Biomedical subjects

Aarão Mendes Pinto-Neto

Publications and source records attributed to Aarão Mendes Pinto-Neto.

11 recordsLinked to original sources

PubMed2006

The attitude of gynecologists in São Paulo, Brazil 3 years after the Women's Health Initiative study.

OBJECTIVE: The objective of this study was to evaluate gynecologists' knowledge of the WHI study, and its repercussions on their attitudes and practice 3 years after publication. DESIGN: A self-administered, anonymous questionnaire containing 19 questions was sent to 6000 gynecologists, members of the São Paulo Society of Obstetrics and Gynecology. RESULTS: The response rate was 24.2% (1453 completed questionnaires) with a sample error of 2.23% and confidence level of 95%. Although 95.9% of the respondents were aware of the WHI study, only 24.4% knew of all the other studies mentioned (HERS I, HERS II and Million Women Study). Although 84.6% stated that the results of the WHI study could not be extrapolated to other forms of HT, 23.1% and 25.2%, respectively, stopped prescribing CEE or MPA, 63.7% decreased the dose, 55.2% opted for drugs such as bisphosphonates, tibolone and SERMS, and 46.3% began to prescribe tranquilizers, isoflavone and other natural medications. Moreover, 59.2% agreed that HT should be used for only 4-5 years. Prescriptions decreased significantly for all indications (p<0.0001). The principal reason for physicians to discontinue HT in a patient was increased risk of breast cancer (62.3%), whereas, according to the physicians, the most important factor for the patients was fear of HT (80.3%). CONCLUSION: A high percentage of gynecologists in this study knew of the WHI study and followed its recommendations concerning cardiovascular prevention; consequently they changed their management of the treatment of postmenopausal women by restricting indications for HT and decreasing its duration of use and dose.

Adult↗

PubMed2006

[Constipation in postmenopausal women].

OBJECTIVES: To investigate the prevalence and factors associated with constipation in postmenopausal women and evaluate the level of agreement between different diagnostic criteria. METHODS: A cross-sectional study was conducted with 100 postmenopausal women more than 45 old. The Rome II criteria, stool frequency per week and patient self-evaluation were the diagnostic criteria applied. Social demographic and clinical characteristics with their descriptive analysis were assessed. Subsequently, kappa (ê) statistics was used to assess the level of agreement between diagnostic criteria. The association between constipation and its possible determinants was studied by bivariate and multivariate analyses, using the prevalence ratio (PR). The confidence interval was set at 95% (95% CI). RESULTS: The mean age of participants was 58.9+/-5.9 years (range, 46-76 years). The prevalence of constipation was 47%, 37% and 26%, according to patient self-evaluation, the Rome II criteria and < 3 bowel movements per week, respectively. The best agreement found was between patient self-evaluation and the Rome II criteria (k: 0.63; 95% CI: 0.48-0.78). After multivariate analysis, the history of perianal surgery (PR: 2.69; 95% CI: 1.03-7.01), according to the Rome II criteria; the presence of hemorrhoids, according to stool frequency (PR: 2.53; 95% CI: 1.16-5.51) and patient self-evaluation (PR: 1.78; 95% CI: 1.01-3.15) were associated with constipation. CONCLUSIONS: Prevalence of constipation in postmenopausal women was high. Agreement between diagnostic criteria ranged from moderate to good. History of perianal surgery and presence of hemorrhoids were associated with constipation.

Aged↗

PubMed2006

Factors associated with quality of life in a cohort of postmenopausal women.

OBJECTIVE: To evaluate quality of life (QOL) and identify its associated factors in a cohort of postmenopausal women who had not received hormone therapy. METHODS: A cross-sectional study was conducted among 81 postmenopausal women who had not used hormone therapy in the last six months. Sociodemographic and clinical characteristics, in addition to the prevalence of menopausal symptoms, were evaluated. QOL was assessed by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire, which may be condensed into two summaries: Physical Component Summary and Mental Component Summary. Generalized linear models were used to analyze the data, allowing the identification of factors affecting QOL, adjusting for confounding variables. RESULTS: The mean (+/-standard deviation) age of the participants was 58.1 +/- 4.7 years. The most prevalent symptoms were nervousness (67%) and hot flushes and sweating (51%). Factors associated with poorer QOL were sweating, palpitations, nervousness (physical component), and dizziness, nervousness, depression, insomnia and dyspareunia (mental component). CONCLUSION: We observed that menopausal symptoms negatively affected the physical and mental components of QOL in postmenopausal women.

