The annual ovarian cycle in Northern pit vipers (Bothrops atrox) using serum steroids and ultrasound of the female reproductive tract.

Knowledge on hormonal regulation of reproductive cycles in viperid snakes is still incipient, especially when it comes to females and tropical species. There is an urgent need to understand the reproduction of venomous snakes to improve assisted reproduction techniques and optimize the maintenance of these animals in captivity. With this in mind, we monitored Northern pit viper females year-round throughout different seasons via serum levels of progesterone (P4) and estradiol (E2) in conjunction with ultrasound examinations. Ovarian follicles were classified according to their size and stage of vitellogenesis in F-I and F-II (non-vitellogenic phase) or in F-III and F-IV (vitellogenic phase). During autumn and winter, five adult males were rotated among these females for reproductive pairing, which resulted in 17 copulations and 2 pregnancies in the first year and 12 copulations and 5 pregnancies in the second year. Then, we assessed changes in P4 and E2 levels according to seasons, predominant ovarian structures and the presence of embryos or eggs in the oviduct. Our findings showed high levels of E2 when a greater number of vitellogenic follicles were detected, indicating a possible influence of E2 on vitellogenesis and higher levels of P4 whenever eggs and embryos were visualized in the oviduct, implying its role in maintaining pregnancy. Descriptive analysis of the vipers' ovarian cycles revealed a greater number of vitellogenic follicles during winter, probably as a result of increases in E2; whereas pregnancies occurred predominantly in spring, under the influence of P4. The use of ultrasound images, as a minimally invasive methodology, associated with serum steroid levels has proven to be an efficient approach in the reproductive monitoring of Northern pit vipers in vivo. In addition, these data suggest that female pit vipers under human care display a seasonal reproductive cycle, despite earlier studies involving captive males of the species indicating a lack of seasonality in sperm production and quality.

Correlation of pelvic ultrasonography with pubertal development in girls.

Objectives: This study aims to correlate pelvic ultrasound with female puberty and evaluate the usual ultrasound parameters as diagnostic tests for the onset of puberty and, in particular, a less studied parameter: the Doppler evaluation of the uterine arteries. Methods: Cross-sectional study with girls aged from one to less than eighteen years old, with normal pubertal development, who underwent pelvic ultrasound examination from November 2020 to December 2021. The presence of thelarche was the clinical criterion to distinguish pubescent from non-pubescent girls. The sonographic parameters were evaluated using the ROC curve and the cutoff point defined through the Youden index (J). Results: 60 girls were included in the study. Uterine volume ≥ 2.45mL had a sensitivity of 93%, specificity of 90%, PPV of 90%, NPV of 93% and accuracy of 91% (AUC 0.972) for predicting the onset of puberty. Mean ovarian volume ≥ 1.48mL had a sensitivity of 96%, specificity of 90%, PPV of 90%, NPV of 97% and accuracy of 93% (AUC 0.966). Mean PI ≤ 2.75 had 100% sensitivity, 48% specificity, 62% PPV, 100% NPV and 72% accuracy (AUC 0.756) for predicting the onset of puberty. Conclusion: Pelvic ultrasound proved to be an excellent tool for female pubertal assessment and uterine and ovarian volume, the best ultrasound parameters for detecting the onset of puberty. The PI of the uterine arteries, in this study, although useful in the pubertal evaluation, showed lower accuracy in relation to the uterine and ovarian volume.

Accuracy of ultrasound and visual inspection in antral follicular count in crossbred Holstein cows raised under grazing systems at high altitude.

The objective of this research was to investigate the diagnostic accuracy of post-mortem ultrasound in antral follicle count (AFC) determination and compare it with visual AFC in grazing crossbred Holstein cows, at high altitude in Ecuador. Pre-mortem blood from 80 cows was collected, and AFC and ovarian characteristics were analysed post-mortem by ultrasound and visual techniques. AFC counts were stratified as high, medium or low by terciles. Mean AMH concentration in pre-mortem blood was 280.1 ± 15.53 pg/mL. The AFC obtained by visual inspection (26.9 ± 9.49 follicles) was 23.8% higher than by ultrasound (20.5 ± 7.53 follicles) in all ovaries. Body condition score, age and weight of the cattle did not interact with the count technique. In the low AFC group, visual inspection and ultrasound provided similar AFC results. However, in the Medium- and High-AFC groups, AFC by ultrasound was 14.9% lower than AFC by visual inspection. We confirm that ultrasound can be used with great accuracy for AFC >3 mm (close to the resolution limit) in grazing crossbred Holstein cows at high altitude.

