Importância do diagnóstico por imagem em pacientes com sangramento uterino anormal / Importance of diagnostic imaging in patients with abnormal uterine bleeding

O sangramento uterino anormal é diagnóstico sindrômico comum no consultório do ginecologista e pode comprometer substancialmente a qualidade de vida. O objetivo no diagnóstico de sangramento uterino anormal é distinguir pacientes com causas estruturais (anatômicas), como pólipo, adenomiose, leiomioma, malignidade e hiperplasia, de pacientes que apresentam anatomia normal, nas quais o sangramento pode ser devido a alteração dos mecanismos de coagulação, distúrbios ovulatórios, distúrbios primários do endométrio, iatrogenia, ou ter outra causa não classificada. O diagnóstico se inicia a partir de anamnese detalhada e exame físico geral e ginecológico completos, seguidos da solicitação de exames complementares (laboratoriais e de imagem), conforme indicado. O exame de imagem de primeira linha para identificação das causas estruturais inclui a ultrassonografia pélvica. Histerossonografia, histeroscopia, ressonância magnética e amostragem endometrial para exame de anatomia patológica são opções que podem ser incluídas no diagnóstico a depender da necessidade. O objetivo deste artigo é apresentar a relevância dos exames de imagem na investigação das causas de sangramento uterino anormal.

Abnormal uterine bleeding is one of the commonest presenting complaints encountered in a gynecologist's office and may substantially affect quality of life. The aim in the diagnosis of abnormal uterine bleeding is to distinguish women with anatomic causes such as polyp, adenomyosis, leiomyoma, malignancy and hyperplasia from women with normal anatomy where the cause may be coagulopathy, ovulatory disorders, endometrial, iatrogenic and not otherwise classified. Diagnosis begins with a thorough history and physical examination followed by appropriate laboratory and imaging tests as indicated. The primary imaging test for the identification of anatomic causes include ultrasonography. Saline infusion sonohysterography, magnetic resonance, hysteroscopy, endometrial sampling are options that can be included in the diagnosis depending on the need. The aim of this article is to present the relevance of imaging exams in the investigation of the causes of abnormal uterine bleeding.

Does bisphenol A (BPA) participates in the pathogenesis of Polycystic Ovary Syndrome (PCOS)?

Abstract PCOS is an endocrine disorder characterized by chronic anovulation, hyperandrogenism, and polycystic ovaries. Its etiology is uncertain. It is debated whether BPA would be a component of the environmental factor in the etiology of PCOS. Contamination by BPA can occur from food packaging (exposure during the diet) and through skin absorption and/or inhalation. It can be transferred to the fetus via the placenta or to the infant via breast milk, and it can be found in follicular fluid, fetal serum, and amniotic fluid. The phenolic structure of BPA allows it to interact with Estrogen Receptors (ERs) through genomic signaling, in which BPA binds to nuclear ERα or Erβ, or through nongenomic signaling by binding to membrane ERs, prompting a rapid and intense response. With daily and constant exposure, BPA's tendency to bioaccumulate and its ability to activate nongenomic signaling pathways can alter women's metabolic and reproductive function, leading to hyperandrogenism, insulin resistance, obesity, atherogenic dyslipidemia, chronic inflammatory state, and anovulation and favoring PCOS. The harmful changes caused by BPA can be passed on to future generations without the need for additional exposure because of epigenetic modifications. Not only high BPA levels can produce harmful effects, but at low levels, BPA may be harmful when exposure occurs during the most vulnerable periods, such as the fetal and neonatal periods, as well as during the prepubertal age causing an early accumulation of BPA in the body. Learning how BPA participates in the pathogenesis of PCOS poses a challenge and further studies should be conducted.

