objetivo: analisar a rela o entre a press o de perda com manobra de Valsalva e a press o máxima de fechamento uretral com a queixa clínica em mulheres com incontinência urinária de esfor o. Métodos: estudo retrospectivo no qual foram incluídas 164 pacientes com diagnóstico de incontinência urinária de esfor o ou mista atendidas no setor de Uroginecologia e Cirurgia Vaginal do Departamento de Ginecologia da UNIFESP/EPM. As pacientes submeteram-se à anamnese padronizada, exame físico e estudo urodinamico. A press o de perda foi mensurada sob manobra de Valsalva (Valsalva leak point pressure - VLPP), com volume vesical de 200 mL. O perfil uretral foi realizado utilizando-se cateter de fluxo número 8, sendo medida a press o máxima de fechamento uretral (PMFU). As pacientes foram agrupadas conforme a queixa clínica de perda urinária aos esfor os e realizou-se análise estatística por meio do teste de chi2 para verificar a propor o entre as variáveis. Utilizou-se, a seguir, a análise de variancia (ANOVA) para verificar diferen as entre VLPP e PMFU com rela o à gravidade subjetiva da incontinência. Resultados: a média de idade foi de 51,2 anos (19-82), sendo que 79 encontravam-se no menacme (48,2%) e 85 (51,8%) na pós-menopausa. A paridade média foi de 4,0 filhos (0-18). Houve correla o entre o número de pacientes com VLPP inferior a 60 cmH2O e a queixa clínica (p<0,0001), sendo que o grupo com perda urinária aos mínimos esfor os teve média de 69,1 cmH2O na press o de perda, o grupo com perda urinária aos moderados esfor os teve média de 84,6 cmH2O e o grupo com perda urinária aos grandes esfor os teve média de 90,6 cmH2O. Conclus es: VLPP correlacionou-se com a queixa clínica, sendo menor no grupo com perda aos mínimos esfor os. N o houve correla o entre a PMFU e a queixa clínica.
Fisioterapia para consciência perineal: uma compara??o entre as cinesioterapias com toque digital e com auxílio do biofeedback
Pinheiro, Brenda de Figueiredo;Franco, Gisela Rosa;Feitosa, Suellen Maurin;Yuaso, Denise Rodrigues;Castro, Rodrigo de Aquino;Gir?o, Manoel Jo?o Batista Castelo;
Fisioterapia em Movimento , 2012, DOI: 10.1590/S0103-51502012000300019
Abstract: introduction: a significant number of women (around 30 to 50%) are unable to contract correctly their pelvic floor muscles when given a command. objective: this study's objective was to compare pelvic floor muscle training with digital palpation to pelvic floor muscle training with biofeedback for perineal consciousness of women with stress urinary incontinence. method: it was conducted a randomized clinical trial, comprising two groups, each of them formed by five interventional women with stress urinary incontinence and without perineal consciousness. results: initially, the biofeedback group was formed by six women and the pelvic floor muscle training group was formed by five women, but one patient was excluded from the biofeedback group during the research. it was observed that there was a statistically significant improvement in both groups for the power, endurance, fast and knowledge of the perineal region, but there was no significant difference between the two groups, i.e., both treatments are equally effective. conclusion: given the results, we conclude that both pelvic floor training with digital palpation and with biofeedback are excellent treatment options to gain perineal awareness.
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.