Desfechos reprodutivos e de sobrevida em adolescente tratada com cirurgia preservadora de fertilidade por tumor borderline de ovário em estádio avançado: relato de caso e revisão da literatura / Reproductive and survival outcomes in an adolescent treated with fertility- sparing surgery for advanced stage borderline ovarian tumor: case report and review of the literature

Existem poucos dados na literatura sobre os resultados obstétricos e oncológicos de adolescentes com tumores borderline de ovário em estádio avançado trata- das com cirurgia preservadora da fertilidade. Uma adolescente de 15 anos com diagnóstico de tumor borderline de ovário estádio IIIc foi inicialmente tratada com tumorectomia ovariana bilateral e quimioterapia adjuvante com esquema de platina/taxano (seis ciclos). Durante o seguimento, foi submetida a outras três tumorectomias devido a tumor borderline de ovário (duas vezes) e cistadenoma ovariano (uma vez). Outra recidiva de tumor borderline de ovário ocorreu seis anos após o diagnóstico inicial, quando ela estava grávida; foi tratada com tumorecto- mia realizada durante a cesariana. Em sua última consulta ambulatorial, a mulher de 27 anos não apresentava evidência da doença e tinha um filho saudável. Mesmo em estádio avançado, a cirurgia de preservação da fertilidade foi segura e factível nessa paciente com tumor borderline de ovário.

There are few data in the literature regarding obstetric and oncological outcomes of adolescents with advanced-stage borderline ovarian tumors treated with fertility spa- ring surgery. A 15 years old adolescent who was diagnosed with a stage IIIc borderline ovarian tumor, was treated with bilateral ovarian tumorectomies and adjuvant chemotherapy with platinum/taxane regimen (six cycles). During follow up she was submitted to other three tumorectomies due to borderline ovarian tumor(twice) and ovarian cysta- denoma (once). Another borderline ovarian tumorrecurren- ce occurred six years after initial diagnosis, when she was pregnant; treated with tumorectomy performed during ce- sarean section. At her last outpatient visit, the 27-year-old woman had no evidence of disease and a had healthy child. Even at an advanced stage, fertility sparing surgery was safe and feasible in this patient with borderline ovarian tumor.

Anatomic nomenclature and 3-dimensional regional model of the human ovary: call for a new paradigm.

The ovaries are the female gonads that are crucial for reproduction, steroid production, and overall health. Historically, the ovary was broadly divided into regions defined as the cortex, medulla, and hilum. This current nomenclature lacks specificity and fails to consider the significant anatomic variations in the ovary. Recent technological advances in imaging modalities and high-resolution omic analyses have brought about the need for revision of the existing definitions, which will facilitate the integration of generated data and enable the characterization of organ subanatomy and function at the cellular level. The creation of these high-resolution multimodal maps of the ovary will enhance collaboration and communication among disciplines and between clinicians and researchers. Beginning in March 2021, the Pediatric and Adolescent Gynecology Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development invited subject-matter experts to participate in a series of workshops and meetings to standardize ovarian nomenclature and define the organ's features. The goal was to develop a spatially defined and semantically consistent terminology of the ovary to support collaborative, team science-based endeavors aimed at generating reference atlases of the human ovary. The group recommended a standardized, 3-dimensional description of the ovary and an ontological approach to the subanatomy of the ovary and definition of follicles. This new greater precision in nomenclature and mapping will better reflect the ovary's heterogeneous composition and function, support the standardization of tissue collection, facilitate functional analyses, and enable clinical and research collaborations. The conceptualization process and outcomes of the effort, which spanned the better part of 2021 and early 2022, are introduced in this article. The institute and the workshop participants encourage researchers and clinicians to adopt the new systems in their everyday work to advance the overarching goal of improving human reproductive health.

Calcium chloride diluted in ethanol 95% as female sterilizing agent: effect of transcutaneous delivery in rats.

BACKGROUND: Different fertility control methods are investigated as a tool for population control of free-roaming animals. Chemical castration using calcium chloride has been widely studied over the years in males, but there are few studies related to its use in females. Therefore, we aimed to evaluate the local effects, as a potential chemosterilant, of two concentrations of calcium chloride diluted in 95% ethanol when administered by transcutaneous ultrasound-guided intraovarian injection in rats. In this study, 30 female Wistar rats were randomly divided into three treatment groups, which consisted of transcutaneous ultrasound-guided intraovarian injection of: 0.9% sodium chloride solution (GC); 10% calcium chloride diluted in 95% ethanol (G10); 20% calcium chloride diluted in 95% ethanol (G20). The animals were subdivided into two evaluation times, 15 days (n = 5 of each group) and 30 days (n = 5 of each group) after the intraovarian injection. The ovarian diameter was measured using ultrasound image prior and immediately after the injection and after the treatment period. Furthermore, animals' clinical evaluation, estrous cycles assessment, macroscopic examination of the abdominal cavity and histological evaluation of the ovaries were performed. RESULTS: Ovarian ultrasound measurement revealed changes (p < 0.05) between ovarian diameters before and immediately after the injection in all treatments. Three animals in G20 had a small focal skin lesion at the injection site that evolved to total healing. Extended and abnormal estrous cycles were observed in G10 and G20. At gross examination, adhesions and ovarian cysts were noticed in both groups, G10 and G20. Also, the histopathology analysis revealed changes in ovarian architecture and vessel congestion in G10 and G20, but ovarian tissue damage was greater in the ovaries treated with the highest concentration (G20). CONCLUSIONS: The results indicate that 20% calcium chloride diluted in 95% ethanol may be a potential agent for inducing sterilization in females and was possible to be minimally invasively delivered.

