MAURICIO SIMOES ABRAO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina - Docente
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/58 - Laboratório de Ginecologia Estrutural e Molecular, Hospital das Clínicas, Faculdade de Medicina
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- Role of Eutopic Endometrium in Pelvic Endometriosis(2011) CARVALHO, Luiz; PODGAEC, Sergio; BELLODI-PRIVATO, Marta; FALCONE, Tommaso; ABRAO, Mauricio SimoesEndometriosis is defined as the presence of endometrial tissue outside the uterine cavity and is considered a benign gynecologic condition; however, in some cases, it may be aggressive. The pathogenesis of endometriosis is complex and multifactorial. Despite being one of the most widely studied gynecologic diseases, its pathogenesis remains uncertain. The intrinsic endometrial abnormalities thought lobe associated with endometriosis include abnormal expression of genes, modification of endometrial response to hormones such as progesterone; increased nerve density, and oxidative stress. Evaluation of the endometrium in patients with endometriosis is an important line of investigation in the pathophysiology of the disease. It has been suggested that investigation of eutopic endometrium may help to achieve this goal. Presented herein is a literature review and a comprehensive evaluation of the role of eutopic endometrium in pelvic endometriosis. Clinical correlations of the disease are highlighted, with the objective of understanding the role of eutopic endometrium in endometriosis. Journal of Minimally Invasive Gynecology (2011) 18, 419-427 (C) 2011 AAGL. All rights reserved.
- Vaginal cone use in passive and active phases in patients with stress urinary incontinence(2011) HADDAD, Jorge Milhem; RIBEIRO, Ricardo Muniz; BERNARDO, Wanderley Marques; ABRAO, Mauricio Simoes; BARACAT, Edmund ChadaOBJECTIVE: To evaluate vaginal cone therapy in two phases, passive and active, in women with stress urinary incontinence. METHODS: A prospective study was conducted at the Department of Obstetrics and Gynecology, Sao Paulo University, Brazil. Twenty-four women with a clinical and urodynamic diagnosis of stress urinary incontinence were treated with vaginal cones in a passive phase (without voluntary contractions of the pelvic floor) and an active phase (with voluntary contractions), each of which lasted three months. Clinical complaints, a functional evaluation of the pelvic floor, a pad test, and bladder neck mobility were analyzed before and after each phase. RESULTS: Twenty-one patients completed the treatment. The reduction in absolute risk with the pad test was 0.38 (p < 0.034) at the end of the passive phase and 0.67 (p < 0.0001) at the end of the active phase. The reduction in absolute risk with the pelvic floor evaluation was 0.62 (p < 0.0001) at the end of the passive phase and 0.77 (p < 0.0001) at the end of the active phase. The reduction in absolute risk of bladder neck mobility was 0.38 (p < 0.0089) at the end of the passive phase and 0.52 (p < 0.0005) at the end of the active phase. Complete reversal of symptomatology was observed in 12 (57.1%) patients, and satisfaction was expressed by 19 (90.4%). CONCLUSION: Using vaginal cones in the passive phase, as other researchers did, was effective. Inclusion of the active phase led to additional improvement in all of the study parameters evaluated in women with stress urinary incontinence. Randomized studies are needed, however, to confirm these results.