Sling de aponeurose e com faixa sintética sem tens?o para o tratamento cirúrgico da incontinência urinária de esfor?o feminina
Sartori, Jo?o Paulo;Martins, José Ant?nio Moraes;Castro, Rodrigo de Aquino;Sartori, Marair Gracio Ferreira;Gir?o, Manoel Jo?o Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2008, DOI: 10.1590/S0100-72032008000300005
Abstract: purpose: to compare sling operations of aponeurosis and tension-free vaginal tape (tvt) for the correction of stress urinary incontinence (sui) regarding: the rates of subjective and objective healing, the mobility of the bladder neck with ultrasonography, the variation of the absorbent test, the urodynamic alterations and the incidence of complications. methods: eighty patients with sui were selected. among them, 61 underwent a tvt surgery and 19, an abdominal rectum sling operation of aponeurosis. average age, index of body mass and parity were 50.1 years old, 29.7 kg/m2 and 4.1 deliveries (median=3) for the patients with aponeurosis sling, and 51.7 years old, 28.1 kg/m2 and 4.1 deliveries (median=3) for the ones with tvt. all of them have undergone anamnesis, physical examination, bladder neck ultrasonography, absorbent test and urodynamic evaluation before and at least six months after the surgery. after 15 or 19 months and after about four or five years, they were again interviewed concerning the surgery results. results: after six months, 96.7% of the women with tvt and 89.5% of the ones with sling thought they were healed in the subjective evaluation. nevertheless, after 15 to 19 months, the tvt group kept the same subjective healing rate, while among the sling group the rate decreased to 77.8%. there was a significant decrease in the mobility of the neck bladder that was similar in both groups and an improvement in the absorbent test. at the end of the urodynamic study, 93.4% of the women from the tvt group and 78.9% of the ones from the sling group were classified as having an objective healing. the average time of bladder probing was higher in the sling group. urinary retention was observed in 42.1% of the sling cases and in 9.8% of the tvt's. the rates of late healing were 90% for tvt and 55.6% for sling. conclusions: tvt surgery provided better subjective healing after 15 or 19 months, but the rate of objective healing was the same in both techniques at
Eletroestimula??o funcional do assoalho pélvico versus terapia com os cones vaginais para o tratamento de incontinência urinária de esfor?o
Santos, Patrícia Fernandes Diniz;Oliveira, Emerson;Zanetti, Miriam Raquel Diniz;Arruda, Raquel Martins;Sartori, Marair Gracio Ferreira;Gir?o, Manoel Jo?o Batista Castello;Castro, Rodrigo Aquino;
Revista Brasileira de Ginecologia e Obstetrícia , 2009, DOI: 10.1590/S0100-72032009000900005
Abstract: purpose: to compare the effects of functional electrostimulation of the pelvic floor and therapy with cones in women with stress urinary incontinence (sui). methods: randomized clinical study for which 45 patients with sui were selected. the effects of functional electrostimulation of the pelvic floor were evaluated in the sui treatment of 24 women, with the use of clinical data (micturition diary, pad test and a questionnaire about quality of life - i-qol). the patients were submitted to two 20' weekly sessions for four consecutive months, under the supervision of a physiotherapist. the electrode used had 10 cm length and 3.5 cm width with a double metallic ring and a cylindrical shape, positioned in the medium third of the vagina. the electric parameters used were: intensity varying from 10 to 100 ma and 50 hz of fixed frequency, with pulse duration of 1 ms. also, we evaluated 21 patients who were submitted to vaginal cone treatment. the cone therapy was done with two 45 minute sessions per week. the cones' weight varied from 20 to 100 gr. results: there was no difference between the outcomes of electrostimulation of the pelvic floor and the vaginal cones for the treatment of sui (p>0.05). after four months, there was a significant improvement in the i-qol index of the patients treated both with electrostimulation (40.3 versus 82.9) or with the cones (47.7 versus 84.1). there was a significant decrease in pad weight in both groups, measured before and after the treatment (28.5 and 32 g versus 2.0 and 3.0 g for the electrostimulation and cone group, respectively). finally, there was a significant decrease in the number of urinary leakage evaluated by the micturition diary in both groups (p<0.0001). conclusions: both electrostimulation and vaginal cones were effective in the treatment of women with sui.