Aged↗

PubMed2005

[Prevalence and factors associated with intestinal constipation in postmenopausal women].

BACKGROUND: Constipation occurs more frequently in the female population and it becomes more prevalent with increasing age. There are few studies that have assessed the prevalence of constipation in postmenopausal women. AIM: To investigate the prevalence and factors associated with constipation in postmenopausal women. PATIENTS AND METHODS: A cross-sectional study of postmenopausal women aged over 45 years was conducted. It included 100 women who sought medical attention at the Menopause Outpatient Facility at the State University of Campinas (UNICAMP), Campinas, SP, Brazil, between March, 2003 and January, 2004. The prevalence of constipation was assessed according to the Rome II criteria. Sociodemographic and clinical features of these patients were studied. Physical examinations were performed to evaluate genital dystopias and anal sphincter tone. Statistical analysis was performed by using the mean, standard deviation, median, relative and absolute frequencies and by using the prevalence ratio with a 95% confidence interval and multiple logistic regression. RESULTS: The mean age of the participants was 58.9 +/- 5.9 years and the mean age was 47.5 +/- 5.4 years at menopause. The prevalence of constipation was 37%, the most common symptom being excessive straining when defecating (91.9%), followed by a feeling of incomplete evacuation (83.8%), hard or lumpy stools (81.1%), less than three bowel movements per week (62.2%), sensation of anorectal obstruction during defecation (62.2%) and digital maneuvers to facilitate defecation (45.9%). Bivariate analysis showed that anal sphincter tone and the history of perianal surgery were factors associated with constipation. After applying multiple regression analysis, the history of perianal surgery was significantly associated with constipation (prevalence ratio: 2.68; 95% confidence interval: 1.18-6.11). CONCLUSIONS: The prevalence of constipation in postmenopausal women was high. The history of perianal surgery was significantly associated with constipation, even when the influence of other variables were taken into consideration.

Brazil↗

PubMed2004

Carotid and uterine vascular resistance in short-term hormone replacement therapy postmenopausal users.

OBJECTIVE: To compare the short-term effects of oral hormone replacement therapy (HRT) and placebo on carotid and uterine vascular impedance. METHODS: 80 postmenopausal women selected from the outpatient clinic of the Hospital Leonor Mendes de Barros in São Paulo, Brazil, were randomized to oral HRT (estradiol 2 mg/norethisterone acetate 1 mg-Kliogest(r)) or placebo. Carotid and uterine arteries pulsatility indices (PIs) were assessed by color Doppler at baseline, after 4 and 12 weeks of treatment. Seventy-six women completed the trial, 38 in each group. RESULTS: The carotid PI did not decrease significantly in either group. In the uterine arteries, the drop in PI was steeper and greater for HRT women. Drops occurred despite the supposed counteracting effect of norethisterone acetate. In placebo group, there was no significant difference between 4 and 12 weeks of treatment compared with the baseline. The results did not change when analyzed in a real treatment approach. CONCLUSION: Oral continuous HRT are effective at 12 weeks in reducing impedance to flow in uterine, but not in carotid circulation. These results suggest that the effects of HRT vary by vascular site, and do not have a detectable short-term vascular effect in the carotid area.

Analysis of Variance↗

PubMed2003

[Climacteric syndrome: a population-based study in Campinas, SP, Brazil].