- Quality of Life after Segmental Resection of the Rectosigmoid by Laparoscopy in Patients with Deep Infiltrating Endometriosis with Bowel Involvement(2011) BASSI, Marco Antonio; PODGAEC, Sergio; DIAS JR., Joao Antonio; D'AMICO FILHO, Nicolau; PETTA, Carlos Alberto; ABRAO, Mauricio S.Study Objective: To estimate the quality of life of patients undergoing laparoscopic resection of a segment of the rectosigmoid for the treatment of deep infiltrating endometriosis with bowel involvement. Design: Prospective application of the SF-36 Health Status Questionnaire to 151 women before and 1 year after surgical intervention (Canadian Task Force Design Classification II). Setting: Department of Obstetrics and Gynecology, University of Sao Paulo Medical School, and Samaritano Hospital, Sao Paulo, Brazil. Patients: A total of 151 women (mean age 34.05 +/- 5.65 years) with deep infiltrating endometriosis underwent resection of a segment of the rectosigmoid by laparoscopy between 2002 to 2009. Interventions: All the patients had historical data collected and underwent clinical examination and transvaginal ultrasonography with prior bowel preparation for resection of a segment of the rectosigmoid by laparoscopy indicated for patients with symptoms (pelvic pain) with 1 or more lesions of more than 3 cm in length or multifocal lesions. Measurements and Main Results: Wilcoxon signed rank test verified differences between the degrees of the symptoms and the SF-36 scores before and 1 year after laparoscopic treatment. There was a significant improvement (p < .001) in all pain-related symptoms, as well as a significant increase (p < .001) in scores in all the SF-36 domains and in the sum of the components comprising both physical and mental health. Conclusion: Laparoscopic segmental resection of the rectosigmoid fulfills its essential objective of treating endometriosis with bowel involvement and improving patients' QoL to a significant extent. Journal of Minimally Invasive Gynecology (2011) 18, 730-733 (C) 2011 AAGL. All rights reserved.
- Stem cells in endometrium and their role in the pathogenesis of endometriosis(2011) FIGUEIRA, Paula Gabriela Marin; ABRAO, Mauricio Simoes; KRIKUN, Graciela; TAYLOR, HughThe human endometrium is a dynamic tissue that undergoes cycles of growth and regression with each menstrual cycle. Adult progenitor stem cells are likely responsible for this remarkable regenerative capacity; these same progenitor stem cells may also have an enhanced capacity to generate endometriosis if shed in a retrograde fashion. The progenitor stem cells reside in the uterus; however, less-committed mesenchymal stem cells may also travel from other tissues such as bone marrow to repopulate the progenitor population. Mesenchymal stem cells are also involved in the pathogenesis of endometriosis and may be the principle source of endometriosis outside of the peritoneal cavity when they differentiate into endometriosis in ectopic locations. Finally, besides progenitor stem cells, recent publications have identified multipotent stem cells in the endometrium. These multipotent stem cells are a readily available source of cells that are useful in tissue engineering and regenerative medicine. Endometrial stem cells have been used to generate chondrocytes, myocytes, neurons, and adiposites in vitro as well as to replace dopaminergic neurons in a murine model of Parkinson's disease.
- Stem cells in endometrium and their role in the pathogenesis of endometriosis (vol 1221, pg 10, 2011)(2011) FIGUEIRA, Paula Gabriela Maria; ABRAO, Mauricio Simoes; KRIKUN, Graciela; TAYLOR, Hugh S.
article 52 Citação(ões) na Scopus Fatores ambientais e endometriose(2011) BELLELIS, Patrick; PODGAEC, Sergio; ABRAO, Mauricio SimoesEnvironmental factors and endometriosis Endometriosis represents a common gynecological condition affecting 5%-15% of childbearing age women and up to 3% 5% of post-menopausal women. This disease is defined by the presence of stromal and/or endometrial glandular epithelium implants in extrauterine locations possibly compromising several sites. Humans and animals are daily exposed to chemical pollutants that could adversely influence physiological processes and potentially cause diseases, including endometriosis. In this review, the authors aimed at settling the influence of environmental and dietary factors on endometriosis pathogenesis. The mechanism by which dioxin and its similes (TCDD/PCBs) act changing the endometrial physiology remains uncertain and is speculative due to the difficulty in assessing the exposure over intrauterine life, childhood and adulthood and its actual consequences, in addition to the limitations to its in vitro reproducibility. We need to better understand the mechanism of action of these environmental pollutants, not only on reproductive health, but also on overall health of individuals and so prevention strategies, including not only population education, but setting exposure limits, less polluting techniques and a better use of our natural resources, could be promoted.