VICENTE RENATO BAGNOLI
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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- Metformin versus lifestyle changes in treating women with polycystic ovary syndrome(2012) CURI, Daniella D. G.; FONSECA, Angela Maggio; MARCONDES, Jose Antonio M.; ALMEIDA, Jose Alcione M.; BAGNOLI, Vicente R.; SOARES- JR., Jose Maria; BARACAT, Edmund ChadaObjective: To compare the efficacy of metformin with that of lifestyle changes in patients with polycystic ovary syndrome (PCOS). Design: Prospective, randomized clinical trial of 40 women with PCOS to analyze the effects of metformin and lifestyle intervention treatments on menstrual pattern and hormone and metabolic profile. The duration of treatment was 6 months. Statistical analysis was done using Student's t-test. Results: Fifteen women in the metformin group and 12 in the lifestyle changes group completed the study. The menstrual pattern improved by similar to 67% in both groups. There was a significant decrease in waist circumference in the lifestyle changes group (101.8 +/- 3.9 and 95.1 +/- 3.6, at baseline and at 6 months of treatment, respectively; p<0.001) and in body mass index (BMI) in both groups. The predictor of menstrual pattern improvement was BMI. Conclusions: Both metformin and lifestyle changes may increase the number of menstrual cycles in PCOS. This effect was related to a decrease in BMI.
- Impact of age and body mass on the intensity of menopausal symptoms in 5968 Brazilian women(2013) FONSECA, Angela Maggio Da; BAGNOLI, Vicente Renato; SOUZA, Marilene Alicia; AZEVEDO, Raymundo Soares; COUTO JUNIOR, Euro De Barros; SOARES JUNIOR, Jose Maria; BARACAT, Edmund ChadaObjective: To assess the relationship of onset of menopause and body mass on the menopausal symptoms in post-menopausal Brazilian women. Design: Observational study conducted by the selection and inclusion of 5968 Brazilian women after menopause. The following variables were analyzed in this study: time at menopause; the relationship between age at menarche and age at menopause; vasomotor symptoms compared with age at the time of menopause and the time of menopause; Kupperman menopausal index (KMI) versus total time of menopause; body mass index (BMI) compared to the time of menopause, vasomotor symptoms, and KMI total score. We used the Chi-square test, and the significance level was set at 5%. Results: The age at natural menopause ranged from 41 to 62 years (mean 48.1 +/- 4.07 years). A younger age at menopause was associated with a high intensity of vasomotor symptoms. These symptoms were more intense in the first 5 years of menopause and decreased with time. The KMI total also decreased with time after menopause, with the exception of arthralgia, myalgia, and insomnia, which did not tend to improve over time. In addition, the vasomotor symptoms and total KMI were more frequent with increasing BMI. Conclusions: Our results suggested that the age of menopause and BMI may influence the intensity of vasomotor symptoms.
- Acupuncture ameliorated vasomotor symptoms during menopausal transition: single-blind, placebo-controlled, randomized trial to test treatment efficacy(2021) SOARES-JR, Jose M.; BRANCO-DE-LUCA, Alexandre C.; FONSECA, Angela M.; CARVALHO-LOPES, Ceci M.; ARRUDA-VEIGA, Eduardo C.; ROA, Cristiane L.; BAGNOLI, Vicente R.; BARACAT, Edmund C.Objectives: This study aimed to evaluate the effects of acupuncture on women with vasomotor symptoms during the menopausal transition with the aid of the Kupperman-Blatt Menopausal Index. Method: Crossover, single-blind, sham-controlled trial with 100 women randomly divided into two groups of 50 participants each: G1 and G2. During the first 24 weeks of treatment, the G1 women received acupuncture and the G2 women were given sham acupuncture. The crossover was then applied: the G1 participants were given sham acupuncture, and the G2 participants received acupuncture for 24 more weeks. Results: The mean score of hot flashes of the group who first experienced acupuncture (G1) was statistically higher than that of the group that started with sham acupuncture (G2, P = 0.020). Also, both groups had similar mean scores in the middle of the study (both were receiving acupuncture). During the last 6 months of the study, after crossover, the values of G2 (acupuncture) were lower than those of G1 (sham acupuncture). Conclusions: Acupuncture treatment may mitigate hot flashes and other climacteric symptoms during the menopausal transition.
