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Biomedical subjects

E C Baracat

Publications and source records attributed to E C Baracat.

At least 55 records · Page 3Linked to original sources
PubMed2000

Power Doppler of the urethra in continent or incontinent, pre- and postmenopausal women.

Urethral pressure should exceed bladder pressure, both at rest and on stress, for urinary continence to occur. A decrease in urethral pressure is a major factor explaining the pathogenesis of urinary incontinence. A number of elements, such as smooth and striated periurethral muscles, and connective, vascular and elastic tissues, contribute to urethral pressure. The periurethral vessels are influenced by hormonal changes during the menstrual cycle, during pregnancy and postmenopause. We studied the periurethral vessels in 97 women, 57 of whom were incontinent and 40 continent, using power color Doppler velocimetry. The number of periurethral vessels, systolic peak, minimum diastolic values, pulsatility and resistance indexes, as well as systolic-diastolic ratio, were assessed. Statistically significant differences were found between incontinent women in the premenopausal period and those in the postmenopausal period, regarding the number of periurethral vessels, systolic peak, minimum diastolic values, pulsatility and resistance indexes.

Adult↗
PubMed2000

Modulation of estrous cycle and LH, FSH and melatonin levels by pinealectomy and sham-pinealectomy in female rats.

1. The pineal has been shown to have a role in controlling reproduction of polyestrus mammals (like humans and laboratory rodents). It influences the age of sexual maturation; the timing of the ovulatory cycle; and gonadal steroidogenesis. 2. Here the authors report the early and late effects of pinealectomy (Px) and sham-pinealectomy (SPx) on the estrous cycle periodicity, plasma LH, FSH and urinary 6-sulphatoxymelatonin (6-SMT) excretion in female rats. 3. Female Wistar rats (3-4 months of age) were maintained on 12/12 L/D cycle. Orbital venous plexus blood and urine samples were collected from the same rat during the estrus phase before surgery, 4-7 and 55-60 days post surgery. 4. Daily vaginal smears were taken to monitor the estrous cycle and they showed a time dependent increase in the estrus stage duration in Px rats (estrus stage: 1 day in control; 3-4 days after 45 days Px). 5. The decrease of gonadotropins at early post Px was due to surgical stress. 6. 6-SMT levels were significantly lower at 4-7 days post SPx, but at 55-60 d post surgery these levels returned to control values, which indicate pineal gland integrity. The reduction in urinary 6-SMT may be attributed to a possible high level of plasma corticosterone occurring after surgical manipulations. 7. 6-SMT levels in Px rats were extremely lower at 4-7 and 55-60 days post surgery, but not null, confirming the surgical removal of the pineal gland and indicating the synthesis of melatonin in sites other than the pineal gland.

Animals↗
PubMed2000

Histomorphometric aspects of adult castrated rat endometrium after the use of estrogen, progesterone and tamoxifen.

The aim of this study was to analyse the morphologic and morphometric aspects of endometrium in rats receiving hormone replacement therapy with conjugated equine estrogen (CEE), medroxyprogesterone acetate (MPA) and tamoxifen (TMX). Thirty-five adults rats, 2-3 months of age were ovariectomized four days prior to using the drugs. Rats were divided according to the following treatments for 60 days: CEE (50 microg); CEE/MPA (50 microg/2 mg); MPA (2mg); TMX (250 microg); vehicle (propyleneglycol). Fragments of endometrium were removed and analysed by light microscopy. The endometrium suffered evident morphologic modifications under the action of hormones and TMX. The endometrium was significantly thicker in the CEE, CEE/MPA and TMX group when compared to the control, however the MPA group showed no differences when compared to the control group.

Animals↗
PubMed2000

A morphologic and morphometric study of the vesical mucosa and urethra of castrated female rats following estrogen and/or progestogen replacement.

PURPOSE: The aim of this study was to analyze the morphologic and morphometric changes in the urethra and vesical mucosa following hormonal replacement METHODS: We analyzed the changes in the urethra and vesical mucosa of 35 castrated adult female rats that had been subjected to estrogen and/or progestogen replacement. RESULTS: Estrogen replacement, whether or not accompanied with progestogen replacement, provoked metaplasia, hyperplasia and an increased occurrence of stratified epithelia. In the proximal urethra hypoestrogenism caused a higher occurrence of pseudo-stratified and transition epithelia, whereas in the urethral-vesical junction it caused a higher frequency of pseudo-stratified epithelia. The thickness of the epithelium increased following estrogen replacement whereas only a trend towards an increase of the propria lamina thickness was identified. Nuclear volume was only altered in the bladder epithelium. CONCLUSION: Estrogen replacement acted both morphometrically and morphologically on the lower urinary tract.

