22 results on '"Paulo Francisco Ramos Margarido"'
Search Results
2. Validation of Serological Methods for COVID-19 and Retrospective Screening of Health Employees and Visitors to the São Paulo University Hospital, Brazil
- Author
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Robert Andreata-Santos, Rafael Rahal Guaragna Machado, Rúbens Prince dos Santos Alves, Natiely Silva Sales, Camila Pereira Soares, Karine Bitencourt Rodrigues, Mariângela Oliveira Silva, Marianna Teixeira de Pinho Favaro, Mônica Josiane Rodrigues-Jesus, Márcio Massao Yamamoto, Juliana Bannwart de Andrade, Ricardo Ambrósio Fock, Paulo Francisco Ramos Margarido, Cristiane Rodrigues Guzzo Carvalho, Silvia Beatriz Boscardin, Edison Luiz Durigon, and Luís C. S. Ferreira
- Subjects
SARS-CoV-2 ,serology ,ELISA ,health employees ,ECLIA ,surveillance ,Microbiology ,QR1-502 - Abstract
Reliable serological tests for the detection of SARS-CoV-2 antibodies among infected or vaccinated individuals are important for epidemiological and clinical studies. Low-cost approaches easily adaptable to high throughput screenings, such as Enzyme-Linked Immunosorbent Assays (ELISA) or electrochemiluminescence immunoassay (ECLIA), can be readily validated using different SARS-CoV-2 antigens. A total of 1,119 serum samples collected between March and July of 2020 from health employees and visitors to the University Hospital at the University of São Paulo were screened with the Elecsys® Anti-SARS-CoV-2 immunoassay (Elecsys) (Roche Diagnostics) and three in-house ELISAs that are based on different antigens: the Nucleoprotein (N-ELISA), the Receptor Binding Domain (RBD-ELISA), and a portion of the S1 protein (ΔS1-ELISA). Virus neutralization test (CPE-VNT) was used as the gold standard to validate the serological assays. We observed high sensitivity and specificity values with the Elecsys (96.92% and 98.78%, respectively) and N-ELISA (93.94% and 94.40%, respectively), compared with RBD-ELISA (90.91% sensitivity and 88.80% specificity) and the ΔS1-ELISA (77.27% sensitivity and 76% specificity). The Elecsys® proved to be a reliable SARS-CoV-2 serological test. Similarly, the recombinant SARS-CoV-2 N protein displayed good performance in the ELISA tests. The availability of reliable diagnostic tests is critical for the precise determination of infection rates, particularly in countries with high SARS-CoV-2 infection rates, such as Brazil. Collectively, our results indicate that the development and validation of new serological tests based on recombinant proteins may provide new alternatives for the SARS-CoV-2 diagnostic market.
- Published
- 2022
- Full Text
- View/download PDF
3. Referral gynecological ambulatory clinic: principal diagnosis and distribution in health services
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Adna Thaysa Marcial da Silva, Camila Lohmann Menezes, Edige Felipe de Sousa Santos, Paulo Francisco Ramos Margarido, José Maria Soares, Edmund Chada Baracat, Luiz Carlos de Abreu, and Isabel Cristina Esposito Sorpreso
- Subjects
Ambulatory care ,Health services use ,Gynecology ,Women’s health ,Health care levels ,Gynecology and obstetrics ,RG1-991 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background The association between gynecological diagnoses and their distribution in the health sectors provides benefits in the field of women’s health promotion and in medical and interdisciplinary education, along with rationalization according to level of care complexity. Thus, the objective is analyze the clinical-demographic characteristics, main diagnoses in gynecological ambulatory care, and their distribution in health services. Method This is a research project of retrospective audit study design with a chart review of data from 428 women treated at University Ambulatory Clinic of Women’s Health, the facility in gynecology and training for Family and Community Medical Residents, São Paulo, Brazil, from 2012 to 2014. Clinical and demographic information, gynecological diagnoses (International Classification of Diseases), and distribution of health services (primary, secondary, and tertiary) were described. Results The female patients present non-inflammatory disorders of the female genital tract (81.07%, n = 347) and diseases of the urinary system (22.66%, n = 97) among the gynecological diagnoses. The chances of having benign breast disease and non-inflammatory disorders of the female genital tract during the reproductive period corresponds to being 3.61 (CI 1.00–16.29) and 2.56 times (CI 1.58–4.16) higher, respectively, than during the non-reproductive period. The non-inflammatory disorders of the female genital tract (93.33%, n = 28) are most related to the tertiary sector. The distribution in health services was the following: 71.30% (n = 305) in the primary sector, 21.70% (n = 93) in the secondary sector and 7% (n = 30) in the tertiary sector. Conclusion The studied women presented non-inflammatory disorders of the female genital tract and diseases of the urinary system as determined by gynecological diagnoses. Low-assistance complexity followed in most cases.