OBJECTIVES: To study the prevalence of climacteric, urogenital and sexual symptoms in a population of Brazilian women. METHODS: A cross-sectional descriptive population-based study was conducted. The selection of 456 women aged 45-60 years, living in Campinas, SP, in 1997, was done through area cluster sampling, according to data from the Brazilian Institute of Geography and Statistics. Data were collected via home interviews, using structured pretested questionnaires. Data were analyzed using the chi-squared test and the nonparametric Kruskal-Wallis test; a probability of <0.05 was considered statistically significant. The degree of climacteric symptoms was analyzed through circulatory and psychological indices. Analysis of the main components was used to determine symptom interrelationships. RESULTS: The most prevalent symptoms were nervousness (82%), hot flushes (70%), headache (68%), irritability (67%) and sweating (59%). Hot flushes, sweating and insomnia were significantly more prevalent in the peri and postmenopausal phases. The frequency (severity) of vasomotor and psychological symptoms did not vary according to the menopause phase. The prevalence of urinary incontinence was 27.4%. Complaints of dyspareunia and vaginal dryness were infrequent. Decreased libido was the most frequent sexual complaint. It was observed that some climacteric complaints were interrelated. The first cluster included hot flushes and sweating (vasomotor cluster). The second cluster included nervousness, depression and irritability (psychological cluster). The third cluster included dizziness and palpitation (atypical cluster). CONCLUSION: Climacteric symptoms in this population were highly prevalent and similar to those described in developed Western countries.

Brazil↗

PubMed2002

Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis.

CONTEXT: Measurements of bone density taken by dual-energy x-ray absorptiometry are the most accurate procedure for the diagnosis of osteoporosis. This procedure has the disadvantage of measuring the density of all mineral components, including osteophytes, vascular and extra vertebral calcifications. These alterations can influence bone density results and densitometry interpretation. OBJECTIVE: To correlate radiography and densitometry findings from women with osteoporosis, analyzing the influence of degenerative processes and vertebral fractures on the evaluation of bone density. DESIGN: Retrospective study. SETTING: Osteoporosis outpatients' clinic at Hospital das Clínicas, Universidade Estadual de Campinas. PARTICIPANTS: Ninety-six postmenopausal women presenting osteoporosis diagnosed by bone density. MAIN MEASUREMENTS: Bone mineral density of the lumbar spine and femoral neck were measured by the technique of dual-energy x-ray absorptiometry, using a LUNAR-DPX densitometer. Fractures, osteophytes and aortic calcifications were evaluated by simple x-rays of the thoracic and lumbar spine. RESULTS: The x-rays confirmed vertebral fractures in 41.6%, osteophytes in 33.3% and calcifications of the aorta in 30.2%. The prevalence of fractures and aortic calcifications increased with age. The mean bone mineral density was 0.783g/cm2 and the mean T-score was - 3.47 DP. Neither fractures nor aortic calcifications had significant influence on bone mineral density (P = 0.36 and P = 0.09, respectively), despite the fractured vertebrae having greater bone mineral density (P < 0.02). Patients with lumbar spine osteophytes showed greater bone mineral density (P = 0.04). Osteophytosis was associated with lumbar spine bone mineral density after adjustment for fractures and aortic calcifications by multiple regression (P = 0.01). CONCLUSION: Osteophytes and lumbar spine fractures can overestimate bone density interpretation. The interpretation of densitometry results should be carried out together with the interpretation of a simple lumbar spine x-ray in elderly women.

Absorptiometry, Photon↗

PubMed2002

[Climacteric women seeking medical care, Brazil].

OBJECTIVE: To study the causes and factors associated with climacteric women seeking medical care. METHODS: A descriptive exploratory cross-sectional population-based study was carried out. Subjects were 456 women aged 45 to 60 years resident in a metropolitan area of Southeastern, Brazil, selected through area cluster sampling. Data were collected through home interviews using a structured, pre-tested questionnaire. Statistical analysis were performed using Chi-square test, Cramer's coefficient and logistic multiple regression. RESULTS: About 80% sought medical care due to menstrual irregularities and climacteric symptoms. The main factors associated with women seeking medical care were hormone replacement therapy, marital status, and stronger psychological symptoms. The main reason for not seeking medical care was women's thought that their complaint did not justify medical attention. CONCLUSIONS: There was a high demand for medical care by climacteric women, but a significant percentage did not seek medical attention because they believed their symptoms were ordinary.

Climacteric↗

PubMedDate not supplied

Ovarian volume, age, and menopausal status.