- Acupuncture-ameliorated menopausal symptoms: single-blind, placebo-controlled, randomized trial(2011) LUCA, A. Castelo Branco de; FONSECA, A. Maggio da; LOPES, C. M. Carvalho; BAGNOLI, V. R.; SOARES JR., J. M.; BARACAT, E. C.Objectives To evaluate the effects of acupuncture and sham-acupuncture on women with menopausal symptoms as reflected in the intensity of their hot flushes and the Kupperman Menopausal Index (KMI). Method This was a randomized, single-blind, placebo-controlled, cross-over trial with 81 patients assigned to two groups: Group 1 received 12 months of acupuncture, then 6 months of sham-acupuncture treatment (n = 56) and Group 2 received 6 months of sham-acupuncture, then 12 months of acupuncture treatment (n = 25). The needles were inserted in a harmonic craniocaudal manner at a depth of about 2 cm, and each session lasted approximately 40 min. The efficacy of acupuncture in ameliorating the climacteric symptoms of patients in postmenopause was determined through the KMI and the intensity of hot flushes. The analysis of variance method for two factors and repeated measures was applied. Results The baseline values of the women in both groups were similar for the KMI score and number of hot flushes. At the end of 6 months, the values for the KMI and hot flushes for the women in Group 1 were lower than those of the women in Group 2 (p < 0.05). After 12 months, the KMI and hot flush data were similar in both groups. After 18 months, the values of the KMI and hot flushes for the women in Group 2 for were lower than those of the women in Group 1 (p < 0.05). Conclusion Acupuncture treatment for relieving menopausal symptoms may be effective for decreasing hot flushes and the KMI score in postmenopausal women.
article 6 Citação(ões) na Scopus Transdermal estrogen therapy effects on fibrinogen levels in women with a past history of venous thromboembolism: a pilot study(2011) MARGARIDO, P. F. R.; BAGNOLI, V. R.; FONSECA, A. Maggio da; MACIEL, G. A. R.; SOARES JR., J. M.; D'AMICO, E. A.; BARACAT, E. C.Objective: To evaluate thromboelastographic parameters and fibrinogen levels in women treated with transdermal 17 beta estradiol. Methods: 29 menopausal women with a history of venous thromboembolic disease were included. Nine patients composed the treatment (HT) group and 20 the control group. Coagulation was assessed by thromboelastography in samples of whole blood and platelet-poor plasma (PPP). The following thromboelastographic variables were measured: time for initial coagulation (R), blood clotting speed (K and the a angle), clot tensile strength (MA and G), global index of coagulation (Cl) and fibrinolysis (LY30) and fibrinogen levels. Results: There were no differences in the other parameters comparing both groups. Fibrinogen levels showed a 13.77 +/- 19.94% reduction in the HT group and a 5.51 +/- 8.09% increase in the control group after 6 months. Conclusions: Our data suggested that transdermal estrogen may not increase blood coagulability, but that it reduces fibrinogen levels in FIT women.- Dyslipidemia in women with polycystic ovary syndrome: incidence, pattern and predictors(2011) ROCHA, Michelle P.; MARCONDES, Jose A. M.; BARCELLOS, Cristiano R. G.; HAYASHIDA, Sylvia A. Y.; CURI, Daniela D. G.; FONSECA, Angela M. da; BAGNOLI, Vicente R.; BARACAT, Edmund C.One hundred forty-two women with polycystic ovary syndrome (PCOS) with an average body mass index (BMI) of 29.1 kg/m(2) and average age of 25.12 years were studied. By BMI, 30.2% were normal, 38.0% were overweight and 31.6% were obese. Thirty-one eumenorrheic women matched for BMI and age, with no evidence of hyperandrogenism, were recruited as controls. The incidence of dyslipidemia in the PCOS group was twice that of the Control group (76.1% versus 32.25%). The most frequent abnormalities were low high-density lipoprotein cholesterol (HDL-C; 57.6%) and high triglyceride (TG) (28.3%). HDL-C was significantly lower in all subgroups of women with PCOS when compared to the subgroups of normal women. No significant differences were seen in the total cholesterol (p = 0.307), low-density lipoprotein cholesterol (LDL-C; p = 0.283) and TGs (p = 0.113) levels among the subgroups. An independent effect on HDL-C was detected for glucose (p = 0.004) and fasting insulin (p = 0.01); on TG for age (p = 0.003) and homeostatic model assessment insulin resistance (p = 0.03) and on total cholesterol and LDL-C for age (p = 0.02 and p = 0.033, respectively). In conclusion, dyslipidemia is common in women with PCOS, mainly due to low HDL-C levels. BMI has a significant impact on this abnormality.
- The expression of the estrogen receptor in obese patients with high breast density (HBD)(2014) SOUZA, Marilene Alicia; FONSECA, Angela de Maggio da; BAGNOLI, Vicente Renato; BARROS, Nestor de; NEVES, Erica Mendonca das; MORAES, Sandra Dircinha Teixeira de Araujo; HORTENSE, Victor Hugo Souza; SOARES, Jose Maria; BARACAT, Edmund ChadaObjective: Obesity has been associated with increased risk for breast cancer (BC) mortality. Verifying in women with high breast density (HBD) post-menopausal, the frequency of polymorphisnns of estrogen receptor (ER)alpha-Pvull, ER alpha-Xbal and if they influence the body mass index (BMI). Methods: Study with 308 women with HBD post-menopause divided into two groups according to BMI: 1st group = BMI <25 kg/m(2), 2nd group = BMI >= 25 kg/m(2). It was characterized in the clinical history: menarche, menopause, parity, family history of BC, smoking and alcohol intake. Results: Allele and genotype frequencies for the ER alpha-397-Pvull and ER alpha-351-Xbal: P =43.99%, p =56.01%, pp =32.14%, Pp =47.73%, PP =X =20.13% and X=41.56%, x=58.44%; xx = 33.44%; Xx =50.00%; XX =16.56%, respectively. Both Pvull and Xbal influenced BMI. When Xbal is mutated the tendency is toward higher BMI (0.039), and women with lower BMI were more frequent in Pvull genotype (p = 0.002). More frequent risk factors for BC: menarche before the age of 12 years (35.38%), nulliparity or 1st child after 28 years old (41.66%), family history of BC (19.16%) and overweight/obesity (62.01%). Conclusion: Variations in the ER alpha gene affected the BMI in women with HBD, who already are at increased risk for BC.
