ABSTRACT
OBJECTIVE: To evaluate treatment of Brazilian patients with gestational trophoblastic disease (GTD). STUDY DESIGN: A retrospective cohort study with analysis of medical reports performed in 10 Brazilian referral centers from January 2000 to December 2011. RESULTS: Of 5,250 patients 3 died (0.06%) at the time of uterine evacuation. Spontaneous remission of GTD (group G1) was observed in 4,103 cases, and 1,144 (21.8%) progressed to gestational trophoblastic neoplasia (GTN) (G2). In G1 2,716 (66.2%) had complete hydatidiform mole (HM) and 1,210, partial HM (29.5%); 3,772 patients (92.7%) recovered as noted in December 2012. In G2, of 1,118 patients treated, initial histopathological results of previous gestation were complete HM (77.5% [n = 886]), partial HM (8.8% [n = 100]), and choriocarcinoma (8.0% [n = 92]); 930 (81.3%) were low-risk, 200 (17.5%) were high-risk GTN, and 14 had placental site trophoblastic tumor (PSTT) (1.2%); cure was achieved in 1,078 cases (96.4%), but 26 patients (2.3%) died (4 low-risk [0.4%], 19 high-risk [9.5%], and 3 PSTT [21.4%]). CONCLUSION: The highest death rates were due to high-risk GTN and PSTT. Patients with molar pregnancy should be referred to a referral center for an early diagnosis and prompt treatment of GTN in order to reduce the morbidity and mortality found in advanced stages.
Subject(s)
Gestational Trophoblastic Disease/epidemiology , Gestational Trophoblastic Disease/therapy , Brazil/epidemiology , Choriocarcinoma/epidemiology , Choriocarcinoma/therapy , Cohort Studies , Consensus , Female , Gestational Trophoblastic Disease/pathology , Humans , Hydatidiform Mole/epidemiology , Hydatidiform Mole/therapy , Neoplasm Staging , Pregnancy , Remission, Spontaneous , Retrospective Studies , Risk Factors , Trophoblastic Tumor, Placental Site/epidemiology , Trophoblastic Tumor, Placental Site/therapy , Uterine Neoplasms/epidemiology , Uterine Neoplasms/therapySubject(s)
Humans , Female , Trophoblastic Neoplasms , Choriocarcinoma , Hydatidiform Mole , Hydatidiform Mole, Invasive , Uterine NeoplasmsABSTRACT
The authors report a case of pelvic congenital arteriovenous fistula from a 37 year old woman. They discuss the diagnosis and therapeutic options for this problem, reviewing the litterature on the subject.
Subject(s)
Humans , Female , Adult , Mesenteric Artery, Inferior/abnormalities , Pelvic Pain/etiology , Arteriovenous Fistula/congenital , Hypogastric Plexus/blood supply , Arteriovenous Fistula/surgery , Arteriovenous Fistula/complications , Arteriovenous Fistula/diagnosis , Follow-Up StudiesABSTRACT
Foram estudadas 140 pacientes portadoras de candidíase vaginal, confirmadas micologicamente em um estudo multicêntrico aberto, comparativo e randomizado com dois esquemas terapêuticos: 200 mg duas vezes ao dia, por um dia ou 200 mg uma vez ao dia, por três dias. Uma semana após o final do tratamento, os resultados mostraram que 87 por cento e 92 por cento, respectivamente para um e três dias de tratamento, estavam curadas clínica e micologicamente. A tolerabilidade foi considerada boa, ocorrendo efeitos colaterais leves, transitórios, que desapareceram espontaneamente, restritos ao trato gastrintestinal. Os autores concluem pela eficácia do esquema de um dia de tratamento com itraconazol para candidíase aguda e crônica
