Comparative clinical evaluation of breast augmentation using silicone foam coated implants and textured implants

Abstract Purpose To evaluate whether silicone foam implants have a different evolution pattern compared to conventional texture implants. Methods Fifty-eight female patients underwent surgery. They were divided into two groups (silicone foam - Lifesil® - and microtexturized silicone - Lifesil®). The evolution was analyzed in postoperative consultations, with physical examination, photographic documentation and filling in a satisfaction questionnaire, in the postoperative period of one month, four months, one year and then annually, up to a maximum of 3 years of follow-up. Results There were no statistically significant differences in presence of rippling, stretch marks, breast ptosis, capsular contracture and quality of scars. There was a higher rate of patients who were very satisfied with the outcome 360 days after surgery in the group receiving silicone foam implants (p = 0.036). Conclusion In short time, silicone foam envelope implants proved to be as reliable as textured silicone envelope implants, making them an option for augmentation mammoplasty.

Experiência Subjetiva com Medicamentos de Pacientes convivendo com o Câncer de Mama: um Fotovoz / Subjective Experience with Medications of Patients living with Breast Cancer: a Photovoice / Experiencia subjetiva con Medicamentos de Pacientes conviviendo con el cáncer de Mama: un Fotovoz

Introdução: A experiência subjetiva com medicamentos deve ser compreendida e explorada no dia a dia da prática clínica. Objetivo: Compreender a experiência subjetiva com medicamentos de mulheres convivendo com o câncer de mama. Método: Estudo qualitativo com orientação teórico-metodológica da Experiência Subjetiva com Medicamentos, proposta por Ramalho de Oliveira & Shoemaker, e do fotovoz na perspectiva de Wang & Burris, de um hospital oncológico em Minas Gerais, entre agosto e novembro de 2017. A amostra com três participantes foi estabelecida no momento em que a inclusão de novos participantes não acrescentava nada de novo à pesquisa e os objetivos foram alcançados. O critério de inclusão foi intencional entre mulheres acompanhadas pelo serviço de Gerenciamento da Terapia Medicamentosa e que aceitaram participar da pesquisa. As participantes utilizaram fotografias para retratar as suas experiências com o uso de medicamentos. Essas fotografias foram discutidas e interpretadas nos fotodiálogos, que foram gravados e transcritos, e cujos dados foram interpretados pela análise indutiva dos dados. Resultados: A experiência com o uso de medicamentos foi definida em quatro unidades temáticas: 1. Quimioterapia e a ideia de perda de cabelo; 2. Implicações da experiência subjetiva com medicamentos nas relações familiares e de trabalho; 3. Valorizando o uso da terapia endócrina: adesão ao tratamento. 4. Resposta do corpo às reações da quimioterapia! Conclusão: Os temas do estudo validaram a importância da atenção farmacêutica operacionalizada pelo gerenciamento da terapia medicamentosa no contexto da mulher com câncer de mama.

AbstractIntroduction: The subjective experience with medication must be understood and explored in the day-to-day clinical practice. Objective:To understand the subjective experience with the medications of women living with breast cancer. Method: Qualitative study with the theoretical and methodological orientation of the Subjective Experience with Medications proposed by Ramalho de Oliveira & Shoemaker and Photovoice from the perspective of Wang and Burris from a cancer hospital in Minas Gerais between August and November 2017. The sample of three participants was established at the time when the inclusion of new participants did not add anything new to the research and the objectives were achieved. The inclusion criterion was intentional among women accompanied by the Medication Therapy Management services and who accepted to participate in the study. Participants used photographs to portray their experiences with the use of medications. These photographs were discussed and interpreted in photodialogue; these were recorded and transcribed whose data were interpreted by the inductive data analysis. Results: The experience with the use of medications was defined in four thematic units: 1. Chemotherapy and the idea of hair loss; 2. Implications of subjective experience with medications in family and work relationships; 3. Valuing the use of endocrine therapy: adherence to treatment. 4. The body's response to chemotherapy reactions! Conclusion: The themes of the study validated the importance of Pharmaceutical Care operationalized by the Medication Therapy Management in the context of women with breast cancer.