Ovarian contrast-enhanced ultrasonography and Doppler fluxometry in bitches during the postovulatory estrus and corpora lutea formation.

The aim of the present study was to evaluate the vascularization features of canine ovaries during the follicular phase and the formation of the corpora lutea by using Doppler ultrasonography and Contrast-Enhanced Ultrasound (CEUS). Eight healthy bitches were enrolled in the study and were evaluated at five different timepoints (T1 - T5) of the estrous cycle established by vaginal cytology and serum progesterone concentration. Ultrasonographic examinations were performed by a single operator using the ACUSON S2000/SIEMENS machine equipped with a linear multifrequency transducer (9.0 MHz). Color-coded Doppler evaluation of the ovarian parenchyma was performed to investigate the aspects of the signal detection throughout the different timepoints. Pulsed-wave Doppler of the intraovarian arteries was performed to evaluate spectral waveform and doppler velocimetric parameters of Systolic Peak Velocity (SPV cm/s), End Diastolic Velocity (EDV cm/s), Resistivity Index (RI) and Pulsatility Index (PI). CEUS evaluation of the ovaries was performed using a vascular contrast agent (SonoVue®, Bracco, Sao Paulo, Brazil) and the CADENCE™ Contrast Pulse Sequencing (CPS, Siemens) software, in order to perform both qualitative and quantitative analysis. Perfusion parameters of pixel number, peak intensity (PPI in %), time to peak intensity (TTP in s), mean transit time (MTT in s) and area under the curve (AUC in %). Colour-coded Doppler evaluation demonstrated an increase in signal detection as cycle progressed, with blood flow initially detected with few coloured pixels and mainly at the ventral surface of the ovaries. Further on, the number of coloured pixels increased and spreading to the central region, resulting in a circular-like pattern around the corpora hemorrhagica. The spectral waveform was consistent at all timepoints. SPV (cm/s) and EDV (cm/s) presented a numeric trend and a slight statistical difference at all timepoints, whereas no difference was found for RI and PI. CEUS evaluation demonstrated an increase in pixel intensity across all the timepoints. Quantitative CEUS analysis revealed a statistical difference in PPI (%), MTT (s) and AUC (%) at T5. CEUS evaluation of the ovaries was feasible and demonstrated a marked increase in perfusion parameters in the late postovulatory period, demonstrating its applicability in the assessment of canine corpora lutea development.

Ovarian and uterine two-dimensional and Doppler ultrasonographic changes in the feline peri-estrus period.

OBJECTIVES: The aim of this study was to evaluate two-dimensional and Doppler ultrasonographic changes of the ovary and uterus during estrus and the early post-estrus period in domestic cats. METHODS: Two-dimensional and Doppler ultrasonographic evaluations of the ovaries and uterus were performed in seven queens on days 1, 3 and 5 of estrus, and 5 days after estrus (AE5). RESULTS: On day 1, 5.4 ± 0.5 follicles of 2.1 ± 0.1 mm were detected progressively increasing in number and size up to day 5 and then decreased on AE5 (P <0.05). A maximum follicular diameter of 4.1 ± 0.1 mm was achieved on day 5. Both during and after estrus, the uterus was generally hypoechoic compared with the surrounding tissues and delineated by a thin hyperechoic line corresponding to the serosa. In some animals, the uterine layers were distinguished during and after estrus. The blood flow waveforms of the intraovarian and uterine arteries were characterized by a systolic peak and diastolic flow extending throughout the remainder of the cardiac cycle to the next systole. In the uterine artery waveforms, the early diastolic notch was mild or absent during most estrous observations. The resistance index of the intraovarian arteries decreased up to day 5, and then increased on AE5 (P <0.05). The resistance index of the uterine arteries was lower during estrus than in the post-estrus period (P <0.05). CONCLUSIONS AND RELEVANCE: It is concluded that in the domestic cat, follicular number and diameter as well as ovarian and uterine blood flow changed during and immediately after estrus. Doppler ultrasound proved suitable to evaluate the hemodynamic changes involved in the cyclic remodeling of ovarian and uterine tissues that occurs during and after follicular growth in domestic cats.

Ovarian cancer staging: What the surgeon needs to know.

Ovarian cancer (OC) is the leading cause of gynecological cancer death, and most cases are diagnosed at advanced stages due to a nonspecific and insidious clinical presentation. Radiologists play a critical role in the decision of which patients are candidates for primary debulking surgery and who may benefit from neoadjuvant chemotherapy. This pictorial review summarizes the dissemination patterns of OC, main imaging findings of metastatic disease, and which findings may alter the treatment plan or predict suboptimal tumor resection.

