WALTER DA SILVA PINHEIRO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Blind aspiration biopsy versus a guided hysteroscopic technique for investigation of the endometrium in infertile women(2016) EJZENBERG, Dani; SIMOES, Manuel de Jesus; PINHEIRO, Walter; SOARES JUNIOR, Jose Maria; SERAFINI, Paulo Cesar; BARACAT, Edmund ChadaEmbryo implantation failure and recurrent abortion are common indications for endometrial evaluation to determine the implantation window and diagnose endometrial anomalies. There are few research studies comparing the efficacy of different techniques used for endometrial sampling in infertile females during the luteal phase. Likewise, morphometric studies of the endometrium through aspiration biopsy are scant. A cross-sectional study of 30 infertile and 10 fertile females was carried out. The study participants underwent hysteroscopic and aspiration biopsies (pipelle) at the midluteal phase. Computer-assisted morphometric and pathological anatomy analyses were conducted independently by two pathologists blinded to the study. The two endometrial sampling biopsy techniques were compared through morphometric and pathological anatomy analyses using three parameters: a) the amount of material collected for the endometrial studies; b) the scope and origin of sampled materials; and c) the quality of the sample. Both biopsy techniques produced sufficient material for analysis. The directed biopsies yielded higher quality samples from targeted segments of the uterine cavity because samples were homogeneous and had no architectural distortion (p<0.05). Blood was present only in the samples obtained through a Pipelle. Endometritis was detected in 10% of the infertile women. Our findings suggest that hysteroscopic biopsies are superior to blinded aspiration biopsies.
- What is the influence of cyclooxygenase-2 on postmenopausal endometrial polyps?(2015) PEREIRA, A. K. C.; GARCIA, M. T.; PINHEIRO, W.; EJZENBERG, D.; SOARES JR., J. M.; BARACAT, E. C.Background The genesis of the endometrial polyp is as yet unclear. There is evidence that the polyp is related to the inflammatory process and that it interacts with the cyclooxygenase-2 (COX-2) enzyme. Objective To review the influence of COX-2 on the postmenopausal endometrial polyp. Methods A systematic review was made of the Medline, Embase, and Cochrane databases, covering the years of 2001 - 2014. The inclusion criteria were: experimental studies with immunohistological analysis of COX-2 in endometrial polyps; women; hysteroscopic and surgical evaluation; and studies with comparisons between the endometrial polyp and other tissues (normal endometrium, adjacent endometrium, and other uterine diseases). The exclusion criteria were: polyps in other organs; genetic polymorphisms; endometrial cancer exclusively; abnormal uterine bleeding unrelated to polyps. The search key words (taken from the Medical Subject Headings - MeSH) were endometrial polyp and cyclooxygenase-2. Results Seven of ten articles were selected. Results showed positive COX-2 expression in the glandular epithelium of the polyps, and expression was more intense when the polyp was malignant. However, there was a study which did not find any difference between polyps and the normal endometrium, and there was another which compared polyps in menacme with postmenopausal polyps. Conclusion There is no consensus in the literature as to the participation of COX-2 in the development of benign and/or malignant endometrial polyps. In all of the studies, COX-2 was present in the postmenopausal polyps and with greater intensity in the malignant ones.
article Is the combination of mitomycin C, bleomycin and methotrexate effective as a neoadjuvant treatment for cervical cancer in women?(2011) PINHEIRO, W.; PEREIRA, A. K. Cavalcante; SOARES JR., J. M.; BARACAT, E. C.Objective: To determine the effectiveness of the combination of mitomycin C, bleomycin and methotrexate as a neoadjuvant treatment in preparation for surgical treatment of cervical cancer. Methods and Materials: Twenty-seven patients with carcinoma of the uterine cervix (stages exophytic IB2 and IIB-IIIB) who had not previously undergone any treatment received mitomycin C, bleomycin and methotrexate in five sessions, once every four weeks. Results: The objective response rate was approximately 81%, including 16 complete responses and six partial responses. Significant toxic effects were not observed. Responsive patients underwent surgery and remained without evidence of disease for the next 20 years. Unresponsive patients did not fare well and passed away within five years after treatment. Conclusion: Our data suggest that this strategy may be effective for advanced cases, enabling patients to receive surgical treatment.- Accuracy of Ultrasonography in the Evaluation of Tubal Sterilization Microinsert Positioning: Systematic Review and Meta-analysis(2019) CARRETTI, Mayra; SIMOES, Ricardo dos Santos; BERNARDO, Wanderley Marques; PINHEIRO, Walter; PEREIRA, Anne Kristhine Cavalcante; BARACAT, Maria Candida Pinheiro; SOARES JUNIOR, Jose Maria; BARACAT, Edmund ChadaThe current reference standard to check the position of a tubal sterilization microinsert device after its insertion is hysterosalpingography. The objective of this study was to evaluate the accuracy of 2-dimensional (2D) and 3-dimensional (3D) ultrasonography (US) in the positioning of the tubal sterilization microinsert for definitive contraception. We searched MEDLINE, Embase, Cochrane, and Scopus databases through October 2017. Selection criteria included studies that analyzed the accuracy of 2D or 3D US, or both, with respect to the positioning of the microinsert. Data were displayed as forest plots and a summary receiver operating characteristic curves. Values for sensitivity, specificity, and positive and negative likelihood ratios (LRs) were calculated. The pooled analysis produced sensitivity and specificity values for 2D US in the positioning of the microinsert of 0.88 (95% confidence interval [CI], 0.47-1.0) and 0.92 (95% CI, 0.88-0.95), respectively, with positive and negative LRs of 8.68 (95% CI, 1.63-46.1) and 0.35 (95% CI, 0.11-1.11), respectively. Three studies analyzed the performance of 3D US, showing sensitivity, specificity, and positive and negative LRs of 0.75 (95% CI, 0.35-0.97), 0.82 (95% CI, 0.77-0.87), 3.65 (95% CI, 2.31-5.75), and 0.46 (95% CI, 0.2-1.09). In conclusion, 2D and 3D US are methods that show good accuracy in tubal sterilization microinsert positioning.