Introducción: la experiencia subjetiva con medicamentos debe ser comprendida y explotada en el día a día de la práctica clínica. Objetivo: comprender la experiencia subjetiva con medicamentos de mujeres conviviendo con el cáncer de mama. Método: estudio cualitativo, con orientación teórico-metodológica de la experiencia subjetiva con Medicamentos propuesta por ramalho de oliveira & shoemaker y del Fotovoz en la perspectiva de Wang y Burris de un hospital oncológico en Minas Gerais entre agosto y noviembre de 2017. la muestra de tres participantes se estableció en el momento en que la inclusión de nuevos participantes no añadía nada nuevo a la investigación y los objetivos se alcanzaron. el criterio de inclusión fue intencional entre mujeres acompañadas por el servicio de Gestión de la terapia Medicamentosa y que aceptaron participar en la investigación. las participantes utilizaron fotografías para retratar sus experiencias con el uso de medicamentos. estas fotografías fueron discutidas e interpretadas en los fotodiálogos; estos fueron grabados y transcritos cuyos datos fueron interpretados por el análisis inductivo de los datos. Resultados: la experiencia con el uso de medicamentos fue definida en cuatro unidades temáticas: 1. Quimioterapia y la idea de pérdida de cabello; 2. implicaciones de la experiencia subjetiva con medicamentos en las relaciones familiares y de trabajo; 3. Valorizando el uso de la terapia endocrina: adhesión al tratamiento. 4. respuesta del cuerpo a las reacciones de la quimioterapia! Conclusión: los temas del estudio validaron la importancia de la atención Farmacéutica operacionalizada por la Gestión Gestión integral de la Farmacoterapia en el contexto de la mujer con cáncer de mama.

Simvastatin Reduces Capsular Fibrosis around Silicone Implants

Capsular fibrosis and contracture occurs in most breast reconstruction patients who undergo radiotherapy, and there is no definitive solution for its prevention. Simvastatin was effective at reducing fibrosis in various models. Peri-implant capsular formation is the result of tissue fibrosis development in irradiated breasts. The purpose of this study was to examine the effect of simvastatin on peri-implant fibrosis in rats. Eighteen male Sprague-Dawley rats were allocated to an experimental group (9 rats, 18 implants) or a control group (9 rats, 18 implants). Two hemispherical silicone implants, 10 mm in diameter, were inserted in subpanniculus pockets in each rat. The next day, 10-Gy of radiation from a clinical accelerator was targeted at the implants. Simvastatin (15 mg/kg/day) was administered by oral gavage in the experimental group, while animals in the control group received water. At 12 weeks post-implantation, peri-implant capsules were harvested and examined histologically and by real-time polymerase chain reaction. The average capsular thickness was 371.2 μm in the simvastatin group and 491.2 μm in the control group. The fibrosis ratio was significantly different, with 32.33% in the simvastatin group and 58.44% in the control group (P < 0.001). Connective tissue growth factor (CTGF) and transforming growth factor (TGF)-β1 gene expression decreased significantly in the simvastatin group compared to the control group (P < 0.001). This study shows that simvastatin reduces radiation-induced capsular fibrosis around silicone implants in rats. This finding offers an alternative therapeutic strategy for reducing capsular fibrosis and contracture after implant-based breast reconstruction.

Simvastatin Reduces Capsular Fibrosis around Silicone Implants

Capsular fibrosis and contracture occurs in most breast reconstruction patients who undergo radiotherapy, and there is no definitive solution for its prevention. Simvastatin was effective at reducing fibrosis in various models. Peri-implant capsular formation is the result of tissue fibrosis development in irradiated breasts. The purpose of this study was to examine the effect of simvastatin on peri-implant fibrosis in rats. Eighteen male Sprague-Dawley rats were allocated to an experimental group (9 rats, 18 implants) or a control group (9 rats, 18 implants). Two hemispherical silicone implants, 10 mm in diameter, were inserted in subpanniculus pockets in each rat. The next day, 10-Gy of radiation from a clinical accelerator was targeted at the implants. Simvastatin (15 mg/kg/day) was administered by oral gavage in the experimental group, while animals in the control group received water. At 12 weeks post-implantation, peri-implant capsules were harvested and examined histologically and by real-time polymerase chain reaction. The average capsular thickness was 371.2 μm in the simvastatin group and 491.2 μm in the control group. The fibrosis ratio was significantly different, with 32.33% in the simvastatin group and 58.44% in the control group (P < 0.001). Connective tissue growth factor (CTGF) and transforming growth factor (TGF)-β1 gene expression decreased significantly in the simvastatin group compared to the control group (P < 0.001). This study shows that simvastatin reduces radiation-induced capsular fibrosis around silicone implants in rats. This finding offers an alternative therapeutic strategy for reducing capsular fibrosis and contracture after implant-based breast reconstruction.

