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1.
J Perinat Med ; 49(7): 837-846, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-33882202

RESUMO

Brain injury of the surviving twin from monochorionic pregnancies following intrauterine fetal demise during the second and third trimesters is a rare but severe complication. Monochorionicity and gestational age at the time of stillbirth seem to be decisive factors in terms of long-term neurologic outcome prediction for the survivor. Magnetic resonance imaging (MRI), diffusion weighted imaging (DWI) in particular, seem to bring the earliest and most accurate diagnosis. Ultrasound detection of brain damage is possible in later stages of fetal brain injury. It is essential to provide early diagnosis and multidisciplinary counsel to the parents to ensure informed decision making. For couples who choose to terminate pregnancy legislation related to late abortion might lead to further distress. Our paper aims to stress the importance of MRI DWI in the evaluation of surviving twins following single intrauterine fetal demise in monochorionic pregnancies and the delicate context of the medical professionals and parents facing this clinical situation, sometimes complicated by legal constraints.


Assuntos
Aborto Eugênico/legislação & jurisprudência , Lesões Encefálicas/diagnóstico por imagem , Doenças em Gêmeos/diagnóstico por imagem , Morte Fetal , Diagnóstico Pré-Natal/métodos , Gêmeos Monozigóticos , Aborto Eugênico/ética , Aborto Eugênico/psicologia , Tomada de Decisões , Imagem de Difusão por Ressonância Magnética , Feminino , Saúde Global , Humanos , Pais/psicologia , Gravidez , Gravidez de Gêmeos , Ultrassonografia Pré-Natal
2.
J BUON ; 24(3): 1067-1074, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31424662

RESUMO

PURPOSE: To assess the influence of reproductive factors in the occurrence of breast cancer in women, taking into account the presence/absence of genetic predisposing mutations. METHODS: 100 patients with breast cancer were included. The genetic testing was conducted through a multigene panel. Reproductive characteristics were noted for all patients: age of menarche, age of the patient at first full term pregnancy, number of pregnancies, number of full-term pregnancies, breastfeeding interval, number of abortions, and menopausal status at the time of diagnosis. The patients were divided into three groups according to their mutations: BRCA1, positive for mutations other than BRCA1 and negative. RESULTS: The risk of breast cancer was not influenced by the number of abortions, parity, age at first pregnancy, age at menarche and menopausal status, or by oral contraceptive use in carriers of pathogenic mutations group in the BRCA1 group. The present study has demonstrated the protective effect of breastfeeding only in patients without genetic risk (p=0.0344). In contrast, breastfeeding did not influence breast cancer occurrence in BRCA1 mutation carriers' group (p=0.2321). CONCLUSIONS: Breastfeeding represents a protective mechanism only in patients without genetic breast cancer predisposing mutations. Environmental and reproductive factors can impact the risk and the age of onset of breast cancer in patients carrying pathogenic mutations, but the mechanisms of action are not fully understood.


Assuntos
Neoplasias da Mama/genética , Predisposição Genética para Doença/genética , Neoplasias da Mama/patologia , Feminino , Humanos , Mutação , Fatores de Risco
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