Quiste gigante de ovario / Giant cyst of ovary

Introducción: Los tumores de gran tamaño han sido descritos a través de la historia, entre ellos los ginecológicos y los de ovario cuando pesan más de 12 kg constituyen una rareza médica. Las masas tumorales en hemiabdomen inferior son causas frecuentes de consulta en cirugía general. Dentro de estas, los quistes de ovarios son los que con más frecuencia se diagnostican. Objetivo: Describir el caso de un quiste gigante de ovario en una paciente que fue atendida en consulta de cirugia general por aumento de tamaño en el abdomen de varios años de evolución. Caso clínico: Se expone el caso de una paciente femenina, con antecedentes de salud, que acude al servicio de cirugía general por aumento de volumen del abdomen, progresivo, insidioso de 2 años de evolución. Se diagnostica masa quística dependiente de ovario y en el transoperatorio se constata una tumoración quística del ovario que en el análisis histopatológico informa un cistoadenoma seroso de ovario. Conclusión: Los tumores del ovario no son tan frecuentes como los del útero y los de la mama, pero constituyen el tercer grupo de tumores benignos y malignos de la mujer. Se presentó el caso por lo infrecuente que resulta, la escasa frecuencia de reporte de estos casos lo cual aporta conocimiento a la comunidad médica sobre el tema(AU)

Introduction: Large tumors have been described throughout history, including gynecological tumors, and ovarian tumors when they weigh more than 12 kg constitute a medical rarity. Tumor masses in lower hemiabdomen are frequent causes of consultation in general surgery. Within these, ovarian cysts are the most frequently diagnosed. Objective: To describe the case of a giant ovarian cyst in a patient who was treated in a general surgery consultation due to an increase in abdomen size of several years of evolution. Clinical case: The case of a female patient, with a history of health, which goes to the general surgery service due to an increase in abdomen volume, progressive, insidious of 2 years of evolution, is presented. Ovarian-dependent cystic mass is diagnosed and a cystic tumor of the ovary is found in the transoperative period, which in the histopathological analysis reports a serous ovarian cystadenoma. Conclusion: Ovarian tumors are not as frequent as those of the uterus and those of the breast, but they constitute the third group of benign and malignant tumors of women. The case was presented because of the infrequent result, the low frequency of reporting these cases, which brings knowledge to the medical community on the subject(AU)

Ultrasound evaluation of female reproductive system in free ranging Giant Anteater (Myrmecophaga tridactyla): case report / Avaliação ultrassonográfica do sistema reprodutor feminino em tamanduá-bandeira de vida livre (Myrmecophaga tridactyla): relato de caso

An adult, female, 31kg body weight, free range Myrmecophaga tridactyla was referred for medical consultation due to apathy, dehydration, intense flatulence and fetid stools. The animal was submitted to chemical restraint and physical examination, blood count, fecal analysis, and vaginal cytology and abdominal ultrasonography were performed. Good nutritional status and clinical variables within the normal range were observed at physical examination. At vaginal cytology leukocytes, spermatozoa and a large proportion of cornified cells (superficial) were observed, indicating estrus and recent copula. At ultrasound examination it was possible to locate, identify, evaluate and measure the ovaries and the uterine structures, cervix, body, lumen, myometrium and endometrium, a fact never reported in the literature for this species. These data can be used as reference for clinical evaluation of the reproductive tract in Myrmecophaga tridactyla females considered vulnerable species, for the diagnosis of reproductive pathologies, biotechnologies application or estrous cycle evaluation.(AU)

Uma fêmea, com 31kg de peso corporal, de Myrmecophaga tridactyla, de vida livre, foi apresentada para consulta médica em razão de apatia, desidratação, flatulência intensa e fezes fétidas. O animal foi submetido à contenção química e foram realizados exame físico, hemograma, análise fecal, citologia vaginal e ultrassonografia abdominal. Ao exame físico, foi determinado bom estado nutricional e variáveis clínicas dentro da faixa de normalidade. Na citologia vaginal, foram observados leucócitos, espermatozoides e uma grande proporção de células cornificadas (superficiais), indicando estro e cópula recente. No exame ultrassonográfico, foi possível localizar, identificar, avaliar e mensurar os ovários e as estruturas uterinas, o colo do útero, o corpo do útero, o lúmen, o miométrio e o endométrio, fato nunca relatado na literatura para essa espécie. Esses dados podem ser utilizados como referência para avaliação clínica do trato reprodutivo de fêmeas de Myrmecophaga tridactyla considerada espécie vulnerável, para o diagnóstico de patologias reprodutivas, aplicação de biotecnologias ou avaliação do ciclo estral.(AU)

Ultrasound evaluation of female reproductive system in free ranging Giant Anteater (Myrmecophaga tridactyla): case report / Avaliação ultrassonográfica do sistema reprodutor feminino em tamanduá-bandeira de vida livre (Myrmecophaga tridactyla): relato de caso