OBJECTIVE: The purposes of this study were to verify whether ovarian volume differs according to chronological age and menopausal status in healthy women and to evaluate the sensitivity and specificity of ovarian volume alone and ovarian volume associated with age in predicting menopausal status. DESIGN: The participants in this study were premenopausal (n = 121) and postmenopausal (n = 71) women between 40 and 55 years of age who were interviewed about social, demographic, and medical conditions. These women underwent transvaginal ultrasound to determine ovarian volume. Analysis of variance (ANOVA) was applied to evaluate the correlation between ovarian volume, age, and menopausal status. Receiver operating characteristic (ROC) curves were elaborated to evaluate the sensitivity and specificity of ovarian volume and age related to menopausal status. RESULTS: The difference in ovarian volume was significant and uniform as age increased in both groups (P = 0.03). Premenopausal women presented larger ovaries than did postmenopausal women. Menopausal status and age were correlated with ovarian volume. Menopausal status seemed more important than age in determining ovarian volume decrease (R = 0.36) because age contributed little when added to a model already containing menopausal status. ROC curves indicated that ovarian volume and age were effective in determining menopausal status. The best cutoff points in terms of sensitivity and specificity were ovarian volume less than 4 cm and age 48 years or older. The areas under the ROC curves of ovarian volume and ovarian volume plus age were similar. CONCLUSION: Ovarian volume differs according to age in premenopausal and postmenopausal women. Menopausal status is more important than age in determining ovarian volume. The data suggest that ovarian volume and age are quite accurate in predicting menopausal status.

Adult↗

PubMedDate not supplied

Quality of life in Brazilian breast cancer survivors age 45-65 years: associated factors.

The objectives of this study were to evaluate quality of life (QOL) and identify its associated factors in climacteric women with a history of breast cancer. A cross-sectional study was performed including 75 breast cancer survivors age 45-65 years who had undergone complete oncologic treatment and nonusers of hormone therapy or tamoxifen in the last 6 months. Sociodemographic and clinical characteristics in addition to the prevalence of climacteric symptoms were evaluated. QOL was evaluated by the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire, including eight components that can be condensed into two summaries: a physical component summary (physical functioning, role-physical, body pain, general health) and a mental component summary (vitality, social functioning, role-emotional, and mental health). Generalized linear models were used to analyze the data, allowing the identification of factors affecting QOL, adjusting for confounding variables. The mean age of the participants was 53.1+/-5.9 years. Breast cancer survivors reported good QOL. The most prevalent symptoms were nervousness (69%) and hot flashes (56%). Factors associated with poorer QOL were dizziness, postmenopausal status, and breast-conserving therapy (physical component), as well as insomnia and being married (mental component). In conclusion, participants demonstrated good QOL. We identified factors that may influence QOL in women with breast cancer, highlighting being married, climacteric symptoms, postmenopausal status, and breast-conserving therapy. Given the impact of these factors, health professionals and patients must discuss choices for alleviating climacteric symptoms and explanations for the potential repercussions of breast cancer treatment.

Aged↗

PubMedDate not supplied

[Fecal incontinence in postmenopausal women: prevalence, severity and associated factors].

BACKGROUND: Fecal incontinence occurs more frequently in the female population and it becomes more prevalent with increasing age. There are few studies that have assessed the prevalence and severity of postmenopausal women. AIMS: To investigate fecal incontinence. PATIENTS AND METHODS: A cross-sectional study was performed on 100 postmenopausal women over the age of 45. Sociodemographic and clinical characteristics were evaluated, and a descriptive analysis of these characteristics was carried out. The prevalence of fecal incontinence was estimated. St. Mark's incontinence score was applied to study the severity of symptoms associated with fecal incontinence. The score was then categorized according to the tertile and symptom severity was classified as mild, moderate or severe incontinence. Bivariate and multivariate analyses were used to study the association between fecal incontinence and its likely determinants, employing the prevalence ratio. Confidence interval was set at 95%. RESULTS: The mean age of the patients was 58.9 +/- 5.9 years (range, 46-76 years). The prevalence rate was 15% for fecal incontinence. Of incontinent patients, 60% had mild incontinence. After multivariate analysis, factors associated with fecal incontinence was history of forceps delivery (prevalence ratio: 7.80; 95% confidence interval:2.38-25.55). CONCLUSIONS: The prevalence of fecal incontinence was high in postmenopausal women. Data suggest that most women presented mild fecal incontinence. The history of forceps delivery was associated with fecal incontinence.

Aged↗