Animals↗
PubMed1999

Urodynamic and ultrasonographic evaluation after continence surgery.

Our objective was to evaluate urodynamic and ultrasonographic findings after continence surgery. The study consisted of three groups of women according to the surgery performed: group I (Burch colposuspension) with 12 patients; group II (Kelly-Kennedy plication) with 10 patients; and group III (Gittes surgery) with 9 patients. Urodynamic study was done preoperatively and after surgery (on the 7th and 30th postoperative days, and at least 6 months after surgery) and ultrasonography of the bladder neck was performed to evaluate its position in relation to the inferior edge of the pubic symphysis and its mobility, both preoperatively and after surgery (30th postoperative day). All patients remained continent. We observed an increase in the first desire to void and maximum cystometric capacity after 6 months in groups I and II, respectively. There was no change in the urethral closure pressure profile in the three groups. Elevation of the bladder neck and decrease of its mobility were found by ultrasonography. Urinary continence after surgery is not the result of alterations in the urethral closure pressure profile, but rather of an elevation in the bladder neck and limitation of its mobility, which probably improves the abdominal pressure transmission rate to the proximal urethra.

Adult↗
PubMed1999

Hysteroscopic evaluation of the endometrium of post-menopausal patients with breast cancer before and after tamoxifen use.

OBJECTIVE: To evaluate by hysteroscopy and histopathology the influence of tamoxifen in the endometrium of post-menopausal women with previous breast cancer. METHOD: Out of 46 patients studied, 20 of them had been using tamoxifen for an average length of 12 months, and are still being followed-up. Hysteroscopy with endometrial biopsy was performed before and after the use of the drug. RESULTS: The prevalence of endometrial activity before and after this hormoniotherapy was the same, i.e. 10.0%, showing a non-significant variation. CONCLUSION: The hormoniotherapy with tamoxifen has not increased the endometrial proliferactive activity of postmenopausal patients with breast cancer. The most common hysteroscopical finding was numerous vesicles disseminated throughout the uterine cavity probably due to atrophy of the endometrium.

Antineoplastic Agents, Hormonal↗
PubMed1999

Effect of a half dose of tamoxifen on proliferative activity in normal breast tissue.

OBJECTIVES: To investigate the proliferative activity of the mammary gland epithelium and plasma levels of progesterone, estradiol, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and sex hormone-binding globulin (SHBG) in premenopausal women treated with 10 and 20 mg of tamoxifen (TAM) for 22 days. PATIENTS AND METHODS: A randomized double-blind study was performed with 43 premenopausal women with a diagnosis of fibroadenoma of the breast. The patients were divided into three groups: A (n = 15, placebo); B (n = 15, TAM 10 mg/day) and C (n = 13, TAM 20 mg/day). They started taking an oral dose of TAM or placebo on the very first day of the menstrual cycle. Lumpectomy was performed on the 22nd day of therapy. Normal breast tissue samples were collected during surgery, immediately immersed in 10% buffered formalin, processed for routine histology and immunohistochemistry for proliferating cell nuclear antigen (PCNA) detection. Two peripheral blood samples were collected, both on the 22nd day of the menstrual cycle, in order to evaluate the hormone levels. PCNA expressing epithelial cells were quantified by using a digital program Kontron Image System KS-300 in 1000 cells (400 x ). RESULTS: The percentage of cells expressing PCNA was significantly higher in the group receiving placebo (group A, 50.3%) when compared to groups receiving TAM 10 or 20 mg/day (group B, 24.1%; and group C, 23.2%, respectively) (P < 0.001). Differences between groups B and C were not significant. Levels of progesterone, estradiol and SHBG were significantly higher in B and C groups compared to group A. Increasing concentrations of FSH (P < 0.0045) and lower levels of prolactin (P < 0.0055) were only found in the group receiving 20 mg/day of TAM (group C). CONCLUSIONS: A 22-day TAM therapy, either with 10 or 20 mg/day, significantly reduced the PCNA expression and therefore the proliferative activity of the normal human breast tissue. Increasing levels of estradiol, progesterone and SHBG were associated with TAM therapy at 10 or 20 mg/day. However, a significant change of the level of FSH and prolactin was reached only with a 20-mg/day dose.