Effect of zafirlukast on capsular contracture around silicone implants in rats / Efeito do zafirlukast na contratura capsular ao redor de implantes de silicone em ratos

PURPOSE: To evaluate the effect of zafirlukast on capsular contracture around silicone implants by measuring the pressure within the implant, using a rat experimental model. METHODS: Forty adult female Wistar rats were used. Each one received two silicone implants, one with smooth-surface and the other with textured-surface. They were randomly divided into four groups (n=10). The rats of control group I were sacrificed after the implants. The remaining animals were subjected to a daily regimen of intra-peritoneal injection for a period of 90 days and they were distributed as follows: control group II received 0.9 percent physiological saline solution; experimental group I received zafirlukast 1.25 mg/kg; and experimental group II received zafirlukast 5 mg/kg. The measurement of intra-implant pressure of control group I was determined on the surgery day and in other groups on the ninetieth day, after being sacrificed. RESULTS: In the evaluation of textured implants there was an increase of internal pressure in the control group II, and there was no increase in the experimental groups. Compared to the controls there were not significant differences in smooth implants. CONCLUSION: Zafirlukast reduced the risk of developing capsular contracture around silicone implants with textured surface.

OBJETIVO: Avaliar o efeito do zafirlukast na contratura capsular ao redor de implantes de silicone, através da aferição da pressão intra-implante, utilizando-se um modelo experimental de ratos. MÉTODOS: Quarenta ratos fêmeas Wistar foram utilizados. Cada um recebeu dois implantes de silicone, sendo um com superfície lisa e outro texturizada. Foram divididos aleatoriamente em quatro grupos (n=10). Os ratos do grupo controle I foram sacrificados após o implante. O restante dos animais foi submetido a um regime diário de injeção intraperitoneal por um período de 90 dias e foram distribuídos: grupo controle II recebeu solução salina fisiológica 0,9 por cento, grupo experimental I recebeu zafirlukast 1,25 mg/kg, e grupo experimental II recebeu zafirlukast 5 mg/kg. O grupo controle II recebeu solução salina; grupo experimental I, 1,25 mg/kg/dia de zafirlukast; grupo experimental II, 5mg/kg/dia de zafirlukast. A aferição da pressão intra-implante do grupo controle I foi averiguada no dia do ato operatório, e nos outros grupos no nonagésimo dia, após serem sacrificados. RESULTADOS: Na avaliação dos implantes texturizados houve aumento da pressão interna no grupo controle II e, não se observou aumento nos grupos experimentais. Na comparação com os controles não foram observadas diferenças significativas nos implantes lisos. CONCLUSÃO: O Zafirlukast reduziu o risco de desenvolver contratura capsular em torno de implantes de silicone com superfície texturizada.

Breast density in women with premature ovarian failure or postmenopausal women using hormone therapy: analytical cross-sectional study / Densidade mamária em mulheres com falência ovariana prematura ou na pós-menopausa e em uso de terapia hormonal: estudo transversal analítico