- Published
- 2018
- Full Text
- View/download PDF
4. B lymphocytes can be activated to act as antigen presenting cells to promote anti-tumor responses.
- Author
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Renata Ariza Marques Rossetti, Noely Paula Cristina Lorenzi, Kaori Yokochi, Maria Beatriz Sartor de Faria Rosa, Luciana Benevides, Paulo Francisco Ramos Margarido, Edmund Chada Baracat, Jesus Paula Carvalho, Luisa Lina Villa, and Ana Paula Lepique
- Subjects
Medicine ,Science - Abstract
Immune evasion by tumors includes several different mechanisms, including the inefficiency of antigen presenting cells (APCs) to trigger anti-tumor T cell responses. B lymphocytes may display a pro-tumoral role but can also be modulated to function as antigen presenting cells to T lymphocytes, capable of triggering anti-cancer immune responses. While dendritic cells, DCs, are the best APC population to activate naive T cells, DCs or their precursors, monocytes, are frequently modulated by tumors, displaying a tolerogenic phenotype in cancer patients. In patients with cervical cancer, we observed that monocyte derived DCs are tolerogenic, inhibiting allogeneic T cell activation compared to the same population obtained from patients with precursor lesions or cervicitis. In this work, we show that B lymphocytes from cervical cancer patients respond to treatment with sCD40L and IL-4 by increasing the CD80+CD86+ population, therefore potentially increasing their ability to activate T cells. To test if B lymphocytes could actually trigger anti-tumor T cell responses, we designed an experimental model where we harvested T and B lymphocytes, or dendritic cells, from tumor bearing donors, and after APC stimulation, transplanted them, together with T cells into RAG1-/- recipients, previously injected with tumor cells. We were able to show that anti-CD40 activated B lymphocytes could trigger secondary T cell responses, dependent on MHC-II expression. Moreover, we showed that dendritic cells were resistant to the anti-CD40 treatment and unable to stimulate anti-tumor responses. In summary, our results suggest that B lymphocytes may be used as a tool for immunotherapy against cancer.
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- 2018
- Full Text
- View/download PDF
5. Microperforated hymen: a case of delayed diagnosis
- Author
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Olívia Maria Ferraz Ferrarini, Lívia Oliveira Munhoz, Ricardo Santos Simões, Pérsio Yvon Adri Cezarino, Mauricio Paulo Ângelo Mieli, Paulo Francisco Ramos Margarido, Fábio José Guida, and Edmund Chada Baracat
- Subjects
Hymen ,Dysmenorrhea ,Dyspareunia ,Surgical Procedures ,Operative ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Although the incidence of microperforated hymen (MH) is unclear, this hymenal subocclusive anomaly is considered a rare entity. Differently from imperforated hymen, MH may be asymptomatic until puberty when the women’s quality of life is jeopardized. Depending on the size of the microperforation, MH’s clinical features me be very similar to those found in imperforated hymen cases. However, MH may present infectious complications since the accumulated secretion retained in the vaginal canal has contact with the external environment and therefore represents a source of entry for infectious agents. The authors report a case of a 28-year-old woman who sought the gynecologist complaining of inability to have vaginal intercourse. She referred normal menses, but in fact, although regular, bleeding was filiform and was exteriorized only through the right side of the vagina. Physical examination and imaging disclosed a microperforation of the hymenal membrane at 10 o’clock position. Hymenotomy under general anesthesia was undertaken. Outcome was favorable and the patient could thenceforth have a normal life. We conclude that this anomaly may be overlooked, interfering on its incidence determination. The delayed onset of symptoms and psychological embarrassing aspects, which postpone gynecological consultation, may contribute for misdiagnoses. We call attention to a mandatory detailed anamnesis and thorough physical examination to diagnose this anomaly before the puberty, when complications are less frequent and treatment is advisable.
- Published
- 2014
6. Ovarian adenosarcoma simulating a simple cyst in a young patient
- Author
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Leonardo Gomes da Fonseca, Aloisio Felipe-Silva, Samanta Cabral Severino da Silva, Paulo Francisco Ramos Margarido, Elias Abdo Filho, and Paulo Marcelo Gehm Hoff
- Subjects
Mixed Tumor ,Mullerian ,Ovarian Neoplasms ,Neoplasm Staging ,Therapeutics ,Medicine ,Internal medicine ,RC31-1245 - Abstract
Müllerian adenosarcoma is a rare, mixed tumor that can occur throughout the female genital tract, but is most commonly found in the uterus. Ovarian adenosarcoma is rarer and has a poorer prognosis than uterine adenosarcoma. Data on the clinicopathological features of ovarian adenosarcoma are limited, and, due to its rarity, the management is controversial. The authors report a case of a 25-year-old patient who presented with recurrent abdominal pain. Sonography and laparotomy showed an ovarian cyst, and pathologic examination confirmed the diagnosis of cystic low-grade adenosarcoma. The patient remains free of recurrence 6 months after diagnosis. The authors call attention to the differential diagnosis of ovarian masses, especially in young patients, and to the lack of evidence on the management of this neoplasm in the literature.
