Mestrado em Medicina

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http://repositorio.ufes.br/handle/10/17588

Nível: Mestrado Acadêmico
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Navegando Mestrado em Medicina por Autor "Chambô Filho, Antônio"

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    Área placentária em casos de morte perinatal
    (Universidade Federal do Espírito Santo, 2015-03-05) Sodré, Larissa Kerr de Araujo; Vargas, Paulo Roberto Merçon de; Chambô Filho, Antônio; França, Luiz Cláudio; Silva, Rita Elizabeth Checon de Freitas
    The placental area (PA) mirror the endometrium covered by the placenta and the uteroplacental blood flow to the fetus. Recently, has been demonstrated that PA is an early and independent determinant of fetal growth and a marker of adverse reproductive outcome and of adult health conditions and chronic diseases (Barker’s hypothesis). There are few studies regarding PA in fetal diseases and none in perinatal deaths. Objective: To describe the PA distribution and abnormalities in perinatal deaths. Material and methods: Out from all perinatal deaths placentas examined between 2004 and 2014 at two Pathology Laboratories in Vitória City, Espírito Santo State, Brazil, we selected for the study 258 cases in which the gestational age (GA) was confirmed by ultrasound. The placental edge was outlined in a transparent plastic sheet and the PA measured by point counting planimetry, converted to z score (z/GA), classified as small (SGA, z/IG < -1,28), adequate (AGA), and large (LGA, z/IG > +1,28) for GA, and its occurrence calculated according to the socioeconomic status, the environment (fetal or neonatal) and the chronology of death. Results: The PA distribution in perinatal deaths showed a leftward deviance and large variation (z/GA -0,89 ± 1,81), a high proportion of SGA (46,5%), the expected proportion of LGA (12,8%), and not any significant variation according to socioeconomic status, environment or chronology of death. Conclusion: These results confirm that PA is a marker of adverse perinatal outcome, adducing evidence for its routine measurement and assessment in ultrasound and pathological examination.
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    Resistência insulínica em pacientes com câncer de mama. Estudo preliminar da ocorrência e associação com fatores de risco e prognóstico
    (Universidade Federal do Espírito Santo, 2015-09-23) Ferrugini, Carolina Loyola Prest; Vargas, Paulo Roberto Merçon de; Costalonga, Everlayny Fiorot; Chambô Filho, Antônio; Vieira Junior, Luiz Alberto Sobral
    The co-occurrence of insulin resistance (IR) and breast cancer and the possible ethiologic and prognostic link between them has gained increasing importance, although the mechanisms involved are not fully understood. Clinically, the search for understanding of this association has stimulated studies on occurrence and empirical association between RI and risk factors (RF), prognostic factors (PF) and breast cancer subtypes, aiming to improve the treatment of these diseases. Objective. To determine the prevalence of RI and its association with RF and PF in patients with breast cancer. Patients and Methods. Study cases were selected from breast câncer in publicly assisted women at the Mastology Clinic of HUCAM/UFES, in Vitória city, Brazil, between november 2011 and november 2013 in which it was possible to obtain before treatment glucose and insulin blood level. IR was diagnosed by HOMA-IR index. Its occurrence and association with RF and PR was determined in all cases and in groups defined as reproductive and postmenopausal periods. Frequency between groups were contrasted by direct increment, simple rate, chi square test, and odds ratio, intrepreted by the recommended criteria for stochastic and quantitative magnitude significance. Results. In the 80 studied patients, the IR occurrence was 38.7%, higher in reproductive than postmenstrual periods (43.6% versus 28.0%), without significant variation according to RF. Breast cancer with Ki67 expression and HER2 hiperexpression were more frequent in IR patients of postmenopausal period and luminal A breast cancer more frequent in IR patients of reperoductive period. None significant occurrence variation was found in the others PR according IR, either in reproductive or postmenopausal women. Conclusion. These results show that 2 more aggressive PF occur more frequently in postmenopausal IR + patients as the Luminal A tumors, with better prognosis, occurs in  reproductive age IR+ patients, adducing empirical evidence, although based on a small number of cases, for routine assessment of insulin resistance in breast câncer patients, especially during the postmenopausal period.