Melatonin and the cardiovascular system in animals: systematic review and meta-analysis

Melatonin, a hormone released by the pineal gland, demonstrates several effects on the cardiovascular system. Herein, we performed a systematic review and meta-analysis to verify the effects of melatonin in an experimental model of myocardial infarction. We performed a systematic review according to PRISMA recommendations and reviewed MEDLINE, Embase, and Cochrane databases. Only articles in English were considered. A systematic review of the literature published between November 2008 and June 2019 was performed. The meta-analysis was conducted using the RevMan 5.3 program provided by the Cochrane Collaboration. In total, 858 articles were identified, of which 13 were included in this review. The main results of this study revealed that melatonin benefits the cardiovascular system by reducing infarct size, improving cardiac function according to echocardiographic and hemodynamic analyses, affords antioxidant effects, improves the rate of apoptosis, decreases lactate dehydrogenase activity, enhances biometric analyses, and improves protein levels, as analyzed by western blotting and quantitative PCR. In the meta-analysis, we observed a statistically significant decrease in infarct size (mean difference [MD], -20.37 [-23.56, -17.18]), no statistical difference in systolic pressure (MD, -1.75 [-5.47, 1.97]), a statistically significant decrease in lactate dehydrogenase in animals in the melatonin group (MD, -4.61 [-6.83, -2.40]), and a statistically significant improvement in the cardiac ejection fraction (MD, -8.12 [-9.56, -6.69]). On analyzing potential bias, we observed that most studies presented a low risk of bias; two parameters were not included in the analysis, and one parameter had a high risk of bias. Melatonin exerts several effects on the cardiovascular system and could be a useful therapeutic target to combat various cardiovascular diseases.

Ultrasound in the first trimester of pregnancy

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Are women living with HIV prone to osteoporosis in postmenopause? A systematic review

SUMMARY BACKGROUND Some researchers have suggested that HIV infections can increase the cytokines, which might interfere with the bone metabolism and increase the risk of bone mass loss. However, this issue has yet to be consolidated in postmenopausal women. OBJECTIVE To analyze studies that evaluated the loss of bone mass through DEXA in women living with HIV. MATERIALS AND METHODS: A systematic review was conducted following the PRISMA guideline. The MEDLINE, EMBASE and Cochrane databases were consulted from January 1987 to March 2017. Studies assessing bone mineral density (BMD) in postmenopausal women living with HIV were included. The secondary outcome was to evaluate the impact of antiretroviral on BMD. RESULTS Sixty percent of the manuscripts suggested that women living with HIV had more bone loss than women in the control group, mainly in the lumbar spine. Forty percent did not observe any difference between groups. One study reported the influence of antiretroviral drugs on bone mass but did not find any difference between groups. CONCLUSION Our data suggest that HIV infections may have a negative influence on bone mass loss in women. Further studies on the mechanism of this HIV consequence are necessary to clarify the connection as well as the impact of the antiretroviral action on BMD in postmenopausal women.

Chronic pain treatment with spinal cord neurostimulation

The Guidelines Project, an initiative of the Brazilian Medical Association, aims to combine information from the medical field in order to standardize producers to assist the reasoning and decision-making of doctors. The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Concentração do ácido hialurônico e dos pequenos proteoglicanos ricos em leucina no endométrio de pacientes com síndrome dos ovários policísticos em comparação a de mulheres eumenorreicas / Concentration of hyaluronic acid and small leucine-rich proteoglycans in the endometrium of patients with polycystic ovary syndrome in comparison with eumenorrheic women

INTRODUÇÃO: A matriz extracelular no endométrio fornece vasta gama de sinais envolvidos em diferentes processos celulares, tais como morte celular e proliferação. Neste sentido, os glicosaminoglicanos e os proteoglicanos, juntamente com os fatores de crescimento, modulam várias etapas da angiogênese, proliferação celular e remodelação do estroma, o que pode ser importante para o fluxo menstrual regular e a redução dos processos proliferativos. Além disso, são importantes para a adequada interação maternofetal. OBJETIVO: Avaliar a concentração de ácido hialurônico, das enzimas de biossíntese do ácido hialurônico - hialurônico sintases (HAS1, HAS2 e HAS3) e dos pequenos proteoglicanos ricos em leucina (decorim, biglicam, lumicam e fibromodulina) no endométrio de pacientes com síndrome dos ovários policísticos (SOP) e de mulheres eumenorreicas. MÉTODOS: Foram analisadas 20 amostras de endométrio, 10 provenientes de pacientes com SOP e 10 de mulheres com ciclos menstruais regulares na fase proliferativa do ciclo, com idade variando entre 20 e 35 anos, atendidas na Divisão de Clínica Ginecológica do Hospital das Clínicas da FMUSP (HC-FMUSP). A determinação do perfil e da concentração do ácido hialurônico foi efetuada por método bioquímico de ensaio fluorimétrico (ELISA-like). A sua localização no tecido endometrial, assim como as dosagens das enzimas sintases (HAS1, HAS2 e HAS3) e dos pequenos proteoglicanos ricos em leucina (decorim, biglicam, lumicam e fibromodulina e), foi feita por imunoistoquímica e "western blotting". Para a análise dos resultados foi utilizado o teste t de student (p<=0,05). Os cálculos foram realizados com auxílio do programa SPSS versão13 (SPSS, Chicago, IL). RESUTADOS: Houve maior concentração de ácido hialurônico no endométrio de mulheres eumenorreicas na fase proliferativa do ciclo menstrual do que no das com síndrome dos ovários policísticos. Com relação às sintases do ácido hialurônico, observou-se maior reatividade de HAS1 e HAS2 e ...