- Published
- 2014
- Full Text
- View/download PDF
7. Carcinomatous transformation of retroperitoneal endometriosis
- Author
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João Augusto dos Santos Martines, Brenda Margatho Ramos Martines, Silvana Maria Lovisolo, Cornélius Mitteldorf, Paulo Francisco Ramos Margarido, and Daniel Roberto Garzi
- Subjects
Endometriosis ,Adenocarcinoma ,Neoplasm ,Retroperitoneal space. ,Medicine ,Internal medicine ,RC31-1245 - Abstract
The authors present a case of a female patient 45 years old with chronic abdominal pain and a retroperitoneal tumor mass which showed the diagnosis of endometriosis by fine needle biopsy. Bilateral oophorectomy was performed. The patient remained symptomatic,the next four years, with pain and weight loss and new diagnostic images revealed tumor mass growth. Radical surgical treatment was impracticable due to tumor adhesions to major vascular structures. Post operatory was troublesome with septic complications evolving to death. The autopsy results showed the diagnosis of endometrioid adenocarcinoma.
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- 2011
- Full Text
- View/download PDF
8. Diferenças no perfil trombofílico de mulheres com antecedente de tromboembolismo venoso relacionado e não relacionado com a terapia de reposição hormonal
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Paulo Francisco Ramos Margarido, Sérgio Paulo Bydlowski, Vicente Renato Bagnoli, Ângela Maggio da Fonseca, and José Aristodemo Pinotti
- Subjects
Gynecology and obstetrics ,RG1-991 - Published
- 2004
- Full Text
- View/download PDF
9. Abnormal uterine bleeding and chronic iron deficiency
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Venina Viana de Barros, Eliane Azeka Hase, Cristiano Caetano Salazar, Ana Maria Kondo Igai, Fernanda Andrade Orsi, and Paulo Francisco Ramos Margarido
- Subjects
Obstetrics and Gynecology - Published
- 2022
10. Relation between CANDIDA species isolated from vaginal mucosa and lesions caused by high-risk human papillomavirus hpv for cervical cancer
- Author
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Noely Paula Cristina Lorenzi, Edgard Michel Crosato, Marcos Ereno Auler, Paulo Francisco Ramos Margarido, Carina Domaneschi, D.C. Moreira, Maricy Tacla, Claudete Rodrigues Paula, Ana Clara de Souza, Rennan Luiz Oliveira Dos Santos, and Luciana da Silva Ruiz
- Subjects
Cervical cancer ,medicine.medical_specialty ,General Immunology and Microbiology ,biology ,business.industry ,Public Health, Environmental and Occupational Health ,Mucous membrane ,Odds ratio ,biology.organism_classification ,medicine.disease ,Gastroenterology ,Corpus albicans ,Infectious Diseases ,medicine.anatomical_structure ,Internal medicine ,Diabetes mellitus ,medicine ,Papillomaviridae ,Candida albicans ,business ,Fluconazole ,medicine.drug - Abstract
This study characterized and related yeasts of the genus Candida isolated from vaginal mucous membranes of women with lesions caused by high-risk HPV for cervical cancer. Forty-two women treated at the Lower Genital Tract Pathology Clinic of the University of São Paulo Medical School Hospital of Clinics were examined, with 30 high-grade (G1) uterine lesions with a mean age of 36.5 years ± 11. 1 and 12 with low grade (G2) uterine lesions with a mean age of 34.7 years ± 15.5. Clinical conditions and laboratory data on HPV were collected from patients’ medical records; the socio-demographic data obtained from an appropriate questionnaire. For the study of association between the variables, Odds Ratio analysis was used from the STATA 13.1 program. Patients G1 had a higher prevalence for diabetes and the results indicated 27% prevalence of Candida spp. in vaginal mucosa, in G2 this was 33% in vaginal mucosa. Among the species found in vaginal mucosa of patients, Candida albicans was the most isolated with 88%, followed by C. tropicalis (8%) and C. glabrata (4%). The strains of C. albicans isolated from mucosa presented sensitivity to all antifungal agents tested, unlike the C. tropicalis strain isolated in G2 in vaginal mucosa, which presented a resistance profile to fluconazole. Thus, monitoring and supervision through clinical and laboratory testing of HPV patients is important, reinforcing the need for care, treatment and prevention of HPV-related infections and Candida spp. KEY WORDS: vaginal mucosa; uterine cervical neoplasms; human Papillomavirus; Candida spp. Antifungal sensitivity.