An adult, female, 31kg body weight, free range Myrmecophaga tridactyla was referred for medical consultation due to apathy, dehydration, intense flatulence and fetid stools. The animal was submitted to chemical restraint and physical examination, blood count, fecal analysis, and vaginal cytology and abdominal ultrasonography were performed. Good nutritional status and clinical variables within the normal range were observed at physical examination. At vaginal cytology leukocytes, spermatozoa and a large proportion of cornified cells (superficial) were observed, indicating estrus and recent copula. At ultrasound examination it was possible to locate, identify, evaluate and measure the ovaries and the uterine structures, cervix, body, lumen, myometrium and endometrium, a fact never reported in the literature for this species. These data can be used as reference for clinical evaluation of the reproductive tract in Myrmecophaga tridactyla females considered vulnerable species, for the diagnosis of reproductive pathologies, biotechnologies application or estrous cycle evaluation.(AU)

Uma fêmea, com 31kg de peso corporal, de Myrmecophaga tridactyla, de vida livre, foi apresentada para consulta médica em razão de apatia, desidratação, flatulência intensa e fezes fétidas. O animal foi submetido à contenção química e foram realizados exame físico, hemograma, análise fecal, citologia vaginal e ultrassonografia abdominal. Ao exame físico, foi determinado bom estado nutricional e variáveis clínicas dentro da faixa de normalidade. Na citologia vaginal, foram observados leucócitos, espermatozoides e uma grande proporção de células cornificadas (superficiais), indicando estro e cópula recente. No exame ultrassonográfico, foi possível localizar, identificar, avaliar e mensurar os ovários e as estruturas uterinas, o colo do útero, o corpo do útero, o lúmen, o miométrio e o endométrio, fato nunca relatado na literatura para essa espécie. Esses dados podem ser utilizados como referência para avaliação clínica do trato reprodutivo de fêmeas de Myrmecophaga tridactyla considerada espécie vulnerável, para o diagnóstico de patologias reprodutivas, aplicação de biotecnologias ou avaliação do ciclo estral.(AU)

Corpus luteum vascularization during the maternal recognition of pregnancy in llamas (Lama glama).

The aim of this study was to characterize corpus luteum vascularization and its association with plasma progesterone concentration in early stages of pregnancy, when maternal recognition of pregnancy is expected to occur. In all animals, both plasma progesterone concentration and corpus luteum vascularization increased from Day 6 to Day 8 post-mating and afterwards in non-pregnant llamas they started to decrease to reach basal levels around Days 12 to 14 post-mating, while in pregnant animals, both variables remained elevated until the end of the study. A lineal positive relationship between corpus luteum vascularization and plasma progesterone concentration was observed in pregnant (r2  = .46, p < .0001) and non-pregnant llamas (r2  = .66, p < .0001). Pregnant animals showed higher plasma progesterone concentration and corpus luteum vascularization than the non-pregnant ones from Day 12 post-mating until the end of the study (p Ë‚ .05 and p Ë‚ .01, respectively). These results suggest that maternal recognition of pregnancy should occur before Day 12 post-mating in order to expand luteal lifespan, maintaining corpus luteum vascularization and progesterone production. Also, the assessment of CL vascularization area could be a useful and non-invasive method for early pregnancy diagnosis due to its association with plasma progesterone concentration.

Ultrasound monitoring of the uterus and ovaries of dominant and subordinate females of yellow-breasted capuchin (Sapajus xanthosternos) and robust tufted capuchin (Sapajus robustus) in captive colonies during the ovarian cycle and anestrus periods / Acompanhamento ultrassonográfico do útero e ovários de fêmeas dominantes e subordinadas de macacos-prego-do-peito-amarelo (Sapajus xanthosternos) e macacos-prego-de-crista (Sapajus robustus) em colônias cativas, durante o ciclo ovariano e períodos de anestro

The yellow-breasted capuchin (Sapajus xanthosternos) and robust tufted capuchin (Sapajus robustus) are endangered species due to destruction of their natural habitat and predatory chase. However, it is still necessary to elucidate some details of their reproductive physiology in order to obtain better indices in the assisted reproduction of these species. This study aimed to evaluate the ovarian cycle of 13 dominant and subordinate females of S. xanthosternos (n=8) and S. robustus (n=5) using sagittal and transversally scanned ultrasound of their uterus and ovaries. Sonograms were performed every seven days for two months. The ovarian cycle phase and anestrous condition were confirmed by colpocytology. Our results showed different uterine parameters (craniocaudal diameter, dorso-ventral diameter, and transverse diameter) (P<0.05) between anestrous subordinate females and other ovarian cycle phases and social classes. The mean of uterine volume was higher in dominant females than subordinate females in all cycle phases (P<0.05), except in follicular phase. During anestrus, endometrial width was smaller in subordinate females than in dominant females (P<0.05). Subordinate females showed differences in endometrial measures (P<0.05) between anestrous period and follicular and luteal periods. Ovarian measures in dominant females were higher than in subordinate females only during anestrus (P<0.05). In the subordinate females, ovarian parameters were different (P<0.05) between anestrus and follicular and luteal phases. Dominant females showed higher volume of right ovary compared to volume of the left ovary during anestrus and follicular phase (P<0.05). Follicles and corpus luteum were distinguished by ultrasonography in most exams (86.11%). During anestrus, measurable ovarian structures were not observed in both ovaries in dominant and subordinate females. In conclusion, the methodology used in this study allowed to evaluate the ovarian cycle in S. xanthosternos e S. robustus females and that cycle phase/anestrus and social class of the female influenced the size of the uterus and ovaries.(AU)