INTRODUCTION: Endometrium extracellular matrix provides wide range of signals at different cellular levels like cell death and proliferation. In this regard, glycosaminoglycans and proteoglycans, along with growth factors, modulate various stages of angiogenesis, cell proliferation and remodeling of the stroma, which can be important for regulating menses and reducing the proliferative processes. Additionally, it is important for proper fetal-maternal interactions. OBJECTIVE: Evaluate hyaluronic acid concentration, the enzymes of hyaluronic acid synthases (HAS1, HAS2 and HAS3) and small leucine-rich proteoglycans (decorin, lumican, fibromodulim and biglycan) in the endometrium of patients with polycystic ovary syndrome (PCOS) and eumenorrheic women. METHODS: A total of 20 endometrial samples from 10 patients with PCOS and 10 women with regular menstrual cycles in the proliferative phase, with ages ranging between 20 and 35 years, attended at Gynecology Division of Clinical Hospital of the FMUSP (HC-USP). Profile determination and the concentration of hyaluronic acid were performed by biochemical method of fluorimetric assay (ELISA-like). Its location in the endometrial tissue as well as the dosage of enzymes synthases (HAS1, HAS2 and HAS3) and small leucine-rich proteoglycans (decorin, lumican, fibromodulim and biglycan) was done by immunohistochemistry and western blotting. To analyze the results Student t test was used (p < 0.05). The calculations were performed with software SPSS version 13. RESULTS: A higher concentration of hyaluronic acid in eumenorrheic women endometrium in proliferative phase when compared with polycystic ovary syndrome. Regarding hyaluronic acid synthases, there was a higher HAS1 and HAS2 reactivity and lower HAS3 reactivity in the PCOS endometrium compared to women with regular menstrual cycles in the proliferative phase. Decorin and lumican showed higher immunoreactivity in PCOS endometrium. CONCLUSIONS: PCOS patients have a lower...

How to evaluate quality of life in overweight and obese women during climacterium? / Como aferir qualidade de vida de mulheres com sobrepeso e obesidade no climatério?

Objective: identifying the instruments used to measure quality of life during menopausal transition and post-menopause in women with obesity or overweight. Methods: a systematic search using the Embase, Pubmed and Cochrane databases, and the following key-words: menopause/climacteric, quality of life, overweight/obesity. Nineteen papers that fulfilled the including criteria were found. Results: eighteen studies using generic health questionnaires (global quality of life) were identified, six of them were specific for menopause and one specific for obesity. Eleven studies used generic questionnaires, while only eight questionnaires were specific for menopause. Conclusion: there was no consensus in the literature about the use of quality of life questionnaires in women with overweight and obesity in climacterium, which makes de comparison and reproducibility of the results difficult. This is an alert about the need for standardization to better evaluate this specific population. .

Objetivo: identificar os instrumentos utilizados para aferir a qualidade de vida de mulheres com sobrepeso e obesidade no climatério (transição para menopausa e pós-menopausa). Métodos: busca sistemática nas bases de dados Embase, Pubmed e Cochrane com os descritores: menopause/climacteric, quality of life, overweight/obesity. Foram incluídos 19 artigos que preencheram os critérios de inclusão. Resultados: foram identificados 18 questionários genéricos (qualidade de vida global), 6 específicos para menopausa e 1 específico para obesidade. Onze estudos utilizaram instrumentos genéricos, enquanto 8 utilizaram específicos para menopausa. Conclusão: não houve consenso na literatura quanto ao uso de instrumentos de qualidade de vida em mulheres com sobrepeso e obesidade no climatério, o que dificulta a comparação e a reprodutibilidade dos resultados. Este é um alerta quanto à necessidade de padronização para melhor avaliar essa população específica. .

