RESUMO
The giant condyloma acuminatum, also known as Buschke- Lowenstein tumor (BLT), is a rare sexually-transmitted disease. Moreover, the condyloma acuminatum produced by Human Papilloma Virus (HPV) infection becomes one the most common sexually-transmitted infection which affects the perineal region. Under such situations, the first therapeutic option is surgical excision. The objective of this article is to present a case in which the tumor has reached giant dimensions and also to stress the importance of an in toto resection, taking into account the high rate of recurrence and the significant potential of malignant transformation of BLT.
Assuntos
Neoplasias do Ânus/patologia , Tumor de Buschke-Lowenstein/patologia , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/etiologia , Anemia Ferropriva/terapia , Neoplasias do Ânus/cirurgia , Transfusão de Sangue/métodos , Tumor de Buschke-Lowenstein/cirurgia , Condiloma Acuminado/patologia , Condiloma Acuminado/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Períneo/patologia , Períneo/cirurgia , Fatores de Risco , Resultado do TratamentoRESUMO
CONTEXT: Adipokines secreted by fat cells are vital to the control of energy metabolism, communicating the nutrient status with the tissues responsible for controlling both energy intake and expenditure and insulin sensitivity. OBJECTIVE: We aimed to prove in an experimental animal study that maternal obesity has long term adverse fetal metabolic consequences, which pass on even to the next generation of descendants. DESIGN: The effects of maternal obesity have been studied on animal model using 50 obese female Wistar rats, in which we induced obesity by high-calorie high-fat diet administered by gavage. SUBJECTS AND METHODS: Obese rat females were sacrificed at gestation term and we analyzed the secretion of adipokines from maternal venous blood: leptin and adiponectin, placental, pancreatic, liver and brain homogenates lipid peroxidation levels estimated by: MDA (malonyl-dialdehyde), total thiols and GSH - as antioxidant factors and routine biochemistry. RESULTS: Low levels of adiponectin and increased levels of leptin positively correlated with the value of placental and fetal tissue lipid peroxidation (from the liver, pancreas and brain) measured by elevated MDA and total thiols and low levels of GSH. The lipid peroxidation in the organs examined generated consistent results, showing high levels of peroxidation expressed through high values of MDA in the groups with Omega 6 supplements respectively no supplementation, and low levels of antioxidants expressed through glutathione and thiols. CONCLUSIONS: Endocrine secretion of adipokines from the adipocytes and the recruited macrophages of obese mothers is positively correlated with placental and tissue lipid peroxidation level and routine biochemical parameters.
RESUMO
Endometriosis is described as the presence of functioning endometrial tissue at sites outside the uterus. Up to 15% ofwomen in their reproductive period are affected by this condition. Endometriosis is mostly foundon the uterosacral ligaments, inside the rectovaginalseptum or vagina, in the rectosigmoid area, ovarianfossa, pelvic peritoneum, ureters, and bladder, causinga distortion of the pelvic anatomy. Colonic involvement is rare but is usually found at the level of the rectum or the sigmoid colon. Acute presentation with intestinal obstruction or perforation is rare. While malignant transformation of endometrial lesions is rare, findings of dysplasia on pathology sections can give rise to questions of management. Immunohistochemistry and electron microscopy can help decision making. We present the case of a 38 year old woman with intestinal obstruction caused by sigmoid colon endometriosis with moderate dysplasia in which transmission electron microscopy was used for postoperative diagnosis. Detailed analysis of these cases, while logistically difficult, can prove useful in understanding the etiology and pathophysiology of the disease.
Assuntos
Colo Sigmoide/patologia , Endometriose/diagnóstico , Imuno-Histoquímica , Microscopia Eletrônica de Transmissão , Adulto , Colo Sigmoide/cirurgia , Endometriose/complicações , Endometriose/cirurgia , Feminino , Humanos , Obstrução Intestinal/etiologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Resultado do TratamentoRESUMO
Cervical screening by using cytology was proven efficient in reducing the mortality secondary to cervical cancer, but this method has limitations. High risk HPV infection is essential for cervical cancer development so HPV testing is a new tool used for screening patients for cervical neoplasia. HPV testing was proven most useful for women over 30 years old, in cases in which cytology identified ASC-US and after treatment for CIN. This article outlines the clinical significance of HPV-DNA testing for precancerous cervical lesions and the evidence that stands behind these recommendations.