- Metabolic disorder and obesity in 5027 Brazilian postmenopausal women(2014) BAGNOLI, Vicente Renato; FONSECA, Angela Maggio da; ARIE, Wilson Maca Yuki; NEVES, Erika Mendonca Das; AZEVEDO, Raymundo Soares; SORPRESO, Isabel Cristina Esposito; SOARES JUNIOR, Jose Maria; BARACAT, Edmund ChadaObjectives: To evaluate the frequency of obesity in postmenopausal women and assess the potential effects of increased body mass index (BMI) on lipoprotein profile and on risk factors for arterial hypertension and diabetes. Design: A cross-sectional study was conducted with 5027 postmenopausal Brazilian women. Analyses were performed of BMI and cardiovascular factors (systemic blood pressure [BP], total cholesterol, low-density lipoprotein, high-density lipoprotein [HDL-C], triglyceride, and fast glucose). The statistical analysis included the chi-square and Mann-Whitney tests. The significance level was set at 5%. Results: Obesity (BMI >30) in our study characterized approximately 30% of the 5027 postmenopausal women. The comparison of patients with normal BMI and those with high BMI showed that high BMI had a significant negative effect on BP, as evidenced by the increased frequency of hypertension in overweight and obese patients (>25) (p<0.001), that it also negatively and significantly affected triglyceride (p<0.001) and fast glucose levels (p<0.001), and that it was linked significantly to low levels of HDL-C. Conclusion: Our data showed the high frequency of obesity in our population and of the cardiovascular risks (glucose, systemic arterial hypertension, and low HDL-C) associated with high BMI.
- Construction and validation of an instrument that breaks the silence: the impact of domestic and/or sexual violence on women's health, as shown during climacterium(2012) MORAES, Sandra D. Teixeira de Araujo; FONSECA, Angela Maggio da; SOARES JR., Jose M.; BAGNOLI, Vicente R.; SOUZA, Marilena A.; ARIE, Wilson Maca Yuki; BARACAT, Edmund ChadaObjective: The aim of this study was to construct and to validate a measure of the consequences of domestic violence on women's health during climacterium. Methods: A questionnaire was administered at the Outpatient Climacterium Clinic to 124 women aged 40 to 65 years who were the victims of domestic and/or sexual violence (experimental group). They were divided into three groups: (1) those who were victims of violence exclusively during childhood/adolescence, (2) those who were victims of violence exclusively during adulthood, and (3) those who were victims of violence throughout their lives. The instrument included 34 items evaluating the beginning, frequency, and type of violence; the search for health assistance and reporting of the violence; the violence and the number of comorbidities; and violence and the Kupperman Menopausal Index. We also included a control group composed of perimenopausal and postmenopausal women who did not experience any violence (n = 120). Results: The instrument presented a Cronbach alpha = 0.82, good reliability among the examiners (+0.80), and a good possibility of reproducibility. The mean age of menopause was 45.4 years, and the mean age in the control group was 48.1 years. Group 1 showed a mean of 5.1 comorbidities, Group 2 had 4.6, and Group 3 had 4.4. Sexual violence (43.5%) and other types of violence both presented average comorbidities (4.60) but represented a significant impairment in the victim's sexual life. There were significant associations in group 3 and a high Kupperman Menopausal Index score. In the experimental group, 80.6% did not seek health services for the violence they experienced. Conclusions: The questionnaire presented good internal consistency and a validated construction. It can be easily reproduced and is indicated to evaluate the consequences of domestic and/or sexual violence on women's health during climacterium.
- Brazilian Women's Health after 65 Years of Age(2017) FONSECA, Angela Maggio da; BAGNOLI, Vicente Renato; MASSABKI, Josefina Odete Polak; ARIE, Wilson Maca Yuki; AZEVEDO, Raymundo Soares; SOARES JR., Jose Maria; BARACAT, Edmund C.Purpose The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age. Design This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a crosssectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data. Results The age of the patients on their first clinic visit ranged from65 to 98 years, with a mean age of 68.56 +/- 4.47 years; their mean age at the time of natural menopause was 48.76 +/- 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n 1/4 =188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the bodymass index (BMI) found decreases inBMIwith increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n = 70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years. Conclusions Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.