CONTEXT AND OBJECTIVE: Studies on postmenopausal women have reported increased risk of breast cancer relating to the type and duration of hormone therapy (HT) used. Women with premature ovarian failure (POF) represent a challenge, since they require prolonged HT. Little is known about the impact of prolonged HT use on these women's breasts. This study aimed to evaluate the effects of one type of HT on the breast density of women with POF, compared with postmenopausal women. DESIGN AND SETTING: Cross-sectional study at the Department of Obstetrics and Gynecology, Universidade Estadual de Campinas (Unicamp). METHODS: 31 women with POF and 31 postmenopausal women, all using HT consisting of conjugated equine estrogen combined with medroxyprogesterone acetate, and matched according to HT duration, were studied. Mammography was performed on all subjects and was analyzed by means of digitization or Wolfe's classification, stratified into two categories: non-dense (N1 and P1 patterns) and dense (P2 and Dy). RESULTS: No significant difference in breast density was found between the two groups through digitization or Wolfe's classification. From digitization, the mean breast density was 24.1 percent ± 14.6 and 18.1 percent ± 17.2 in the POF and postmenopausal groups, respectively (P = 0.15). Wolfe's classification identified dense breasts in 51.6 percent and 29.0 percent, respectively (P = 0.171). CONCLUSION: There was no difference in breast density between the women with POF and postmenopausal women, who had used HT for the same length of time. These results may help towards compliance with HT use among women with POF.

CONTEXTO E OBJETIVO: Estudos com mulheres na pós-menopausa relatam aumento no risco de câncer de mama relacionado ao tipo e duração da terapia hormonal (TH) utilizada. Mulheres com falência ovariana prematura (FOP) representam desafio por necessitarem de TH prolongada. Pouco se conhece sobre ação da TH nas mamas dessas mulheres. Este estudo objetivou avaliar os efeitos de um tipo de TH sobre a densidade mamária de mulheres com FOP comparativamente à de mulheres pós-menopausa. TIPO DE ESTUDO E LOCAL: Estudo de corte transversal no Departamento de Tocoginecologia, Universidade Estadual de Campinas (Unicamp). MÉTODOS: Estudaram-se 31 mulheres com FOP e 31 mulheres na pós-menopausa, todas usando TH com estrogênio conjugado equino mais acetato de medroxiprogesterona, pareadas pelo tempo de utilização da TH. Todas realizaram mamografia, analisada por digitalização e por classificação de Wolfe, estratificada em duas categorias: não densa (padrão N1 e P1) e densa (P2 e Dy). RESULTADOS: Não houve diferença significativa entre a densidade mamária dos grupos analisadas por digitalização ou classificação de Wolfe. Pela digitalização, calculou-se densidade mamária média em 24.1 por cento ± 14.6 e 18.1 por cento ± 17.2 nas com FOP e pós-menopausa, respectivamente (P = 0,15); pela classificação de Wolfe identificou-se mamas densas em 51,6 por cento e 29,0 por cento, respectivamente (P = 0,171). CONCLUSÃO: Não se observou diferença na densidade mamária de mulheres com FOP comparativamente à de mulheres na pós-menopausa utilizando TH pelo mesmo período de tempo. Estes resultados podem auxiliar na aderência à TH de pacientes com FOP.

Ingestão excessiva de fitoestrógenos e telarca precoce: relato de caso com possível correlação / High intake of phytoestrogens and precocious thelarche: case report with a possible correlation

Telarca precoce, desenvolvimento mamário antes dos 8 anos de idade, apresenta dois picos de incidência, nos dois primeiros anos de vida e após os 6 anos de idade. Uma menina de 4,75 anos apresentou-se com telarca associada à ingestão excessiva de fitoestrógenos. O desenvolvimento puberal M2P1-2, os níveis hormonais e o US pélvico eram compatíveis com puberdade precoce periférica. Durante o seguimento, observou-se ingestão diária de alimentos baseados em soja (> 40 mg fitoestrógenos/dia). Soja contém fitoestrógenos, principalmente genisteína e daidzeína. Embora menos potentes do que o estradiol, sua concentração pode ser 13.000 a 22.000 vezes maior em crianças alimentadas somente com fórmulas baseadas em soja. Os pais foram aconselhados a reduzir para uma vez na semana o seu fornecimento na dieta. O desenvolvimento puberal cessou em M2-3P1 e a paciente, com 8,66 anos, continua a desenvolver-se com idades óssea e cronológica equivalentes. Questões relacionadas à segurança alimentar, principalmente de alimentos baseados em soja, permanecem sem respostas precisas. Embora sejam conhecidas as etiologias da puberdade precoce não progressiva e da telarca prematura, neste caso esteve fortemente relacionada à ingestão excessiva de soja e de outros alimentos ricos em fitoestrógenos que poderiam ter desencadeado a telarca atuando como desreguladores endócrinos.