Extrato de soja no tratamento dos sintomas vasomotores no período menopausal / Soybean extract in the treatment of vasomotor symptoms in menopausal period

Os sintomas vasomotores, tais como fogachos e sudorese noturna, são comuns no período menopausal. A terapia hormonal permanece como a mais efetiva no alívio desses sintomas. No entanto, desperta preocupações sob o risco de aumentar a ocorrência de doenças diretamente relacionadas ao trato genital e mamas, sendo ainda contraindicada em algumas doenças crônicas. Assim, alguns tratamentos alternativos, baseados em alimentos ou suplementos enriquecidos com fitoestrogênios, produtos químicos presentes em algumas plantas, têm sido utilizados. No entanto, existem divergências quanto a sua eficácia. Assim, realizamos esta revisão a partir de artigos recuperados da base de dados Medical Literature Analysis and Retrieval System on Line (MEDLINE), com o objetivo de tentar esclarecer se o uso das isoflavonas está relacionado à redução dos sintomas vasomotores na menopausa. A partir dos artigos recuperados, pudemos observar que não existem evidências de que o uso de fitoestrogênios por mulheres na pós-menopausa reduzem os sintomas vasomotores. Por outro lado, nenhum dos trabalhos analisados mencionou efeitos prejudiciais no uso dessas substâncias. Entretanto, estudos experimentais em animais evidenciaram, quando administradas em altas doses, a ocorrência de metaplasia endometrial.

Hot flushes and night sweats are common vasomotor symptoms during menopausal period. Hormone therapy is believable to be the most effective treatment for relieving these symptoms. However, such treatment concerns us because its use may be directly related to genital tract and breast diseases. It is also contraindicated in some chronic diseases. Thus, some alternative treatments have been used such as consuming foods or supplements enriched with phytoestrogens, which are chemical compounds present in some plants. Whereas there are disagreements regarding its effectiveness, we conducted this review based on articles retrieved from the Medical Literature Analysis and Retrieval System on Line (MEDLINE) data base. Our aim was to try clarifying whether the use of isoflavones are related to reduction of vasomotor symptoms at menopause. From the articles retrieved, we observed that there is no conclusive evidence that the use of isoflavones by postmenopausal women reduces vasomotor symptoms. On the other hand, none of the consulted articles reported harmful effects on the use of such substances. However, experimental studies in animals have shown endometrial metaplasia when they are administered in high doses.

Ultraestrutura do nervo facial intratemporal em pacientes com paralisia facial idiopática: estudo de evidências de infecção viral / Intratemporal facial nerve ultrastructure in patients with idiopathic facial paralysis: viral infection evidence study

A etiologia da paralisia facial periférica idiopática (PFPI) ainda é uma incógnita, no entanto, alguns autores aventam a possibilidade de ser uma infecção viral. OBJETIVO: Analisar a ultraestrutura do nervo facial procurando evidências virais que possam nos fornecer dados etiológicos. MATERIAL E MÉTODO: Foram estudados 20 pacientes com PFP, com graus de moderado a severo, de ambos os sexos, entre 18-60 anos, provenientes de Ambulatório de Distúrbios do Nervo Facial. Os pacientes foram divididos em dois grupos: Estudo, onze pacientes com PFPI e Controle, nove pacientes com Paralisia Facial Periférica Traumática ou Tumoral. Foram estudados fragmentos de bainha do nervo facial ou fragmentos de seus cotos, que durante a cirurgia de reparação do nervo facial, seriam desprezados ou encaminhados para estudo anatomopatológico. O tecido foi fixado em glutaraldeído 2 por cento e analisado em Microscopia Eletrônica de Transmissão. RESULTADO: Observamos no grupo estudo atividade celular intensa de reparação com aumento de fibras colágenas, fibroblastos com organelas desenvolvidas, isentos de partículas virais. No grupo controle esta atividade de reparação não foi evidente, mas também não foram observadas partículas virais. CONCLUSÃO: Não foram encontradas partículas virais, no entanto, houve evidências de intensa atividade de reparação ou infecção viral.