- Published
- 2021
11. Lactate secreted by cervical cancer cells modulates macrophage phenotype
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Jesus Paula Carvalho, Paulo Francisco Ramos Margarido, Renata Ariza Marques Rossetti, Karla Alvarez, Enrique Boccardo, Edmund Chada Baracat, Simone Cardozo Stone, Noely Paula Cristina Lorenzi, Kaori Yokochi, Maricy Tacla, and Ana Paula Lepique
- Subjects
0301 basic medicine ,Angiogenesis ,Interleukin-1beta ,Uterine Cervical Neoplasms ,Monocytes ,Oxidative Phosphorylation ,chemistry.chemical_compound ,0302 clinical medicine ,Immunology and Allergy ,Enzyme Inhibitors ,Aged, 80 and over ,FENÓTIPOS ,Middle Aged ,Interleukin-10 ,Phenotype ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Carcinoma, Squamous Cell ,Female ,Glycolysis ,Adult ,T cell ,Immunology ,Adenocarcinoma ,Biology ,03 medical and health sciences ,Immune system ,Cell Line, Tumor ,Spheroids, Cellular ,Lactate dehydrogenase ,medicine ,Humans ,Secretion ,Lactic Acid ,Aged ,Tumor microenvironment ,L-Lactate Dehydrogenase ,Interleukin-6 ,Macrophages ,Transcription Factor RelA ,Cell Biology ,Hypoxia-Inducible Factor 1, alpha Subunit ,Coculture Techniques ,030104 developmental biology ,Gene Expression Regulation ,chemistry ,Cell culture ,Anaerobic glycolysis ,Cancer research ,Neoplasm Grading - Abstract
Cervical cancer continues to be a public health problem in developing countries. Previous studies have shown that cervical cancer cells display markers of aerobic glycolysis, indicating that these tumors are likely to secrete lactate. Mostly, lactate is recognized as a molecule capable of suppressing immune responses, through inhibition of T cells, Mϕs, and dendritic cells. We and others have previously shown that Mϕs are frequent cells infiltrating cervical cancers with the ability to inhibit antitumor immune responses and promote tumor growth through angiogenesis. Here, we have tested the hypothesis that lactate, secreted by cervical cancer cells, can modulate Mϕ phenotype. First, we showed higher lactate plasma concentrations in patients with increasing cervical lesion grades, with maximum concentration in the plasma of cancer patients, which supported our hypothesis. We then inhibited lactate production in tumor cell spheroids established from cervical cancer derived cell lines, using the lactate dehydrogenase inhibitor, oxamate, prior to co-culture with monocytes. Lactate mediated part of the crosstalk between tumor cells and Mϕs, promoting secretion of IL-1β, IL-10, IL-6, and up-regulation of hypoxia induced factor-1α expression, and down-regulation of p65-NFκB phosphorylation in Mϕs. We also showed that Mϕs from co-cultures treated with oxamate were better inducers of T cell activation. Of note, experiments performed with inhibition of the monocarboxylate transporters rendered similar results. Our data confirms the hypothesis that lactate, secreted by cervical tumor cells, influences the phenotype of tumor Mϕs, promoting a suppressive phenotype.
- Published
- 2019
12. A multicenter, randomized trial comparing pelvic organ prolapse surgical treatment with native tissue and synthetic mesh: A 5-year follow-up study
- Author
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Edmund Chada Baracat, Silvia da Silva Carramão, Paulo Francisco Ramos Margarido, Stergios K. Doumouchtsis, Jorge Milhem Haddad, Simone dos Reis Brandão da Silveira, Zsuzsanna I. K. Jarmy-Dibella, Antomio P. F. Auge, and Claudinei Alves Rodrigues
- Subjects
Reoperation ,medicine.medical_specialty ,5 year follow up ,Urology ,030232 urology & nephrology ,Hysterectomy ,Polypropylenes ,Pelvic Organ Prolapse ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Quality of life ,Randomized controlled trial ,law ,Recurrence ,Uterine Prolapse ,Surveys and Questionnaires ,medicine ,Humans ,Fascia ,Surgical treatment ,Aged ,Pelvic organ ,030219 obstetrics & reproductive medicine ,Mesh repair ,business.industry ,Suture Techniques ,Middle Aged ,Plastic Surgery Procedures ,Surgical Mesh ,Surgery ,Treatment Outcome ,Native tissue ,Vagina ,Quality of Life ,Female ,Neurology (clinical) ,Sexual function ,business ,Follow-Up Studies - Abstract
Introduction The aim of this study was to compare long-term outcomes in patients who underwent either native tissue repair or monofilament macroporous polypropylene mesh. Methods This multicenter, randomized trial included-at the end of 5 years follow-up-122 women with severe pelvic organ prolapse, who were randomly assigned to undergo surgical treatment using native tissue repair (native tissue group, n = 59) or synthetic mesh repair (mesh group, n = 63). Cure criterion was when pelvic organ prolapse-quantification (POP-Q) point was ≤0. Quality of life was assessed using the prolapse quality-of-life questionnaire and sexual function with the quality of sexual function. Results Groups were homogeneous preoperatively with the exception of the previous pelvic surgery variable, which was higher in mesh (P = .019). Cure rate was significantly better for mesh group in the anterior compartment (P = .002) and in the combination of all compartments (P = .001). Native tissue group was significantly better when there was prolapse in the posterior and apical compartment (P = .031). In the quality of life analysis, mesh group showed a significant improvement compared with native tissue group (P = .004). Complications were significantly higher in mesh and recurrence in native tissue. Regarding the reoperation rate, there was no difference between groups, but native tissue had a higher reoperation rate due to recurrence (P = .031). Conclusions Outcomes in women with severe POP were better with mesh use than native tissue repair, both in the anterior compartment and in the multicompartmental prolapse after 5-year follow-up. Complications were more common in the mesh group and recurrences were more frequent in the native tissue group.