O macaco-prego-do-peito-amarelo (Sapajus xanthosternos) e o macaco-prego-de-crista (Sapajus robustus) encontram-se em risco de extinção devido a destruição do seu habitat e a caça predatória. Porém, ainda necessita-se elucidar alguns detalhes de sua fisiologia reprodutiva, para obterem-se melhores índices por meio de reprodução assistida. Sendo assim, o objetivo deste trabalho foi acompanhar o ciclo ovariano de 13 fêmeas dominantes e subordinadas de S. xanthosternos (n=8) e S. robustus (n=5) por meio de cortes ultrassonográficos sagitais e transversais do útero e dos ovários. Estas fêmeas foram examinadas uma vez por semana durante dois meses. A fase do ciclo ovariano/anestro foi confirmada pela colpocitologia. Os resultados da pesquisa demonstrou diferença significativa (P<0,05) relacionada ao diâmetro crânio-caudal, diâmetro dorso-ventral e diâmetro transversal entre as fêmeas subordinadas em anestro com todas as outras fases do ciclo ovariano e classes sociais. A média do volume uterino foi maior nas fêmeas dominantes que nas subordinadas em todas as fases do ciclo (P<0,05) a exceção da fase folicular. A largura endometrial, durante o período de anestro, foi menor nas fêmeas subordinadas quando comparada às dominantes (P<0,05). Nas fêmeas subordinadas, houve diferenças (P<0,05) nas mensurações endometriais entre o período de anestro e das fases folicular e lútea. Quanto aos ovários, as médias das medidas observadas nas fêmeas dominantes foram superiores as das subordinadas durante o anestro (P<0,05). As médias das medidas das variáveis ovarianas das fêmeas subordinadas apresentaram diferenças entre o anestro e as fases folicular e lútea (P<0,05). Nas fêmeas dominantes o volume do ovário direito foi maior que o do ovário esquerdo durante o anestro e na fase folicular (P<0,05). Folículos e corpos lúteos foram diferenciados pela ultrassonografia na maioria das coletas (86,11%). Durante o anestro não foram observadas estruturas ovarianas mensuráveis nos ovários em ambas as classes sociais. Concluiu-se que a metodologia empregada neste estudo permitiu o acompanhamento do ciclo ovariano das fêmeas S. xanthosternos e S. robustus e que as fases do ciclo/anestro e a classe social das fêmeas influenciaram as medidas do útero e ovários.(AU)

Ultrasound monitoring of the uterus and ovaries of dominant and subordinate females of yellow-breasted capuchin (Sapajus xanthosternos) and robust tufted capuchin (Sapajus robustus) in captive colonies during the ovarian cycle and anestrus periods / Acompanhamento ultrassonográfico do útero e ovários de fêmeas dominantes e subordinadas de macacos-prego-do-peito-amarelo (Sapajus xanthosternos) e macacos-prego-de-crista (Sapajus robustus) em colônias cativas, durante o ciclo ovariano e períodos de anestro

The yellow-breasted capuchin (Sapajus xanthosternos) and robust tufted capuchin (Sapajus robustus) are endangered species due to destruction of their natural habitat and predatory chase. However, it is still necessary to elucidate some details of their reproductive physiology in order to obtain better indices in the assisted reproduction of these species. This study aimed to evaluate the ovarian cycle of 13 dominant and subordinate females of S. xanthosternos (n=8) and S. robustus (n=5) using sagittal and transversally scanned ultrasound of their uterus and ovaries. Sonograms were performed every seven days for two months. The ovarian cycle phase and anestrous condition were confirmed by colpocytology. Our results showed different uterine parameters (craniocaudal diameter, dorso-ventral diameter, and transverse diameter) (P<0.05) between anestrous subordinate females and other ovarian cycle phases and social classes. The mean of uterine volume was higher in dominant females than subordinate females in all cycle phases (P<0.05), except in follicular phase. During anestrus, endometrial width was smaller in subordinate females than in dominant females (P<0.05). Subordinate females showed differences in endometrial measures (P<0.05) between anestrous period and follicular and luteal periods. Ovarian measures in dominant females were higher than in subordinate females only during anestrus (P<0.05). In the subordinate females, ovarian parameters were different (P<0.05) between anestrus and follicular and luteal phases. Dominant females showed higher volume of right ovary compared to volume of the left ovary during anestrus and follicular phase (P<0.05). Follicles and corpus luteum were distinguished by ultrasonography in most exams (86.11%). During anestrus, measurable ovarian structures were not observed in both ovaries in dominant and subordinate females. In conclusion, the methodology used in this study allowed to evaluate the ovarian cycle in S. xanthosternos e S. robustus females and that cycle phase/anestrus and social class of the female influenced the size of the uterus and ovaries.(AU)