The etiology of idiopathic peripheral facial palsy (IPFP) is still uncertain; however, some authors suggest the possibility of a viral infection. AIM: to analyze the ultrastructure of the facial nerve seeking viral evidences that might provide etiological data. MATERIAL AND METHODS: We studied 20 patients with peripheral facial palsy (PFP), with moderate to severe FP, of both genders, between 18-60 years of age, from the Clinic of Facial Nerve Disorders. The patients were broken down into two groups - Study: eleven patients with IPFP and Control: nine patients with trauma or tumor-related PFP. The fragments were obtained from the facial nerve sheath or from fragments of its stumps - which would be discarded or sent to pathology exam during the facial nerve repair surgery. The removed tissue was fixed in 2 percent glutaraldehyde, and studied under Electronic Transmission Microscopy. RESULTS: In the study group we observed an intense repair cellular activity by increased collagen fibers, fibroblasts containing developed organelles, free of viral particles. In the control group this repair activity was not evident, but no viral particles were observed. CONCLUSION: There were no viral particles, and there were evidences of intense activity of repair or viral infection.

Melatonina: modulador de morte celular / Melatonin: cell death modulator

A apoptose ou morte programada é um fenômeno biológico essencial para o desenvolvimento e manutenção de uma população celular. Neste processo, as células senescentes ou indesejáveis são eliminadas após ativação de um programa de morte celular, que envolve a participação de moléculas pró-apoptóticas (Fas, FasL, Bax, Caspases 2, 3, 6, 7, 8 e 9). A ativação destas moléculas provoca típicas alterações morfológicas como a retração celular, perda de aderência à matriz extracelular e às células vizinhas, condensação da cromatina, fragmentação do DNA e formação de corpos apoptóticos. Moléculas antiapoptóticas (Bcl2, FLIP) bloqueiam o surgimento e a evolução destas alterações celulares e evitam a morte celular. É o equilíbrio entre moléculas pró e antiapoptóticas que assegura a homeostase tecidual. O descontrole da apoptose pode contribuir para o aparecimento de diversas doenças neoplásicas, autoimunes e neurodegenerativas. Diversos agentes indutores e inibidores de apoptose são reconhecidos como armas potenciais no combate a doenças relacionadas a distúrbios de proliferação e morte celular, dentre eles, destacam-se os hormônios. A melatonina tem sido relatada com importante ação antiápoptótica em diversos tecidos, modulando a expressão de agentes, reduzindo a entrada de cálcio na célula, bem como atenuando a produção de espécies reativas de oxigênio e de proteínas pró-apoptóticas, tal como, diminuição da Bax. O conhecimento de novos agentes capazes de atuar nas vias da apoptose é de grande valia para o desenvolvimento de futuras terapias no tratamento de diversas doenças. Assim, o objetivo dessa revisão é elucidar os principais aspectos da morte celular pela apoptose e o papel da melatonina neste processo.

Apoptosis or programmed death is a biological phenomenon, which is essential for the development and maintenance of a cell population. In this process, senescent or damaged cells are eliminated after activation of a cell death program involving participation of pro-apoptotic molecules (Fas, Fas-L, Bax, caspases 2, 3, 6, 7, 8 and 9). Molecule activation causes typical morphological changes, such as cell shrinkage, loss of adhesion to the extracellular matrix and neighboring cells, chromatin condensation, DNA fragmentation and formation of apoptotic bodies. Anti-apoptotic molecules (Bcl-2, FLIP) block the emergence and evolution of these cell changes and prevent cell death. The balance between molecules pro and anti-apoptotic ensures tissue homeostasis. When apoptosis is out of control, it contributes to the emergence of several neoplastic, autoimmune and neurodegenerative diseases. Several inducing and inhibitors of apoptosis agents are recognized as potential weapons in the fight against diseases related to proliferation and cell death disorders among which stand out hormones. Melatonin has been reported as important anti-apoptotic agent in various tissues by reducing cell calcium uptake, modulating expression of anti-oxidants and decreasing pro-apoptotic protein, such as Bax. The knowledge of new agents capable to act on the course pf apoptosis is important and of great value for developing further therapies against many diseases. Thus, the objective of this review was to elucidate the main aspects of cell death by apoptosis and the role of melatonin in this process.