- Published
- 2019
13. B lymphocytes can be activated to act as antigen presenting cells to promote anti-tumor responses
- Author
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Luisa L. Villa, Maria Beatriz Sartor de Faria Rosa, Edmund Chada Baracat, Luciana Benevides, Paulo Francisco Ramos Margarido, Kaori Yokochi, Renata Ariza Marques Rossetti, Noely Paula Cristina Lorenzi, Jesus Paula Carvalho, and Ana Paula Lepique
- Subjects
0301 basic medicine ,B Cells ,medicine.medical_treatment ,T-Lymphocytes ,Cancer Treatment ,Uterine Cervical Neoplasms ,lcsh:Medicine ,Lymphocyte Activation ,Cervical Cancer ,Mice ,White Blood Cells ,Spectrum Analysis Techniques ,Animal Cells ,Medicine and Health Sciences ,Medicine ,Cytotoxic T cell ,lcsh:Science ,education.field_of_study ,B-Lymphocytes ,Immunity, Cellular ,Multidisciplinary ,T Cells ,Flow Cytometry ,MONÓCITOS ,medicine.anatomical_structure ,Oncology ,Spectrophotometry ,B7-1 Antigen ,Female ,Immunotherapy ,Cytophotometry ,Cellular Types ,Research Article ,T cell ,Immune Cells ,Population ,CD40 Ligand ,Immunology ,Antigen-Presenting Cells ,Cytotoxic T cells ,Research and Analysis Methods ,03 medical and health sciences ,Immune system ,Animals ,Humans ,CD40 Antigens ,education ,Antigen-presenting cell ,Antibody-Producing Cells ,Molecular Biology Techniques ,Molecular Biology ,CD86 ,Homeodomain Proteins ,Blood Cells ,business.industry ,lcsh:R ,Biology and Life Sciences ,Cancers and Neoplasms ,Dendritic Cells ,Cell Biology ,030104 developmental biology ,Cancer research ,lcsh:Q ,B7-2 Antigen ,Interleukin-4 ,business ,Gynecological Tumors ,CD80 ,Cloning - Abstract
Immune evasion by tumors includes several different mechanisms, including the inefficiency of antigen presenting cells (APCs) to trigger anti-tumor T cell responses. B lymphocytes may display a pro-tumoral role but can also be modulated to function as antigen presenting cells to T lymphocytes, capable of triggering anti-cancer immune responses. While dendritic cells, DCs, are the best APC population to activate naive T cells, DCs or their precursors, monocytes, are frequently modulated by tumors, displaying a tolerogenic phenotype in cancer patients. In patients with cervical cancer, we observed that monocyte derived DCs are tolerogenic, inhibiting allogeneic T cell activation compared to the same population obtained from patients with precursor lesions or cervicitis. In this work, we show that B lymphocytes from cervical cancer patients respond to treatment with sCD40L and IL-4 by increasing the CD80+CD86+ population, therefore potentially increasing their ability to activate T cells. To test if B lymphocytes could actually trigger anti-tumor T cell responses, we designed an experimental model where we harvested T and B lymphocytes, or dendritic cells, from tumor bearing donors, and after APC stimulation, transplanted them, together with T cells into RAG1-/- recipients, previously injected with tumor cells. We were able to show that anti-CD40 activated B lymphocytes could trigger secondary T cell responses, dependent on MHC-II expression. Moreover, we showed that dendritic cells were resistant to the anti-CD40 treatment and unable to stimulate anti-tumor responses. In summary, our results suggest that B lymphocytes may be used as a tool for immunotherapy against cancer.