O macaco-prego-do-peito-amarelo (Sapajus xanthosternos) e o macaco-prego-de-crista (Sapajus robustus) encontram-se em risco de extinção devido a destruição do seu habitat e a caça predatória. Porém, ainda necessita-se elucidar alguns detalhes de sua fisiologia reprodutiva, para obterem-se melhores índices por meio de reprodução assistida. Sendo assim, o objetivo deste trabalho foi acompanhar o ciclo ovariano de 13 fêmeas dominantes e subordinadas de S. xanthosternos (n=8) e S. robustus (n=5) por meio de cortes ultrassonográficos sagitais e transversais do útero e dos ovários. Estas fêmeas foram examinadas uma vez por semana durante dois meses. A fase do ciclo ovariano/anestro foi confirmada pela colpocitologia. Os resultados da pesquisa demonstrou diferença significativa (P<0,05) relacionada ao diâmetro crânio-caudal, diâmetro dorso-ventral e diâmetro transversal entre as fêmeas subordinadas em anestro com todas as outras fases do ciclo ovariano e classes sociais. A média do volume uterino foi maior nas fêmeas dominantes que nas subordinadas em todas as fases do ciclo (P<0,05) a exceção da fase folicular. A largura endometrial, durante o período de anestro, foi menor nas fêmeas subordinadas quando comparada às dominantes (P<0,05). Nas fêmeas subordinadas, houve diferenças (P<0,05) nas mensurações endometriais entre o período de anestro e das fases folicular e lútea. Quanto aos ovários, as médias das medidas observadas nas fêmeas dominantes foram superiores as das subordinadas durante o anestro (P<0,05). As médias das medidas das variáveis ovarianas das fêmeas subordinadas apresentaram diferenças entre o anestro e as fases folicular e lútea (P<0,05). Nas fêmeas dominantes o volume do ovário direito foi maior que o do ovário esquerdo durante o anestro e na fase folicular (P<0,05). Folículos e corpos lúteos foram diferenciados pela ultrassonografia na maioria das coletas (86,11%). Durante o anestro não foram observadas estruturas ovarianas mensuráveis nos ovários em ambas as classes sociais. Concluiu-se que a metodologia empregada neste estudo permitiu o acompanhamento do ciclo ovariano das fêmeas S. xanthosternos e S. robustus e que as fases do ciclo/anestro e a classe social das fêmeas influenciaram as medidas do útero e ovários.(AU)

Rare Case of Sarcomatoid Squamous Cell Carcinoma Arising in an Ovarian Mature Teratoma.

Although mature cystic teratoma (MCT) is benign, malignant transformation (MT) occurs in ∼ 1% to 2% of all cases, and usually consists of squamous cell carcinoma (SCC), which accounts for ∼ 80% of the cases. Spindle-cell (sarcomatoid) carcinoma (SCSC) is an uncommon type of SCC, comprising up to 3% of all cases. The lack of characteristic symptoms and specific imaging findings may lead to preoperative misdiagnosis. Moreover, the clinicopathologic characteristics, the treatment, the prognostic factors and the mechanism of MT have not yet been well understood due to the rarity of such tumors, especially in women of reproductive age. The authors present a case of a 34-year-old patient with 14 weeks of gestation who was diagnosed with an adnexal mass suggestive of ovarian teratoma. A laparoscopy salpingo-oophorectomy was performed after 6 months of delivery, and the histological exam revealed a sarcomatoid SCC in the MCT.

Embora o teratoma cístico maduro (MCT) seja benigno, a transformação maligna (MT) ocorre em cerca de 1% a 2% dos casos, e geralmente apresenta-se sob a forma de carcinoma espinocelular (CEC), responsável por cerca de 80% dos casos. O carcinoma (sarcomatoide) de células fusiformes (CSCF) é um tipo incomum de CEC, compreendendo até 3% de todos os casos. A falta de sintomas característicos e achados imagiológicos específicos pode levar a erros diagnósticos pré-operatórios. Além disso, as características clinico-patológicas, o tratamento, os fatores prognósticos e o mecanismo da MT ainda não são bem compreendidos devido à raridade de tais tumores, principalmente em mulheres em idade reprodutiva. Os autores apresentam um caso de uma paciente de 34 anos com 14 semanas de gestação que foi diagnosticada com uma massa anexial sugestiva de teratoma do ovário. A anexectomia laparoscópica foi realizada após 6 meses do parto, e o exame histológico revelou um CEC sarcomatoide tendo como origem um MCT.