Hiperatividade do detrusor: compara??o entre oxibutinina, eletroestimula??o funcional do assoalho pélvico e exercícios perineais. Estudo randomizado
Arruda, Raquel Martins;Sousa, Gabriela Olbrich de;Castro, Rodrigo de Aquino;Sartori, Marair Gracio Ferreira;Baracat, Edmund Chada;Gir?o, Manoel Jo?o Batista Castello;
Revista Brasileira de Ginecologia e Obstetrícia , 2007, DOI: 10.1590/S0100-72032007000900003
Abstract: purpose: to evaluate and to compare the effectiveness of oxybutynin, electrostimulation (es) and pelvic floor training (pft) in the management of women with detrusor overactivity. methods: a total of 64 women, 35 to 80 years old, were enrolled in this randomized prospective trial. patients were randomized in three groups: oxybutynin (n=22), es (n=21) and pft (n=21). there were no statistical differences between the three groups with regards to race (p=0.948), age (p=0.747), hormonal status (p=0.813), time of symptomatology (p=0.789), previous surgery for urinary incontinence (p=0.993), or body mass index (p=0.897). patients were assessed before and after treatment by urodynamic test, a seven-day voiding diary, and subjective response. the duration of the treatment was twelve weeks. for statistical analyses, the pearson c2, analysis of variance (anova) and the paired t-test were used. results: there was a decrease in the urge-incontinence episodes and in the number of pads required in all groups (p<0.05). there was reduction in the frequency of micturition in the oxybutynin group (p=0.014). oxybutynin and es groups had reduction in nocturia episodes (p=0.003 and p=0.036, respectively). there were no significant differences in improvement between the three groups (p>0.05). urgency was resolved in 14 (63.6%), 11 (52.4%) and 12 (57.1%) patients of the oxybutynin, es and pft groups, respectively, without differences among the groups (p=0.754). subjectively, 17 (77.3%), 11 (52.4%) and 16 (76.2%) women who had accomplished oxybutynin, es and pft, respectively, were satisfied, without differences among the groups (p = 0.142). urodynamic was normal in 8 (36.4%), 12 (57.1%) and 11 (52.4%) patients of the oxybutynin, es and pft groups, respectively. this urodynamic analysis revealed no differences between the three groups (p=0.358). the reduction of urge-incontinence correlated with patient satisfaction (p<0.05). conclusions: treatments were equally effective; reduction of urg
Histomorphometric analysis of a rat bladder after electrical stimulation
Franco, Gisela Rosa;Oliveira, Emerson de;Baracat, Edmund Chada;Sim?es, Manoel de Jesus;Sartoria, Marair Gracio Ferreira;Gir?o, Manuel Jo?o Batista Castello;Castro, Rodrigo Aquino;
Revista da Associa??o Médica Brasileira , 2011, DOI: 10.1590/S0104-42302011000100010
Abstract: objective: we sought to analyze the effects of electrical stimulation (es) of the pelvic floor on the bladder of rats. methods: forty rats were studied and divided into the following groups: gi (control group) - did not receive es, gii (placebo) - did not receive es but had an electrode inserted into the vagina; giii - underwent six sessions of es of the pelvic floor and giv - rats that underwent 12 sessions of es. subsequently, the bladder was removed and the epithelium, muscle and blood vessels were analyzed. results: the muscle wall in giv had increased thickness when compared to other groups. further, the number of blood vessels was similar in giii and giv, which was higher than that found in gi and gii. finally, there was an increase in the relative percentage of muscle fibers in relation to collagen for giv compared to gi. conclusion: after 12 sessions of es in rats the muscle layer, the number of blood vessels and the relative percentage of muscle fibers were increased.
Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence
Zanetti, Míriam Raquel Diniz;Castro, Rodrigo de Aquino;Rotta, Adriana Lyvio;Santos, Patrícia Diniz dos;Sartori, Marair;Gir?o, Manoel Jo?o Batista Castello;
Sao Paulo Medical Journal , 2007, DOI: 10.1590/S1516-31802007000500003
Abstract: context and objective: urinary incontinence is a public health problem that affects more than 200 million people worldwide. stress incontinence is the most prevalent type. pelvic floor muscle exercises have been used for treating it, although there is no consensus regarding their application. the aim of this study was to compare the results from treating female stress urinary incontinence with pelvic floor muscle exercises with or without physiotherapist supervision. design and setting: this was a randomized, prospective, controlled trial in the urogynecology and vaginal surgery sector, universidade federal de s?o paulo. methods: forty-four women were randomized to be treated for stress urinary incontinence with pelvic floor exercises for three consecutive months, into two groups: one with and the other without physiotherapist supervision. they were evaluated before and after treatment using a quality-of-life questionnaire, pad test, micturition diary and subjective evaluation. descriptive analysis was used to evaluate the population. the homogeneity of the two groups was evaluated using the kruskal-wallis and chi-squared tests. the success of the two groups after treatment was evaluated using the wilcoxon test. results: the supervised group showed statistically greater improvement in the pad test, micturition diary and quality of life than did the control group. in the subjective evaluation, only 23.8% of the control group patients were satised with their treatment. in the supervised group, 66.8% of patients did not want any other treatment. conclusion: supervised pelvic floor muscle exercises presented better results in objective and subjective evaluations than did unsupervised exercises.
