NILSON ROBERTO DE MELO
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
3 resultados
Resultados de Busca
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- An individualized approach to the management of vaginal atrophy in Latin America(2019) PALACIOS, Santiago; NAPPI, Rossella E.; SHAPIRO, Marla; MELO, Nilson Roberto de; WENDER, Maria Celeste Osorio; FERNANDES, Cesar Eduardo; PARDINI, Dolores; MACHADO, Rogerio Bonassi; KULAK, Jaime; CELIS-GONZALEZ, Cuauhtemoc; MARTINO, Mabel T.; PIZZI, Rita R.; VILLASECA, Paulina; STORCH, Eduardo; DANCKERS, Luis Fernando; HERNANDEZ-BUENO, Jose AlbertoObjective: In the absence of guidelines specific for Latin America, a region where the impact of menopause is becoming increasingly important, an evidence-based specialist opinion on management of vaginal atrophy will help improve outcomes. Methods: An advisory board meeting was convened in Sao Paulo, Brazil, to discuss practical recommendations for managing vaginal atrophy in women in Latin America. Before the meeting, physicians considered various aspects of the condition, summarizing information accordingly. This information was discussed during the meeting. The expert consensus is now summarized. Results: In Latin America, given the relatively early age of menopause, it will be beneficial to raise awareness of vaginal atrophy among women before they enter menopause, considering cultural attitudes and involving partners as appropriate. Women should be advised about lifestyle modifications, including attention to genital hygiene, clothing, and sexual activity, and encouraged to seek help as soon as they experience vaginal discomfort. Although treatment can be started at any time, prompt treatment is preferable. A range of treatments is available. By addressing the underlying pathology, local estrogen therapy can provide effective symptom relief, with choice of preparation guided by patient preference. An individualized treatment approach should be considered, giving attention to patients' specific situations. Conclusions: It is critical that women are empowered to understand vaginal atrophy. Educating women and healthcare providers to engage in open dialogue will facilitate appreciation of the benefits and means of maintaining urogenital health, helping to improve outcomes in middle age and beyond. Women should receive this education before menopause.
- Combined oral contraceptives: update recommendations of the Latin American contraceptive association(2023) PALACIOS, Santiago; AYALA, Gabriela; GONZALEZ, Gemarilis; BADILLA-APUY, Can L.; MARCHENA, Jeannette; MARTINEZ, Katia; MOSTAJO, Desiree; VERNAZA, Maria S.; PARADAS, Alejandro; HERNANDEZ, Luis; VASQUEZ-AWAD, David; CELIS-GONZALEZ, Cuauhtemoc; MELO, Nilson Roberto deBackground: In recent years, new combined oral contraceptives (COCs) have become available, representing an advance in terms of individualization and compliance by users.Objective: To provide recommendations regarding COCs: formulations, use, efficacy, benefits and safety.Method: For these recommendations, we have used the modified Delphi methodology and carried out a systematic review of studies found in the literature and reviews performed in humans, published in English and Spanish in Pubmed, Medline and advanced medicine and computer networks until the year 2021, using the combination of terms: 'oral contraceptives', 'estroprogestins' and 'combined oral contraceptives'.Results: Regarding the estrogen component, initially switching from mestranol (the pro-drug of ethinylestradiol) to ethinylestradiol (EE) and then reducing the EE dose helped reduce side effects and associated adverse events. Natural estradiol and estradiol valerate are already available and represent a valid alternative to EE. The use of more potent 19-nortestosterone-derived progestins, in order to lower the dose and then the appearance of non-androgenic progestins with different endocrine and metabolic characteristics, has made it possible to individualize the prescription of COC according to the profile of each woman.Conclusion: Advances in the provision of new COCs have improved the risk/benefit ratio by increasing benefits and reducing risks. Currently, the challenge is to tailor contraceptives to individual needs in terms of safety, efficacy, and protection of female reproductive health.
- Contraception and reproductive planning during the COVID-19 pandemic(2020) FERREIRA-FILHO, Edson Santos; MELO, Nilson Roberto de; SORPRESO, Isabel Cristina Esposito; BAHAMONDES, Luis; SIMOES, Ricardo Dos Santos; SOARES-JUNIOR, Jose Maria; BARACAT, Edmund ChadaIntroduction The coronavirus disease (COVID-19) is a global health emergency. Major disruption to healthcare services during the current COVID-19 pandemic will last even after its peak. Sexual and reproductive health (SRH), specially contraception, needs to be understood as an essential service. Areas covered This paper is a narrative review. Data from PubMed/MEDLINE, Scopus, and websites of scientific societies were screened during the months of April and May 2020. It addresses the main aspects related to contraception during the COVID-19 pandemic, with special emphasis on family planning services, extended use of long-acting reversible contraceptive (LARC) methods, drug interactions, and thromboembolism risk. We also specified some issues focused on the Brazilian reality. Expert opinion Ensuring proper contraception use in the COVID-19 time is very important. We encourage women, healthcare providers, policymakers, and the society to consider SRH services as priority.