Rare case of sarcomatoid squamous cell carcinoma arising in an ovarian mature teratoma / Caso raro de carcinoma espinocelular sarcomatoide que surge em um teratoma ovariano maduro

Abstract Although mature cystic teratoma (MCT) is benign, malignant transformation (MT) occurs in ~ 1% to 2% of all cases, and usually consists of squamous cell carcinoma (SCC), which accounts for ~ 80% of the cases. Spindle-cell (sarcomatoid) carcinoma (SCSC) is an uncommon type of SCC, comprising up to 3% of all cases. The lack of characteristic symptoms and specific imaging findings may lead to preoperative misdiagnosis. Moreover, the clinicopathologic characteristics, the treatment, the prognostic factors and the mechanism of MT have not yet been well understood due to the rarity of such tumors, especially in women of reproductive age. The authors present a case of a 34- year-old patient with 14 weeks of gestation who was diagnosed with an adnexal mass suggestive of ovarian teratoma. A laparoscopy salpingo-oophorectomy was performed after 6 months of delivery, and the histological exam revealed a sarcomatoid SCC in the MCT.

Resumo Embora o teratoma cístico maduro (MCT) seja benigno, a transformação maligna (MT) ocorre em cerca de 1% a 2% dos casos, e geralmente apresenta-se sob a forma de carcinoma espinocelular (CEC), responsável por cerca de 80% dos casos. O carcinoma (sarcomatoide) de células fusiformes (CSCF) é um tipo incomum de CEC, compreendendo até 3% de todos os casos. A falta de sintomas característicos e achados imagiológicos específicos pode levar a erros diagnósticos pré-operatórios. Além disso, as características clinico-patológicas, o tratamento, os fatores prognósticos e o mecanismo da MT ainda não são bem compreendidos devido à raridade de tais tumores, principalmente em mulheres em idade reprodutiva. Os autores apresentam um caso de uma paciente de 34 anos com 14 semanas de gestação que foi diagnosticada comumamassa anexial sugestiva de teratoma do ovário. A anexectomia laparoscópica foi realizada após 6 meses do parto, e o exame histológico revelou um CEC sarcomatoide tendo como origem um MCT.

[Embolization of insufficient pelvic veins for pelvic congestion syndrome. Analysis of 17 cases]. / Dolor pélvico crónico secundario a síndrome de congestión pélvica. Resultados del tratamiento endovascular de la insuficiencia venosa pelviana y várices genitales.

BACKGROUND: Pelvic venous insufficiency may cause pelvic congestion syndrome that is characterized by chronic pelvic pain exacerbated by prolonged standing, sexual activity or menstrual cycle. It may be treated by embolizing the dysfunctional pelvic venous drainage and sometimes resecting vulvar, perineal and thigh varices. AIM: To assess the results of embolization of insufficient pelvic or ovarian veins on pelvic congestion syndrome. MATERIAL AND METHODS: Analysis of 17 female patients aged 32 to 53 years, who underwent subjected to a selective coil embolization of insufficient pelvic and/or ovarian veins through the jugular, basilic or cephalic veins. In the preoperative period, all patients had a lower extremity venous duplex pelvic ultrasound examination and some had an abdominal and pelvic CT angiogram. RESULTS: The technical success of the procedure was 100% and no complications were registered. During a 32 month follow up, no patient had symptoms of pelvic venous insufficiency or relapse of vulvar or thigh varices. CONCLUSIONS: Embolization of insufficient pelvic and ovarian veins is a safe and successful procedure for the treatment of pelvic venous insufficiency or vulvar varices.

Ovulatory status of overweight women without Polycystic Ovary Syndrome.

OBJECTIVE: Obesity is one of the extra hypothalamic-pituitary-ovarian axis factors that can influence ovulation. The isolated impact of obesity on ovulation without other comorbidities needs to be further studied. Our goal is to evaluate the association between the anovulation in the ultrasonographic monitoring of the ovulation cycle and the body mass increase of infertile patients without polycystic ovaries of a university service. METHODS: Case-control study performed at the Human Reproduction Laboratory of the University Hospital. We evaluated 1,356 ultrasound monitoring reports of ovulation between January 2011 and December 2015. We named case those patients who ovulated on the monitored cycle. After applying the exclusion criteria, we consolidated a total of 110 cases and 118 controls. The exposure variables were normal BMI or patients classified with a BMI above normal. Data analysis was performed using SPSS 22.0. Differences in proportions were assessed by X2 test Pearson, Fisher and Wilcoxon test. The value of p<0.05 was considered statistically significant. RESULTS: The groups were comparable in age, age at menarche, number of pregnancies, deliveries, cesarean sections and abortions, number of antral follicles, FSH, prolactin and TSH values. Among the anovulatory patients, 57 (51.82%) were overweight, while among ovulatory patients, 44 (37.29%) were in this same BMI category. The odds ratio was 1.8655, with a significant p value (p<0.05). CONCLUSION: There was an association between anovulation and increase in the Body Mass Index, with an increased risk of anovulation in patients with BMI above normal.