Valor da Queixa Clínica e Exame Físico no Diagnóstico da Incontinência Urinária
Feldner Jr Paulo Cezar,Bezerra Leonardo Robson P.S.,Gir?o Manoel Jo?o Bastista C.,Castro Rodrigo Aquino de
Revista Brasileira de Ginecologia e Obstetrícia , 2002,
Abstract: Objetivo: analisar a prevalência das queixas clínicas uroginecológicas correlacionando-as com o diagnóstico definitivo após o exame urodinamico e comparar o sinal clínico de perda urinária com o estudo urodinamico. Métodos: foram analisadas, retrospectivamente, 114 pacientes atendidas no período de junho de 2000 a janeiro de 2001. Todas as pacientes foram avaliadas por meio de anamnese padronizada, exame físico e estudo urodinamico, sendo classificadas de acordo com o queixa clínica, presen a do sinal de perda urinária durante o exame ginecológico e diagnóstico urodinamico. Utilizou-se a análise estatística dos dados amostrais, por meio da determina o interna de um teste diagnóstico, para calcular a sensibilidade, especificidade e os valores preditivos positivo e negativo do sinal clínico. Resultados: a média de idade foi de 51 anos (19-80), sendo que 61 encontravam-se no menacme (53,5%) e 53 (46,5%) na pós-menopausa. Destas, 10 (18,8%) faziam uso da terapia de reposi o hormonal. Do total de pacientes, 25 (21,9%) haviam se submetido a cirurgias prévias para incontinência. A queixa de perda urinária isolada foi referida por 41 pacientes (36,0%), a urgência/urge-incontinência isolada por 13 (11,4%) e os sintomas mistos por 60 (52,6%). Das pacientes com perda isolada, observou-se, à avalia o urodinamica, que 34 (83%) tinham incontinência urinária de esfor o (IUE), nenhuma paciente apresentava instabilidade do detrusor (ID), 2 (4,9%) incontinência urinária mista (IUM) e em 5 (12,1%) o estudo foi normal. Daquelas com queixa de urgência/urge-incontinência isolada, observamos na avalia o urodinamica que nenhuma tinha IUE, 5 (38,5%) ID, 1 (7,7%) IUM e em 7 (53,8%) o estudo foi normal. Daquelas com sintomas mistos, identificamos na avalia o urodinamica 25 com IUE (41,6%), 10 com ID (16,7%), 10 IUM (16,7%) e em 15 o estudo foi normal (25,0%). O sinal clínico de perda ao exame físico foi identificado em 50 (43,9%) pacientes. Destas, 35 (70%) tinham diagnóstico urodinamico de IUE, 6 (12%) IUE e outro diagnóstico e 9 (18%) n o tinham IUE. O sinal clínico estava ausente em 64 (56,1%) mulheres. Destas, 23 (35,9%) tinham diagnóstico urodinamico de IUE, 7 (11%) IUE e outro diagnóstico e 34 (53,1%) n o tinham IUE. Conclus es: a história clínica associada ao exame físico têm importancia no manejo da incontinência urinária; porém, n o devem ser utilizados como único critério para o diagnóstico. Os testes objetivos est o disponíveis e devem ser utilizados em conjunto com os dados clínicos.
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