- Published
- 2018
14. Ovarian adenosarcoma simulating a simple cyst in a young patient
- Author
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Aloísio Felipe-Silva, Samanta Cabral Severino da Silva, Paulo M. Hoff, Leonardo Gomes da Fonseca, Elias Abdo Filho, and Paulo Francisco Ramos Margarido
- Subjects
lcsh:Internal medicine ,medicine.medical_specialty ,Ovarian Adenosarcoma ,medicine.medical_treatment ,Simple cyst ,Uterus ,lcsh:Medicine ,Mixed Tumor, Mullerian ,Therapeutics ,Mixed Tumor ,Pathology and Forensic Medicine ,Laparotomy ,Internal Medicine ,medicine ,lcsh:RC31-1245 ,Neoplasm Staging ,Gynecology ,Ovarian Neoplasms ,Mixed tumor ,Ovarian cyst ,business.industry ,lcsh:R ,medicine.disease ,medicine.anatomical_structure ,Adenosarcoma ,Artigo / Relato de Caso Clínico ,Radiology ,TERAPÊUTICA ,Mullerian ,Differential diagnosis ,business ,Article / Clinical Case Reports - Abstract
Müllerian adenosarcoma is a rare, mixed tumor that can occur throughout the female genital tract, but is most commonly found in the uterus. Ovarian adenosarcoma is rarer and has a poorer prognosis than uterine adenosarcoma. Data on the clinicopathological features of ovarian adenosarcoma are limited, and, due to its rarity, the management is controversial. The authors report a case of a 25-year-old patient who presented with recurrent abdominal pain. Sonography and laparotomy showed an ovarian cyst, and pathologic examination confirmed the diagnosis of cystic low-grade adenosarcoma. The patient remains free of recurrence 6 months after diagnosis. The authors call attention to the differential diagnosis of ovarian masses, especially in young patients, and to the lack of evidence on the management of this neoplasm in the literature.
- Published
- 2014
15. Microperforated hymen: a case of delayed diagnosis
- Author
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Livia Oliveira Munhoz, Fabio Jose Guida, Paulo Francisco Ramos Margarido, Edmund Chada Baracat, Pérsio Yvon Adri Cezarino, Maurício Paulo Angelo Mieli, Olívia Maria Ferraz Ferrarini, and Ricardo Simoes
- Subjects
lcsh:Internal medicine ,Hymen ,medicine.medical_specialty ,medicine.medical_treatment ,lcsh:Medicine ,Physical examination ,Hymenotomy ,Asymptomatic ,Pathology and Forensic Medicine ,Dysmenorrhea ,Quality of life ,Internal Medicine ,medicine ,lcsh:RC31-1245 ,Anamnesis ,Surgical Procedures ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,General surgery ,lcsh:R ,Operative ,Surgery ,Dyspareunia ,medicine.anatomical_structure ,Surgical Procedures, Operative ,Vagina ,Artigo / Relato de Caso Clínico ,medicine.symptom ,business ,Article / Clinical Case Reports ,PROCEDIMENTOS CIRÚRGICOS OPERATÓRIOS - Abstract
Although the incidence of microperforated hymen (MH) is unclear, this hymenal subocclusive anomaly is considered a rare entity. Differently from imperforated hymen, MH may be asymptomatic until puberty when the women’s quality of life is jeopardized. Depending on the size of the microperforation, MH’s clinical features me be very similar to those found in imperforated hymen cases. However, MH may present infectious complications since the accumulated secretion retained in the vaginal canal has contact with the external environment and therefore represents a source of entry for infectious agents. The authors report a case of a 28-year-old woman who sought the gynecologist complaining of inability to have vaginal intercourse. She referred normal menses, but in fact, although regular, bleeding was filiform and was exteriorized only through the right side of the vagina. Physical examination and imaging disclosed a microperforation of the hymenal membrane at 10 o’clock position. Hymenotomy under general anesthesia was undertaken. Outcome was favorable and the patient could thenceforth have a normal life. We conclude that this anomaly may be overlooked, interfering on its incidence determination. The delayed onset of symptoms and psychological embarrassing aspects, which postpone gynecological consultation, may contribute for misdiagnoses. We call attention to a mandatory detailed anamnesis and thorough physical examination to diagnose this anomaly before the puberty, when complications are less frequent and treatment is advisable.
