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Objective: The objective of this study was to evaluate the action of soy isoflavones (ISO) and 17β-estradiol on collagen I (CollI) and sulfated glycosaminoglycans (GAGs) in the bone matrix of diabe...

Entrapments of the intrapelvic portions of the lumbosacral plexus are an important extraspinal cause of sciatica and pudendal neuralgia. They can be treated using Laparoscopic Neuronavigation (LANN), a minimally invasive technique that has set the foundations of an emerging field in Medicine—Neuropelveology. This retrospective-prospective study analyzes the outcomes of 63 patients treated with the LANN technique over a 10 year time period. One year after surgery, 78.3% of patients reported clinically relevant pain reduction, defined as ≥ 50% reduction in Numeric Rating Scale (NRS) score; these results were maintained for a mean follow up of 3.2 years. Preoperative chronic opioid use (≥ 4 months of ≥ 10 mg morphine equivalents/day) was a predictor of poor surgical outcome—clinically relevant pain reduction was observed in only 30.8% in this group of patients, compared to 91.5% in patients not regularly taking opioids preoperatively (p

Objective: The aim of this study was to analyze the macroscopic and histological changes that occur in experimental endometriosis after treatment with Uncaria tomentosa. Study design: Experimental endometriosis was induced in twenty-five female Wistar rats. After three weeks, 24 animals developed grade III experimental endometriosis and were divided into two groups. Group ‘‘U’’ received U. tomentosa extract orally (32 mg/day), and group ‘‘C’’ (control group) received a 0.9% sodium chloride solution orally (1 ml/100 g of body weight/day). Both groups were treated with gavage for 14 days. At the surgical intervention and after the animal was euthanized, the implant volume was calculated with the following formula: [4p (length/2) (width/2) (height/2)/3]. The autotransplants were removed, dyed with hematoxylin–eosin, and analyzed by light microscopy. The Mann– Whitney test was used for the independent samples, and the Wilcoxon test analyzed the related samples, with a significance level of 5%. Results: The difference between the initial average volumes of the autotransplants was not significant between the groups (p = 0.18). However, the final average volumes were significantly different between the groups (p = 0.001). There was a significant increase (p = 0.01) between the initial and final average volumes in the control group, and treatment with the U. tomentosa caused a marked reduction in the growth over time (p = 0.009). Histologically, in the experimental group (n = 10) six rats had a wellpreserved epithelial layer, three had mildly preserved epithelium, and one had poorly preserved epithelium. The epithelial layer occasionally presented sporadic epithelial cells. The control group (n = 12) presented seven cases (58.3%) of well-preserved epithelial cells and five cases (41.7%) of mildly preserved epithelial cells. Conclusions: Cat’s claw extract appears to be a promising alternative for treating endometriosis.

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. OBJETIVO: Analisar os efeitos da eletroestimulação (ES) de assoalho pélvico na bexiga de ratas. MÉTODOS: 40 ratas foram estudadas e divididas nos seguintes grupos: GI (Grupo controle) - não receberam ES GII (placebo) - não foram submetidas a ES mas possuíam um eletrodo introduzido dentro da vagina; GIII - submetidas a seis sessões de ES do assoalho pélvico e GIV - ratas que receberam 12 sessões de ES. Posteriormente, a bexiga foi removida e analisou-se o seu epitélio, musculatura e os vasos sanguíneos. RESULTADOS: Observou-se aumento na espessura da parede muscular em GIV em relação aos demais grupos. Encontramos, ainda, que o número de vasos sanguíneos foi similar em GIII e GIV, sendo maior ao observado em GI e GII. Por fim, houve aumento na porcentagem relativa de fibras musculares em relação ao colágeno em GIV quando comparada à GI. CONCLUSÃO: Após 12 sessões de ES em ratas houve aumento da camada muscular, número de vasos e da porcentagem relativa de fibras musculares.

O teratoma congênito de orofaringe é o tipo mais raro de teratoma, compreendendo apenas 2% desses tumores fetais. O diagnóstico deve ser realizado o mais precocemente possível, preferencialmente durante o pré-natal. O prognóstico irá depender do tamanho e localização da lesão, da velocidade de crescimento desta, do envolvimento de estruturas intracranianas e da ressecção adequada do tumor com equipe multidisciplinar. Relatamos o caso de uma paciente que teve diagnosticado durante a gestação feto com teratoma congênito de orofaringe (epignathus) por meio de ultra-sonografia. O feto evoluiu para óbito intra-uterino na 29ª semana de gestação, sendo então induzido o parto por via vaginal. O exame anatomopatológico revelou feto do sexo feminino, compatível com 27-28 semanas, teratoma orofaríngeo e outras malformações congênitas. Oropharyngeal teratoma is the most rare type of teratoma, with only 2% of fetal teratomas. The diagnosis must be established as early as possible, preferably during the prenatal period. The prognosis will depend on the size and location of the lesion, growth rate of the lesion, degree of intracranial spread, its resectability, and immediate care at birth by a multisciplinary team. We report aparticular case of congenital oropharyngeal teratoma (epignathus). The diagnosis was made during the prenatal period by ultrasound, and the fetus evolved to intrauterine death at the 29th week. The anatomopathological examination revealed a female fetus, compatible with 27-28 weeks, oropharyngeal teratoma and congenital malformations. Universidade Federal de São Paulo (UNIFESP) Departamento de Ginecologia UNIFESP, Depto. de Ginecologia SciELO

The immunological aspects of urinary tract infection are of great importance in patients with recurrent episodes. Host factors such as immune response to uropathogens and increased susceptibility are reported. The authors describe pathogenic aspects of bacteria, including determinants of aggressiveness and interactions with normal bacterial flora. Initial efforts with vaccines to prevent the recurrence of infection are also considered.