Precocious thelarche is the breast development before 8 years of age with two peaks of incidence during the first two years of life and after 6 years of age. A 4.75-year-old girl presented with thelarche associated to an excessive intake of phytoestrogens (phye). Tanner development B2P1-2, hormonal levels and pelvic US were compatible with peripheral precocious puberty. During follow-up, a daily intake of soy-based foods was observed (> 40 mg phye/day). Soy is rich in phytoestrogens, mainly genistein and daidzein. Although phye are less strong than estradiol, its concentration could be from 13,000 to 22,000 times stronger in children fed only by soy-based formulas. Parents were advised and soy intake was reduced to once a week. Progression of pubertal development ceased at B2-3P1. The patient, now 8.66 years old, keeps growing with similar bone and chronological ages. Some questions related to industrial food security, mainly the soy-based food, remain without precise answer. Although it is well known the entity of non-progressive precocious puberty and premature thelarche, pubertal development in this case was strongly related to excessive daily intake of soy and other phye-rich food that could trigger puberty as endocrine disruptor.

Comparative study of the outcome of the treatment with danazol and or without sports brassieres in the management of mastalgia

Mastalgia is described as diffused or itching pain of the breast. Usually, active movement of heavy breast supported by weak suspensory ligaments contribute mainly to the etiology of mastalgia which is considered the most frequent complaint of women attending Al-Elwiya teaching hospital for consultation. The aim was to minimize breast pain in mastalgic women by wearing the sport brassieres with or without the use of danazol. Tow hundred and fifty cyclic and non cyclic women suffering from some degrees of mastalgia were chosen randomly from breast clinic of AL-Elwiya teaching hospital from June 2004 till August 2005. The mastalgic women were divided into 3 groups: group A was prescribed to take 200 mg. danazol daily, group B was instructed to wear the sport brassieres while group C was prescribed to take 100 mg. danazol daily plus wearing the sport brassieres .The duration of the project was 12 weeks. All women under study were educated to complete a breast pain chart using visual analogue scale, [VAS]. The outcome of the breast pain study revealed that, the combined use of sport brassieres plus the intake of 100 mg. danazol associated with highly significant decrease in VAS with low side effects. The management of mastalgia suffering women was the combined use of the sport brassieres beside the intake of 100 mg danazol which decreased breast pain and minimized side effects

Efectividad de la terapia con leuprolide acetato de depósito cada tres meses en pubertad precoz central / Effectiveness of Leuprolide acetate therapy every three months in central precocious puberty

Background: Precocious puberty may reduce final adult height, and affected children may suffer social and emotional problems. The efficacy of treatment with a long acting agonist analogue of the gonadotropin releasing hormone (aLHRH) has been well demonstrated. Aim: To evaluated the efficacy of a new formulation of aLHRH (leuprolide, Lupron ®) for the suppression of gonadotropin activation and clinical signs of puberty. Material and methods: Eleven children (ten females) with idiopathic central precocious puberty, with a mean chronological age of 7.5±1.8 years and a bone age of 9.7±1.8 years were recruited. Testicular volume in the male was 15 ml. In females, Tanner stage for breast development was between 2-4 and mean ovarian volume was 2.3±0.8 ml. They were treated during 18 months with aLHRH, 11.25 mg administered intramuscularly every three months. Results: Clinical, hormonal and ultrasonographic signs of puberty regressed in all patients. The degree of suppression of LH was 87.7±5.1% at the end of the 18 months. No significant changes in bone mineral content were observed during the treatment period. Conclusions: Leuprolide (aLHRH) 11.25 mg, injected every three months, is effective for the control of central precocious puberty and allows to reduce the number of yearly injections from 12 to 4.

Mammographic changes related to different types of hormonal therapies.