- Published
- 2014
16. Transformação carcinomatosa de endometriose retroperitoneal
- Author
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João Augusto dos Santos Martines, Brenda Margatho Ramos Martines, Cornelius Mitteldorf, Paulo Francisco Ramos Margarido, Silvana Maria Lovisolo, and Daniel Roberto Garzi
- Subjects
medicine.medical_specialty ,business.industry ,Endometriosis ,Autopsy ,medicine.disease ,Pathology and Forensic Medicine ,Surgery ,Retroperitoneal tumor ,medicine.anatomical_structure ,Weight loss ,Female patient ,Internal Medicine ,medicine ,Retroperitoneal space ,Neoplasm ,Adenocarcinoma ,medicine.symptom ,business - Abstract
The authors present a case of a female patient 45 years old with chronic abdominal pain and a retroperitoneal tumor mass which showed the diagnosis of endometriosis by fine needle biopsy. Bilateral oophorectomy was performed. The patient remained symptomatic,the next four years, with pain and weight loss and new diagnostic images revealed tumor mass growth. Radical surgical treatment was impracticable due to tumor adhesions to major vascular structures. Post operatory was troublesome with septic complications evolving to death. The autopsy results showed the diagnosis of endometrioid adenocarcinoma.
- Published
- 2011
17. Biofilm formation on intrauterine devices in patients with recurrent vulvovaginal candidiasis
- Author
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René Peter Schneider, Paulo Francisco Ramos Margarido, F. E. Matsumoto, Fabio Rodrigues, Mauricio S. Abr Ão, Bosco Christiano Maciel da Silva, Marcos Ereno Auler, Debora Morreira, Claudete Rodrigues Paula, and Eriques Gonçalves Silva
- Subjects
Adult ,Antifungal Agents ,BIOFILMES ,medicine.drug_class ,Antibiotics ,Microbial Sensitivity Tests ,Intrauterine device ,Microbiology ,Recurrence ,Amphotericin B ,Candida albicans ,medicine ,Humans ,In patient ,Fluconazole ,Candidiasis, Vulvovaginal ,biology ,business.industry ,Biofilm ,General Medicine ,biology.organism_classification ,Infectious Diseases ,Biofilms ,Immunology ,Recurrent vulvovaginal candidiasis ,Female ,business ,Intrauterine Devices ,medicine.drug - Abstract
A biofi lm is a complex community of surface-associated cells enclosed in a polymer matrix. They attach to solid surfaces and their formation can be affected by growth conditions and co-infection with other pathogens. The presence of biofi lm may protect the microorganisms from host defenses, as well as signifi cantly reduce their susceptibility to antifungal agents. Pathogenic microbes can form biofi lms on the inert surfaces of implanted devices such as catheters, prosthetic cardiac valves and intrauterine devices (IUDs). The present study was carried out to analyze the presence of biofi lm on the surface of intrauterine devices in patients with recurrent vulvovaginal candidiasis, and to determine the susceptibility profi le of the isolated yeasts to amphotericin B and fl uconazole. Candida albicans was recovered from the IUDs and it was found to be susceptible to the antifungal agents when tested under planktonic growing conditions. These fi ndings indicate the presence of the biofi lm on the surface of the IUD as an important risk factor for recurrent vulvovaginal candidiasis.
- Published
- 2009
18. Thrombophilic profile of climacteric and menopausal women with venous thromboembolism
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Hans Wolfgang Halbe, Elbio Antonio D'Amico, Paulo Francisco Ramos Margarido, Vicente Renato Bagnoli, Angela Maggio da Fonseca, and J.A. Pinotti
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Internal medicine ,Obstetrics and Gynecology ,Medicine ,General Medicine ,Hormone replacement therapy ,business ,Climacteric ,Venous thromboembolism - Abstract
(2002). Thrombophilic profile of climacteric and menopausal women with venous thromboembolism. Climacteric: Vol. 5, No. 1, pp. 87-89.