A utilização de agentes hipoglicemiantes no tratamento de pacientes com síndrome dos ovários policísticos / The use of hipoglycemic agents on the treatment of patients with polycystic ovary syndrome

A síndrome dos ovários policísticos é a mais comum afecção endócrina na idade reprodutiva, acometendo 5 a 10 porcento das mulheres. Caracteriza-se por anovulação crônica, anormalidades menstruais e hiperandrogenismo laboratorial e ou clínico. O principal distúrbio na fisiopatologia ainda é desconhecido, mas há importantes evidências de que a resistência insulínica, hiperandrogenismo e alterações na liberação pulsátil das gonadotrofinas estejam envolvidos. Além das gonodatrofinas, fatores de crescimento e outros peptídeos participam da regulação do desenvolvimento folicular ovariano e da esteroidogênese e podem ter participação na SOP. Além disso, sabe-se que muitas mulheres com esta síndrome têm resistência insulínica, que pode ser corrigida pelos agentes sensibilizadores do receptor de insulina. Nesta revisão, analisou-se a ação da tiazolidinediona rosiglitazona em amenizar a sintomatologia na SOP, corrigindo a hiperinsulinemia. Sugere-se, então, que a rosiglitazona é alternativa para a correção da resistência insulínica em mulheres com a síndrome dos ovários policísticos.

The polycystic ovary syndrome is the most common endocrine-gynecological disorder of premenopausal women, affecting 5 - 10 percent of this population. It is characterized by chronic anovulation, menstrual disturbance and laboratorial and or clinic hyperandrogenism. The primary pathophysiological defect is unknown, but important characteristics include insulin resistance, androgen excess and abnormal gonadotropin dynamics. Growth factors, such as IGF-I, and other peptides have also been shown to play an important role in the regulation of ovarian follicular maturation and steroidogenesis. These factors might have important role in PCOS. Furthermore, some patients with PCOS may have insulin resistance and the insulin-sensitizing drugs may correct this condition. In this review, we analyzed the action of the thiazolidinedione rosiglitazone on decreasing SOP symptoms and regulating hyperinsulism. Our review suggests that rosiglitazone is an alternative to ameliorate insulin resistance in women with polycystic ovary syndrome.

Indirect evaluation of estrogenic activity post heterotopic ovarian autograft in rats / Avaliação indireta da atividade estrogênica após transplante heterotópico de ovário em ratas

PURPOSE: To morphologically evaluate the estrogenic effect on the uterus and vagina of rats submitted to ovarian autografts. METHODS: Twenty Wistar EPM-1 adult rats were bilaterally ovariectomized, followed by ovarian transplants in retroperitoneal regions. The animals were divided in four groups of five animals, according to the day of euthanasia: G4, G7, G14 and G21, corresponding to the 4th, 7th, 14th and 21st day after surgery, respectively. Vaginal smears were collected from the first day of surgery until euthanasia day. After that, the vagina and uterus were removed, fixed in 10 percent formaldehyde and submitted to histological analysis and stained with hematoxiline and eosine. RESULTS: All animals showed estrous cycle changes during the experiment. In 4th day, the uterus showed low action of estrogen with small number of mitosis and eosinophils as well as poor development. On the 7th day, the endometrium was atrophic without mitotic signals and presented a small number of eosinophils. On the 14th and 21th days the histological findings were similar, with the presence of mitosis in the endometrial glands and intense leucocyte infiltration with a large number of eosinophils. Morphometric results showed that the endometrial and myometrial thickness as well as the number of eosinophils presented the highest values during the 14th and 21th days of the evaluation. The 7th day group also presented the lowest eosinophil numbers. Vaginal epithelium features were: 4th and 7th day groups presented non-keratinized stratified epithelium with 5 and 2 cell layers, respectively. The 14th and 21st day groups presented non-keratinized stratified epithelium with 14 and 15 cell layers. CONCLUSION: Experimental ovarian autografts in the evaluated organs presented maximum estrogen activity after the 21st day of surgery, according to morphological and morphometric data.