OBJECTIVES: To determine the effects of different types of hormone therapies (HT) on mammographic breast density changes. MATERIAL AND METHOD: Between 1999 and 2002, mammograms obtained before and 12-18 months after different types of HT in 170 women were evaluated Estrogen alone (n = 66), or estrogen in cyclic (n = 59) or continuous (n = 45) combination with progesterone were used. The baseline mammographic density was classified according to the Breast Imaging Reporting and Data Systems (BI-RADS). The serial changes observed mammographically were categorized as follows; no change, minimal change (10-25% increased density), moderate change (26-50% increased density), and marked change (> 50% increased density). Results: Twelve (7%) of the women developed an increase in parenchymal density after HT: Mammographic changes were minimal change in five (2.9%) of the women, moderate change in four (2.3%), and marked change in three (1.8%). No mammographic change was observed in women receiving cyclic estrogen-progesterone. A greater percentage of women who had undergone continuous estrogen-progesterone therapy (22.2%, 10 of 45) demonstrated more change than those who had estrogen alone (3%, 2 of 66). The difference was statistically significant (p < 0.01). Conclusion: Changes of increased density after HT was seen in only 7% of mammograms and depended on the selected hormone regimen.

Effectiveness and safety of raloxifene in post-menopausal females

To determine effects of raloxifene on lipid profile, breast tissue and endometrial thickness in post-menopausal women. A longitudinal cohort study. The study was conducted at Department of Gynaecology and Obstetrics, PNS Shifa Hospital, Karachi over a period of one year. Fifty cases of postmenopausal women, aged 45-60 years, who had last menstrual period 2-8 years back, visiting Gynea OPD at PNS Shifa Hospital, Karachi, were included in the study. The subject received raloxifene [Evista] 60 mg once daily. The tests done at the start of study as baseline were serum lipid profile [HDL, LDL, total triglyceride and cholesterol levels], TVS [trans vaginal sonography] for endometrial thickness and mammography. The above tests were again done at the end of study after 12 months. The adverse effects were recorded. Fifty women were enrolled for study out of which 48 completed the study that is 96%. Mean age was 54 years, SD = 3.95. The mean value of LDL, total triglyceride and cholesterol decreased by 15.2%, 1.2% and 10.2% respectively. The change was statistically significant. [p<0.001] HDL change was 0.665% and was not statistically significant. TVS, for endometrial thickness, and mammography for breast density showed no change. Adverse effects reported were hot flushes, leg cramps and vaginal symptoms in few cases. Raloxifene therapy significantly decreases cardiovascular risk markers LDL, total triglyceride and cholesterol. No abnormal change in breast density and in endometrial thickness indicate good safety profile of this agent

Carcinogenic effect of nicotine on normal mammary ductal epithelial cells and the protective role of beta-carotene.

A number of carcinogens like polycyclic hydrocarbons and aromatic amines have been incriminated to induce mammary carcinomas in vitro and in vivo. Studies have supported an inter-relationship between tobacco consumption and breast cancer. Because nicotine is the major alkaloid present in tobacco this study was conducted to find the direct in vitro effect of nicotine on normal mammary ductal epithelial cells. It was seen in the present work that nicotine causes a statistically significant increase in the proliferative rate and ER (estrogen receptor) expression as compared to the control group. This change was more pronounced with a lower concentration of nicotine (650 microg/ml). Colony efficiency also showed a similar trend. Beta carotene was added in the present work to study its anti oxidant effect on nicotine induced changes. Beta carotene significantly decreased the proliferation rate induced by 650 microg/ml nicotine. It also prevented the cytotoxic effect of higher dose of nicotine, however, it failed to alter significantly the ER expression induced by lower concentration of nicotine though it showed decreasing trend.

Los fármacos y la leche materna / The drugs and the mother's milk

La autora explica la acción de los medicamentos durante la lactancia materna. Describe términos de farmacología, el proceso del pasaje de los fármacos a la leche materna y cita una lista de medicamentos de acuerdo a su efecto en la lactancia o en el niño lactante

Efeitos da terapia de reposiçäo hormonal na densidade mamográfica de mulheres na pós-menopausa / Effects of HRT on mammography density in post-menopausal women

Avaliar a influência da terapia de reposiçäo hormonal (TRH) no comportamento da densidade mamográfica em mulheres na pós-menopausa. Foi realizado um estudo de coorte com 81 usuárias de TRH e 46 näo-usuárias. As mamografias foram reavaliadas e classificadas segundo os critérios de Wolfe (1976). O aumento da densidade mamográfica foi avaliado em usuárias e näo-usuárias de TRH. Foram também avaliados para o grupo de usuárias de TRH (estrógeno ou estrógenos associados a progestágenos) a influência do tipo e o esquema em uso. Para este estudo utilizou-se os testes de Qui-Quadrado, Exato de Fisher e t de Student. Foi observado 12,4 por cento de aumento de densidade mamográfica em usuárias de TRH. O tipo, o esquema e a dose de progesterona utilizados no grupo de usuárias de TRH näo influenciaram o aumento de densidade mamográfica. As implicaçöes desta situaçäo devem ser consideradas.