Adolescent↗
PubMed1999

Effects of conjugated estrogens and progestogen in surgically induced endometriosis in oophorectomized rats.

This study aimed to verify whether estrogen replacement alone or associated with progesterone promotes the recurrence of experimental endometriosis in oophorectomized rats. The procedure utilized for endometriosis induction was adapted from the one described by Jones (1984). The rats were castrated three weeks after the induction. Hormonal replacement was started 14 days after the castration and was given for 24 days. One group received estrogen alone, another received estrogen associated with medroxiprogesterone acetate, and a last one received placebo. At the end of this study, the animals who received hormonal medication showed recurrence of the disease. This fact was more evident in the group that received estrogen alone. We concluded that estrogen alone leads to recurrence of endometriosis in oophorectomized rats with surgically induced endometriosis. The association of medroxiprogesterone promotes involutional changes in the implants, and should be added upon the existence of a past history of endometriosis.

Animals↗
PubMed1998

High implantation and pregnancy rates with transfer of human blastocysts developed in preimplantation stage one and blastocyst media.

OBJECTIVE: To evaluate the proficiency of preimplantation stage one (P1) and blastocyst media in supporting human blastocyst development and to document implantation and clinical pregnancy rates from the transfer of the normally developed blastocysts. DESIGN: Retrospective clinical study. SETTING: Private IVF unit of a university-affiliated center. PATIENT(S): Twenty-eight women aged 33.7 +/- 2.9 years who underwent IVF treatment for infertility. INTERVENTION(S): Bipronucleate oocytes obtained from IVF and intracytoplasmic sperm injection were cultured in vitro with P1 and blastocyst media for 96-120 hours. One to three embryos were transferred (2.1 +/- 0.2 for the patients who became pregnant and 1.5 +/- 0.3 for those who did not become pregnant). MAIN OUTCOME MEASURE(S): Total number and percentage of developed blastocysts, frequency of blastocysts of grades A and B, and implantation and pregnancy rates. RESULT(S): From 431 oocytes retrieved, 269 bipronucleate oocytes were cultured, producing 81 blastocysts that resulted in the transfer of 54 embryos in 27 procedures. Blastocysts developed in 39.7% +/- 5.5% of the pregnant group and 30.2% +/- 4.5% of the nonpregnant group. From 15 (15/27 = 55.6%) clinical pregnancies, 18 (18/54 = 33.3%) gestational sacs were visualized. The rate of implantation in the pregnant group was 58.1% (18/31). CONCLUSION(S): These results provide evidence for the benefits of extending human embryo culture with P1 and blastocyst media for all normally fertilized embryos in vitro.

Adult↗
PubMed1998

Efficacy and acceptability of two monophasic oral contraceptives containing ethinylestradiol and either desogestrel or gestodene.

OBJECTIVE: To assess the contraceptive efficacy, cycle control and acceptability of two monophasic oral contraceptives containing either 30 micrograms ethinylestradiol plus 150 micrograms desogestrel or 30 micrograms ethinylestradiol plus 75 micrograms gestodene. METHODS: In a randomized, open-label, six-cycle, group-comparative, multicenter study performed in Brazil, pregnancies, cycle-control parameters, incidence of side-effects and the presence and severity of acne vulgaris were assessed, and blood pressure and body weight were measured at pretreatment and after one, three and six cycles of oral contraceptive use. RESULTS: Of the 595 women enrolled, 274 (86.7%) in the desogestrel/ethinylestradiol group and 227 (81.4%) in the gestodene/ethinylestradiol group completed the six cycles, providing data for 1753 and 1487 treatment cycles, respectively. Two pregnancies occurred, one of which (in the desogestrel/ethinylestradiol group) was attributed to user failure, whilst the other (in the gestodene/ethinylestradiol group) was thought to result from method failure. Cycle control was observed to be excellent; the incidences of irregular bleeding and minor side-effects were low in both groups and decreased after an initial increase in the first cycle. Pre-existing acne improved in both groups, whereas blood pressure and body weight remained essentially unchanged. CONCLUSIONS: Both desogestrel/ethinylestradiol and gestodene/ethinylestradiol provide effective oral contraception with comparable cycle control and acceptability.

Acne Vulgaris↗
PubMed1998

[A hysteroscopic and anatomicopathological study in women with breast cancer].

