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Biomedical subjects

J A Pinotti

Publications and source records attributed to J A Pinotti.

At least 91 records · Page 5Linked to original sources
PubMedDate not supplied

Microlaparoscopy in gynecology: analysis of 16 cases and review of literature.

Microlaparoscopy represents the development of endoscopic surgery towards a minimally invasive surgical procedure. The advantages include fewer surgical complications, faster return to daily activities, more comfortable postoperative recovery, and satisfactory aesthetic results. The possibility of performing surgery under sedation may result in shorter hospitalization, lower hospital costs, and easier anesthetic procedures. The authors report their preliminary experience with the use of microlaparoscopy, using optics and 2mm instruments, as well as a review of the literature since the introduction of this new technique. The report of these 16 cases demonstrates that microlaparoscopy is a feasible technique with satisfactory results. On the other hand, this new technique requires precise indications and a training period for the development of the skills necessary for performing these surgeries.

Adolescent↗
PubMedDate not supplied

[Colpocytology in a preventive gynecological ambulatory service].

BACKGROUND: evaluate the results of Pap smear in women attended at a gynecology preventive ambulatory (University of São Paulo Medical School Clinical Hospital). METHODS: 6821 women were submitted to a medical interview, clinical and gynecologic exam. Cervical and vaginal cytology (Pap smear) were analyzed according to the Papanicolaou method and classification. All women were grouped according to their age into three categories:under 40 years old, between 41 and 60 years and over 60 years. RESULTS: most of them, and mainly the younger ones, had been submitted to a previous Pap smear in a period shorter than 1 year (44.2%). The majority of women recognized the usefulness of the exam and knew its interval; the group that best knew its importance and interval was the one with ages between 41 and 60 years, while most women over 60 years did not know both its importance and interval. Cytological material was considered insufficient for analysis in 15,1% and inadequate in 1.1%, and for those with adequate material results were classes I (21.7%), II (59.9%), III (2.0%), IV (0.1%) and V (0.1%). Distribution of cervical intraepithelial neoplasia (CIN) were similar in the three groups. The main microbiologic findings was Gardnerella sp. (8,6%) and Human papillomavirus (HPV) incidence was significantly lower among women over 60 years. CONCLUSION: Cytological diagnoses of neoplastic modifications were performed in 2,2% and Gardnerella sp. was the most prevalent microbiologic agent. Distribution of HPV showed a decrease with age. Older women had lower knowledge on the importance of regular Pap smear examination.

Adult↗
PubMedDate not supplied

Wertheim-Meigs radical hysterectomy.

Wertheim-Meigs hysterectomy is the treatment of choice for invasive cervix cancer stage IB and IIA at the University of São Paulo Medical School. It was performed in 168 patients between 1974 and 1993. Pelvic lymph node metastases were found in 19 patients (11.3%) and 149 were negative lymph node. The recurrence rate was 21% in the positive lymph node and 6% in the negative lymph node patients. Complications occurred in 35 patients (20.83%) and were as follows: atonic bladder in 9.52%; fistulae in 5.59%; urinary incontinence in 4.76%; ureteral stenosis in 2.97%; dehiscence in 2.38% and lymphedema in 1.19%. Intraoperative complications occurred at a rate of 4.76% and involved injuries to the bladder, ureter and great vessels.

Endometrial Neoplasms↗
PubMedDate not supplied

[Immediate breast reconstruction with the use of a microsurgical flap of the rectus abdominis muscle].

Breast cancer in advanced stages is a condition still frequently diagnosed in the female patients of this hospital. The surgical treatment proposed tends to be radical and mutilating. The importance of the breast for the female self-image is recognized, as well as the sameness of the prognosis of the disease after breast reconstruction, for which different techniques may be proposed to the patients. Among them is the use of the m. rectus abdominis as musculo-cutaneous free flap. This paper reports our experience in regard to the indication, tactics, results and complications of this technique.

Breast Neoplasms↗
PubMedDate not supplied

Treatment of carcinoma in situ of the cervix experience at the Faculty of Medicine, University of São Paulo.

The authors studied a total of 334 cases of carcinoma in situ of the cervix (1975-1990). The patients were 19 to 61 years old (mean age, 36.6 years). The following procedures were performed: cervical amputation in 54.5% of cases, cervical enlarged amputation with resection of the adjacent vaginal mucosa in 23.3%, abdominal hysterectomy in 15.3%, electrocauterization in 3.6%, simple conization in 2.4%, and vaginal hysterectomy in 0.9%. Recurrence rates were: 9.8% after cervical amputation, 1.3% after cervical enlarged amputation, 25% after simple conization, 5.8% after abdominal hysterectomy, and 33% after electrocauterization. Recurrences were detected before the 18th month after treatment and none of them was of the invasive type. The treatment procedure with the highest rate of complications was cervical enlarged amputation (16%), followed by simple conization (12%), total abdominal hysterectomy (3.9%), and cervical amputation (2.9%). The authors conclude that, although cervical enlarged amputation was followed by the lowest recurrence rate, it was also the treatment followed by the largest number of complications. On this basis, they recommend cervical amputation or hysterectomy. For young women who wish to have children, simple conization is recommended.

Adult↗
PubMedDate not supplied

[Interventions to reduce maternal mortality].

The authors comment a proposal to adopt measures to reduce maternal death and suggest four levels of action: 1) actions aimed at improving the knowledge about the number and factors associated to high risk maternal mortality during pregnancy, delivery and puerperium; they comment on the undernumeration of maternal death cases and propose an improvement in vital statistics, epidemiologic investigation and the creation of maternal mortality committees; 2) action to assist pregnancy, delivery and puerperium, to increase both the coverage and the quality of medical care, prenatal care, institutional care to delivery, and post-partum care; 3) action to prevent pregnancy in women with high risk of maternal mortality, improving diagnosis and treatment of diseases that increase maternal risk, and promoting contraception for these cases; 4) other actions aimed at reducing the risk of death brought about by induced abortion.

Abortion, Spontaneous↗
PubMedDate not supplied

[The experience of the Resting Home at the Center for Integral Women's Health Care of the State University of Campinas, Brazil].

The CAISM--Center for Integral Women's Health Care, of the Unicamp--State University of Campinas created a low complexity unit called a "Resting Home" according to the model adopted by other tertiary care centers in Brazil and in other countries. With 35 beds, the Resting Home staff includes two registered nurses, one social worker, and one occupational therapist. The institution admits women who have a high risk of acute complications of pregnancy or who require frequent check-up, mothers of premature babies under care in neonatal units who require their mother's breast feeding, and gynecological cancer patients who are in the process of staging and final diagnosis, or who are under frequent sessions of radiotherapy or chemotherapy. The common characteristic is that all of them need to go frequently to the outpatient services of the hospital, they live far away from the hospital, and they cannot afford rapid and easy transportation from their homes. The Resting Home offers them lodging and food, and a minimum of comfort (occupational therapy, TV, reading) at a cost that is only a small fraction of the cost of an inpatient. The authors present the statistics for the first 31 months of operation.

Brazil↗