Study of the action of tamoxifen on the mammary gland epithelium of premenopausal patients by lysosome quantification

Tamoxifen is an antiestrogen drug widely utilized for the adjuvant hormonal treatment of breast carcinoma. Its use in the primary prophylaxis of this disease is currently being proposed. Although the drug has few side effects, its precise action on breast tissue that has not undergone neoplastic transformation has not been fully elucidated. This prospective, randomized study assessed the estrogen activity of tamoxifen on the mammary gland epithelium of premenopausal patients using a quantitative analysis of mammary epithelium lysosomes identified by the cytochemical technique of GOMORI for acid phosphatase and by light microscopy. Tamoxifen significantly increased the number of lysosomes only during the secretory phase of the menstrual cycle. We concluded that the early effect of the drug on normal mammary tissue is synergistic with the effect of estrogen during the premenopausal period.

Efeito da sulpiride sobre o aparelho genital da ratas virgens / Effects of sulpiride between genital arrangement in virgin rats

Com o objetivo de acompanhar os efeitos da sulpiride, droga neuroléptica derivada das benzaminas de açäo hiperprolactinêmica por bloqueio dos receptores da dopamina, nas mamas, no útero e nos ovários de ratas virgens. Utilizaram-se 40 ratas Wistar, virgens, com idade entre 70 a 100 dias e peso variando de 224 a 299 g aleatoriamente divididas em dois grupos de 20 ratas, SF e MED. Às ratas do grupo MED administrou-se 10 mg/100g de peso de sulpiride por sondagem orogástrica, diarimente e ao grupo SF, soluçäo fisiológica em igual volume. Cinco animais de cada grupo foram sorteados para sacrifício nos 7§, 14§, 21§ e 42§ dias após o início do tratamento. Ressecava-se 1 cm² de pele e tela subcutânea contendo o mamilo inguinal direito e por laparotomia, o útero e os ovários. No estudo histopatológico avaliava-se nas mamas: concentraçäo de alvélos por campo, o diâmetro dos ductos e a presença ou ausência de secreçäo no interior dos mesmos. No útero observa-se: a fase do endométrio e a sua espessura. As medidas foram feitas com ocular milimetrada. Nos ovários, verificava-se a predominância de folículos e a presença de corpos lúteos. Cinco animais foram excluídos do experimento. O estudo histológico das mamas mostrou aumento do número de folículos por campo à partir do 14§ dia (p<0,05). Estes mostrava-se dilatados em todos os tempos observados (p<0,05). Secreçäo esteve presente a partir do 14§ dia e em grande quantidade (p14=0,0397, p21=0,0079, p42=0,0397). Todos os endométrios do SF encontravam-se em fase proliferativa. No grupo MED cinco endométrios estavam em fase secretora e 14 em fase proliferativa. Näo se observou diferença significante quanto a espessura do endométrio. Os ovários exibiam folículos em diferentes fases de desenvolvimento e näo havia diferença entre os grupos. Conclui-se que a sulpiride atua sobre as glândulas mamárias de ratas estimulando seu desenvolvimento e galactogênese, sendo diretamente proporcional ao tempo de uso. Näo se observou influência sobre o endométrio e os ovários

Terapeutica de reposicao hormonal no climaterio: implicacoes sobre a glandula mamaria / Hormonal replacement therapy in climacteric: effects on mammary gland

Os autores fazem uma revisao sobre o desenvolvimento e fisiologia mamarios, enfatizando as influencias dos hormonios sexuais (estrogenios, progestogenios e androgenios) e discutem sua possivel implicacao na genese do cancer mamario, bem como, que a atitude tomar frente aos conhecimentos discutidos. Concluem, pela analise da relacao risco/beneficio, que a terapia de reposicao hormonal (TRH) deve ser indicada a grande maioria das pacientes climatericas