OBJECTIVE: To study the uterine mucosa of women with breast cancer in order to evaluate the frequency of endometrial diseases. EXPERIMENTAL DESIGN: Prospective, controlled study carried out from January to December 1996. SURROUNDINGS: Patients with breast cancer and normal controls from 4 out-patient university services in Porto Alegre, Brazil. PATIENTS: Postmenopausal women without hormonal therapy were compared: 67 of them with breast cancer and 101 normal controls. METHODS: Hysteroscopy followed by endometrial biopsy carried out in both groups as an out-patient procedure. RESULTS: In patients with breast cancer, 29.85% abnormal biopsies were found as follows: 10 endometrial polyps (15.0%), 8 with proliferative changes (11.9%), 1 case of cancer (1.5%), and one case of hyperplasia (1.5%). In the control group 8% abnormal morphological findings were found, as follows: 4 (4%) with endometrial polyps and 4 (4%) with proliferative changes. The differences in abnormal biopsies were statistically significant, mainly in patients with corporal mass index above 27.3. The sensibility of hysteroscopy was 82.14%; its specificity 97.16%; its predictive positive value 85.18% and its predictive negative value 96.48% in detecting endometrial activity, for a prevalence of 16.7% of endometrial activity. CONCLUSIONS: Endometrial evaluation must be included in the initial evaluation of patients with breast cancer, mainly if they were obese. Hysteroscopy, performed in out-patient basis, showed to be an adequate method to evaluate the uterine mucosa, helping to select the area of this cavity for biopsy.

Aged↗
PubMed1997

Rectus fascia colpopexy in posthysterectomy vaginal prolapse: analysis of 18 cases.

Posthysterectomy prolapse of the vaginal vault is a complicated and uncommon occurrence in gynecology. The treatment is surgical and may be either vaginal or abdominal. The great variety of techniques described indicates that there is disagreement about the ideal route or technique to be used. The authors present their experience in surgical correction using colpopexy with rectus abdominal muscle fascia.

Aged↗
PubMed1997

Transvaginal ultrasonography and the progestogen challenge test in postmenopausal endometrial evaluation.

OBJECTIVE: To analyze the morphologic and ultrasonographic aspects of the endometrium of postmenopausal women according to the progestogen challenge test. METHODS: The study was conducted on 150 postmenopausal women. Each patient was submitted to transvaginal ultrasonography for measurement of endometrial echo thickness and to endometrial biopsies, followed by the progestogen challenge test. RESULTS: Women with a negative test presented atrophic endometrium in 94% of cases. The other 6% have shown active endometrium, but none had hyperplasia. However, 56% of the patients with a positive test had atrophic endometrium. There was a correlation between endometrial thickness less than 5 mm and endometrial atrophy in patients with either positive or negative tests. CONCLUSION: Because the progestogen challenge test is cheap and easy to deal with, it can be done as a primary screening method in asymptomatic postmenopausal women. If the test is positive, ultrasonography is required in order to determine who needs a more accurate examination of the endometrium. If the test is negative, ultrasonography is not required due to the great number of women who have atrophic endometrium.

Atrophy↗
PubMed1997

Morphologic and morphometric aspects of the endometrium of postmenopausal women before and after cyclic oestrogen replacement treatment.

OBJECTIVE: The aim of the study is to observe the morphology and morphometry of the endometrium of postmenopausal women treated with cyclic conjugated oestrogens. STUDY DESIGN: Three groups of nine postmenopausal women received cyclic conjugated oestrogens for 21 days (with a seven-day pause) during six months. The endometrial specimens were obtained using a modified Novak suction curet, in the second or third day of the period of drug washout. The slides were stained with haematoxylin and eosin (H.E.) in order to measure epithelial height and determine the gland/stroma ratio. RESULTS: Morphologic examination showed that single daily doses of 0.3 mg of conjugated oestrogens caused discrete endometrial proliferation after three and six months of treatment. However, a more intense effect was observed in women receiving doses of 0.625 and 1.25 mg/day of the hormone, in the same period. Morphometric study revealed significant increases both in epithelial thickness and in the gland-stroma ratio, specially in women receiving higher doses of the conjugated oestrogen (0.625 and 1.25 mg/day). CONCLUSIONS: We concluded that there were marked proliferative alterations without atypias in the endometrium of women that received 0.625 and 1.25 mg of conjugated oestrogens during six months.

