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
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- 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.
- Vaginal Health: Insights, Views & Attitudes (VIVA-LATAM): results from a survey in Latin America(2018) NAPPI, R. E.; MELO, N. R. de; MARTINO, M.; CELIS-GONZALEZ, C.; VILLASECA, P.; ROHRICH, S.; PALACIOS, S.Objective: To investigate awareness in Latin America, knowledge of postmenopausal vaginal atrophy was evaluated in a sample of women from this region.Methods: A total of 2509 postmenopausal women aged 55-65 years, resident in Argentina, Brazil, Chile, Colombia and Mexico, completed a structured online questionnaire.Results: Over half the surveyed population (57%) reported experiencing symptoms of vaginal atrophy. Only 6% of the overall cohort attributed symptoms of vaginal atrophy directly to the condition, and 71% did not consider the condition to be chronic, resulting in many women not accessing effective therapy. Half the women (49%) affected by vaginal atrophy had used lubricating gels and creams; 36% had used some form of local hormone treatment. To understand symptoms and/or treatment options for vaginal discomfort, the majority of survey participants (92%) were willing to seek advice from health-care professionals; most (61%) felt/would feel comfortable talking to their doctor about this.Conclusion: Many women in Latin America lack knowledge of postmenopausal vaginal atrophy, not appreciating the chronic nature of the condition, and may benefit from dialog initiated by health-care professionals to facilitate greater understanding and increased awareness of the availability of effective treatment.
- 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.
- Vitamin D supplementation: position Statement of the Iberoamerican Society of Osteoporosis and Mineral Metabolism (SIBOMM)(2021) PALACIOS, Santiago; CERDAS, Sonia; SILVA, Ramiro Da; PARADAS, Alejandro; VARGAS, Jorge; MOSTAJO, Desiree; TSEROTAS, Konstantinos; DANCKERS, Luis; MORENO, Mario; NAVAS, Maria; MUNOZ-LOUIS, Roberto; MAIDA, Tatiana; ROSERO, Oscar; RUEDA, Camilo; VASQUEZ, David; MELO, Luciano; CORDOBA, Santiago; RASEC-MORALES, Luis; MELO, Nilson Roberto deBackground Vitamin D (VD) deficiency is a global pandemic that affects more than a third of the population worldwide. The population of Latin America and the Caribbean exceeds 620 million inhabitants with diverse ethnic origins and different latitudes and altitudes, which make comparisons and generalizations difficult. Aim and method We sought to establish an expert consensus regarding the recommendations for VD supplementation in Latin America by means of the Delphi methodology. Results The prophylactic dosage of VD in the general population should be individualized according to age, race, body weight, sun exposure of an individual, altitude, and dietary and exercise habits, without ruling out existing chronic diseases. Conclusion The importance of VD has been widely documented and its deficiency is a pandemic. Many individuals have difficulty meeting daily VD requirements through food and the sun. The population of Latin America and the Caribbean has diverse ethnics, cultures, in addition to living in different latitudes and altitudes. Therefore, it is important to make a position on VD supplementation, given the different characteristics, ages and serum levels of 25(OH)D.
- ISGE statement on oral emergency contraception(2014) GLASIER, Anna; GEMZELL-DANIELSSON, Kristina; BOUCHARD, Philippe; GENAZZANI, Andrea R.; AL-AZZAWI, Farook; BERGA, Sarah; BIRKHAEUSER, Martin; BRINCAT, Mark; MELO, Nilson R. De; FOIDART, Jean Michel; KENEMANS, Peter; LUNENFELD, Bruno; MARUO, Takeshi; MILEWICZ, Andrzej; NAFTOLIN, Frederick; NG, Ernest H. Y.; SCHINDLER, Adolf; SIMON, Carlos; SIMONCINI, Tommaso; SIMPSON, Evan; SISELES, Nestor; SMETNIK, Vera; TARLATZIS, Basil; SCHOULTZ, Bo vonUnintended pregnancy is an important public health problem worldwide. Unwanted pregnancies may end in induced abortion (legal or illegal, safe or unsafe) or in childbirth. In many parts of the world both can be life threatening. Even where both are safe, abortion is distressing for all concerned while unwanted births often lead to poor health and social outcomes for both the mother and her child.
- Vaginal Health: Insights, Views & Attitudes survey in Latin America (VIVA-LATAM): focus on Brazil(2021) POMPEI, L. M.; WENDER, M. C. O.; MELO, N. R. de; JR, J. Kulak; PARDINI, D.; MACHADO, R. B.; FERNANDES, C. E.; PALACIOS, S.; NAPPI, R. E.Objective A previous survey investigated postmenopausal vaginal atrophy in a sample of women across Latin America. To help implement a tailored approach to improve postmenopausal care and outcomes in Brazil, we consider results from the survey for this country. Methods A total of 2509 postmenopausal women resident in Argentina, Brazil, Chile, Colombia, or Mexico completed an online questionnaire. The Brazilian cohort comprised 504 women. Results Over half of the Brazilian cohort (56%) reported experiencing symptoms of vaginal atrophy; most described them as moderate or severe (76%), and almost half (48%) experienced symptoms for at least 1 year. Three-quarters of the Brazilian cohort (75%) were unaware of the chronic nature of the condition. Upon experiencing symptoms of vaginal atrophy, 92% had visited a health-care provider to discuss treatment options. Overall, 56% were aware of some form of local hormone therapy and 40% of those affected by vaginal atrophy had used such treatment. Conclusion Postmenopausal women in Brazil are likely to benefit from increased awareness of the symptoms of vaginal atrophy. Health-care providers can potentially improve outcomes by helping women to understand the chronic nature of the condition and available treatment options. Women may be open to education pre menopause, before symptoms occur.