OBJETIVO: Avaliar morfologicamente a atividade estrogênica no útero e vagina de ratas submetidas a transplante autólogo de ovário. MÉTODOS: Foram utilizadas 20 ratas adultas, Wistar EPM-1, submetidas à ooforectomia bilateral seguida de transplante de ovário em retroperitônio, distribuídas em grupos, conforme a data pré-estabelecida para eutanásia, com cinco animais cada: G4, G7, G14 e G21 - eutanásia no 4º, 7º, 14º e 21º dia de pós-operatório, respectivamente. No 1º dia após a cirurgia foi iniciada coleta de esfregaço vaginal diariamente até o dia pré-estabelecido para eutanásia. Após a eutanásia foi realizada exérese em bloco da vagina e útero, que foram fixados em formol 10 por cento para processamento histológico e coloração pela Hematoxilina-Eosina. RESULTADOS: Todos os animais mostraram alterações do ciclo estral no decorrer dos dias do experimento. No 4º dia, o útero mostrava sinais de baixa atividade estrogênica, o endométrio apresentava poucas figuras de mitose, pouco desenvolvimento e pequena quantidade de eosinófilos. Já no 7º dia, o endométrio encontrava-se atrofiado, sem atividade mitótica e com raros eosinófilos. No 14º e 21º dias os achados foram semelhantes, com presença de mitose nas glândulas endometriais e intenso infiltrado leucocitário, com predomínio de eosinófilos. Os resultados da morfometria mostraram que tanto as espessuras endometrial e miometrial quanto o número de eosinófilos foram maiores no 14º e 21º dias de avaliação, com menores valores no 7º dia. As características do epitélio vaginal foram: epitélio pavimentoso não queratinizado no 4º e 7º (com cerca de cinco e duas camadas celulares, respectivamente) e pavimentoso queratinizado em no 14º e 21º dias (com cerca de 14 e 15 camadas celulares, respectivamente) CONCLUSÃO: O transplante experimental autólogo de ovário manteve a atividade estrogênica nos órgãos avaliados, com atividade estrogênica máxima ao final de 21 dias, conforme parâmetros morfológicos...

Does gestrinone antagonize the effects of estrogen on endometrial implants upon the peritoneum of rats?

OBJECTIVE: To evaluate the effects of estrogen treatment in combination with gestrinone on an experimental rat model of endometriosis. METHODS: Uterine transplants were attached to the peritoneum of female Wistar rats via a surgical autotransplantation technique. The implanted area was measured during the proestrus phase and after hormonal treatment. We performed morphometric analysis and examined the macroscopic and morphometric alterations of endometrial implants after hormonal treatment in ovariectomized rats. RESULTS: The high dose of estrogen caused macroscopic increases in the endometrial implant group compared with other groups, which were similar to increases in the proestrus phase. The low dose showed morphometric development of implants, such as an increase in number of endometrial glands, leukocyte infiltration and mitosis. Gestrinone antagonized both doses of estrogen. CONCLUSION: Our findings suggest that gestrinone antagonizes estrogen's effects on rat peritoneal endometrial implants.

Proliferation of the superficial epithelium of ovaries in senile female rats following oral administration of conjugated equine estrogens

OBJECTIVE: To evaluate the effect of different concentrations of estrogen on the ovarian superficial epithelium in senile female rats. Design: Fifty female rats at 15 months of age and with irregular estrous cycles were selected and randomly divided into five experimental groups containing equal numbers of animals in each: GPROP, control group receiving vehicle only; GE0.05mg, group receiving conjugated equine estrogens (CEE) at a dose of 50 µg/kg; GE0.5mg, group receiving CEE at 500 µg/kg; GE1mg, group receiving CEE at 1 mg/kg; and GE2mg, receiving CEE at 2 mg/kg. The length of treatment was 21 days. After this period, the animals were anesthetized and the ovaries were fixed in 10 percent formaldehyde and processed for routine histology. Histomorphology was analyzed by light microscopy, and histomorphometrics were evaluated using the Imagelab program. RESULTS: In the GPROP and GE0.05mg groups, the superficial epithelium of the ovary had a simple cuboidal shape, and as the estrogen dose increased, the epithelium thickened, with pseudo-stratified or stratified epithelium appearing in the GE2mg group. The animals in the group given the highest estrogen dose (GE2mg) showed the thickest ovarian epithelium and the largest perimeter and surface area of the surface ovarian epithelium (P < 0.01). However, the difference in epithelium thickness between the GE0.5mg and GE1mg groups was only slight. CONCLUSION: Our data suggest that CEE at a dose of 2 mg/kg may induce marked proliferation of rat ovarian epithelium.