Cell Division↗
PubMed1997

Gastric emptying of liquids in rats dehydrated by water deprivation.

The gastric emptying of liquids was investigated in male Wistar rats (8 to 10 weeks old, 210-300 g) dehydrated by water deprivation. In this model of dehydration, weight loss, hematocrit and plasma density were significantly higher in the dehydrated animals than in the control groups after 48 and 72 h of water deprivation (P < 0.05). Three test meals (saline (N = 10), water (N = 10) and a WHO rehydrating solution containing in one liter 90 mEq sodium, 20 mEq potassium, 80 mEq chloride and 30 mEq citrate (N = 10)) were used to study gastric emptying following water deprivation for 24, 48 and 72 h. After 72 h, gastric emptying of the water (39.4% retention) and rehydrating solution (49.2% retention) test meals was significantly retarded compared to the corresponding control groups (P < 0.05, Mann-Whitney test). The 72-h period of deprivation was used to study the recovery from dehydration, and water was supplied for 60 or 120 min after 67 h of deprivation. Body weight loss, hematocrit and plasma density tended to return to normal when water was offered for 120 min. In the animals supplied with water for 60 min, there was a recovery in the gastric emptying of water while the gastric emptying of the rehydrating solution was still retarded (53.1% retention; P < 0.02, Kruskal-Wallis test). In the group supplied with water for 120 min, the gastric emptying of the rehydrating (51.7% retention) and gluco-saline (46.0% retention) solutions tended to be retarded (P = 0.04, Kruskal-Wallis test). In this model of dehydration caused by water deprivation, with little alteration in the body electrolyte content, gastric emptying of the rehydrating solution was retarded after rehydration with water. We conclude that the mechanisms whereby receptors in the duodenal mucosa can modify gastric motility are altered during dehydration caused by water deprivation.

Animals↗
PubMed1996

Transvaginal ultrasound, uterine biopsy and hysteroscopy for postmenopausal bleeding.

OBJECTIVES: To determine the importance of endometrial biopsy and transvaginal ultrasound in patients with postmenopausal bleeding. METHODS: Eighty patients with postmenopausal bleeding were submitted to transvaginal ultrasound followed by endometrial biopsy. Hysteroscopy and dilatation and curettage were carried out to confirm normality of the uterine cavity. RESULTS: The endometrial echo could be visualized in all patients with postmenopausal bleeding. The biopsy failed to detect one case (1.38%) of adenocarcinoma and 14 cases (17.5%) of endometrial polyps. The sensitivity in detecting endometrial malignancy was 94.44% for endometrial biopsy and 100% for transvaginal ultrasound, when the endometrial thickness was more than 8 mm. CONCLUSIONS: When the thickness of the endometrial echo is less than 3 mm there is no need for anatomopathologic investigation. When this limit was adopted, all cases were associated with endometrial atrophy, and when the limit was 4 mm or more, active endometria were detected, requiring further histopathologic investigation by hysteroscopy and directed biopsies. Above 8 mm, malignancy may be found.

Aged↗
PubMed1995

Bone density in white Brazilian women: rapid loss at the time around the menopause.

Dual energy x-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) of the lumbar spine and proximal femur (neck, Ward's triangle, and trochanter) in 417 normal women (aged 20-79) living in São Paulo, Brazil. Bone density decreased with age at all sites. At the spine, the greatest decrease occurred during the sixth decade, with an average 11.4% bone loss compared with the previous decade. Stratifying the subjects according to menopausal status revealed that the fastest bone loss occurred at the time around the menopause (ages 45-60) when the rate of bone loss (-0.66%/year) was almost twice as rapid as in postmenopausal women (-0.39%/year). Although significant linear rates of bone loss were detected in all proximal femur sites before the menopause, a menopause-dependent pattern was less evident than at the spine. Lifetime rates of bone loss at the appendicular skeleton were -0.43, -0.62, and -0.35%/year at the femoral neck, Ward's triangle, and trochanteric area, respectively. After the menopause, BMD declined with menopausal age at all sites, although the rate of bone loss was faster at the femoral neck (-0.62%/year) and Ward's triangle (-0.84%/year) than at the spine (-0.49%/year). The results are consistent with the notion that in women, the fastest bone loss occurs at the time around the menopause, most likely consequent to ovarian failure; and that faster rates of bone loss are detected at the proximal femur than at the lumbar spine in late postmenopausal women.

Absorptiometry, Photon↗