- Published
- 2002
19. Update on primary dysmenorrhea: treatment
- Author
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Ricardo Simoes, Paulo Francisco Ramos Margarido, Maurício Paulo Angelo Mieli, Wanderley Marques Bernardo, and Pérsio Yvon Adri Cezarino
- Subjects
medicine.medical_specialty ,Primary (chemistry) ,business.industry ,Internal medicine ,medicine ,General Earth and Planetary Sciences ,business ,General Environmental Science - Published
- 2013
20. Clinical and laboratorial evaluation in elderly women submitted to low doses of hormone replacement therapy (HRT)
- Author
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Angela Maggio da Fonseca, Paulo Francisco Ramos Margarido, J.A. Pinotti, S A Y Hayashida, M H A Arie, J. O. P. Massabki, and Vicente Renato Bagnoli
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medicine.medical_specialty ,Pediatrics ,Endocrinology ,business.industry ,Internal medicine ,Low dose ,Obstetrics and Gynecology ,Medicine ,General Medicine ,Hormone replacement therapy ,business - Published
- 2000
21. Atualização em dismenorreia primária: tratamento
- Author
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Ricardo Simoes, Pérsio Yvon Adri Cezarino, Paulo Francisco Ramos Margarido, Maurício Paulo Angelo Mieli, and Wanderley Marques Bernardo
- Subjects
lcsh:R5-920 ,DIRETRIZES PARA A PRÁTICA CLÍNICA ,General Medicine ,lcsh:Medicine (General) - Abstract
∗ Autor para correspondencia. E-mail: diretrizes@amb.org.br (W.M. Bernardo). 104-4230/$ – see front matter ttp://dx.doi.org/10.1016/j.ramb.2013.10.004 4 Em mulheres portadoras da dismenorreia primaria, o uso do lumiracoxibe apresenta eficacia superior ao naproxeno? a O numero de eventos adversos e significativamente superior b A eficacia analgesica e inferior c A eficacia analgesica e superior d A eficacia analgesica e semelhante
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22. Caracterização e relação de leveduras do gênero Candida isoladas das mucosas oral e vaginal de mulheres com lesões causadas por HPV de alto risco para câncer do colo do útero
- Author
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Ana Clara de Souza, Claudete Rodrigues Paula, Marcos Ereno Auler, Carina Domaneschi, and Paulo Francisco Ramos Margarido
- Abstract
Este estudo caracterizou e relacionou as leveduras do gênero Candida isoladas das mucosas oral e vaginal de mulheres com lesões causadas por HPV de alto risco para câncer do colo do útero. Foram examinadas 42 mulheres tratadas no ambulatório de Patologia do Trato Genital Inferior do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo sendo, 30 com lesões uterinas de alto grau (G1) com média de idade de 36,5 anos ± 11,1 e 12 com lesões uterinas de baixo grau (G2) com média de idade de 34,75 anos ± 15,5. Condições clínicas e dados laboratoriais sobre HPV foram coletados do prontuário médico das pacientes; os dados sócio-demográficos obtidos a partir de um questionário apropriado. Para o estudo de associação entre as variáveis foi utilizada a análise de razão de chance (Odds Ratio) a partir do programa STATA 13.1. Foram identificadas associação entre lesões uterinas de baixo grau com cultura positiva em mucosa oral (OR= 0,215) e com presença de doenças crônicas (OR = 0,167), sendo que pacientes com lesões uterinas de alto grau possuem maior prevalência para diabetes e os resultados indicaram 23% de prevalência de Candida spp. em mucosa oral e 27% em mucosa vaginal, em pacientes do G1,no G2 foi de 42% em mucosa oral e de 33% em mucosa vaginal. Entre as espécies encontradas em mucosa oral e vaginal das pacientes, Candida albicans foi a mais isolada com 88%, seguida de C. tropicalis (8%)e C. glabrata (4%). As cepas de C. albicans isoladas de ambas as mucosas apresentaram sensibilidade a todos os antifúngicos testados, ao contrário da cepa de C. tropicalis isolada no Grupo 2, em mucosa vaginal, que apresentou um perfil de resistência ao fluconazol. Assim, torna-se importante o acompanhamento e supervisão por meio de exames clínicos e laboratoriais das pacientes com HPV, reforçando a necessidade sobre cuidados, tratamento e prevenção de infecções relacionadas ao HPV e a Candida spp. This study characterized and related yeasts of the genus Candida isolated from the oral and vaginal mucous membranes of women with lesions caused by high-risk HPV for cervical cancer. Forty-two women treated at the Lower Genital Tract Pathology Clinic of the University of São Paulo Medical School\'s Hospital of Clinics were examined, with 30 high-grade (G1) uterine lesions with a mean age of 36.5 years ± 11, 1 and 12 with low grade (G2) uterine lesions with a mean age of 34.75 years ± 15.5. Clinical conditions and laboratory data on HPV were collected from patients\' medical records; the socio-demographic data obtained from an appropriate questionnaire. For the study of association between the variables, Odds Ratio analysis was used from the STATA 13.1 program. An association between low grade uterine lesions with positive culture in oral mucosa (OR = 0.215) and presence of chronic diseases (OR = 0.167) was identified. Patients with high grade uterine lesions had a higher prevalence for diabetes and the results indicated 23% prevalence of Candida spp. In oral mucosa and 27% in vaginal mucosa, in G1 patients, in G2 it was 42% in oral mucosa and 33% in vaginal mucosa. Among the species found in oral and vaginal mucosa of patients, Candida albicans was the most isolated with 88%, followed by C. tropicalis (8%) and C. glabrata (4%). The strains of C. albicans isolated from both mucosa presented sensitivity to all tested antifungal agents, unlike the C. tropicalis strain isolated in Group 2, in vaginal mucosa, which presented a resistance profile to fluconazole. Thus, monitoring and supervision through clinical and laboratory testing of HPV patients is important, reinforcing the need for care, treatment and prevention of HPV-related infections and Candida spp.
- Published
- 2018
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