Tamoxifen and Assymptomatic Endometrial Thickness

Tamoxifen is a first-line agent for adjuvant treatment of estrogen-receptor positive breast cancer, and is used to reduce the risk of this condition in high-risk individuals. Retrospective studies established an association between tamoxifen use, endometrial thickness and endometrial cancer. There have been many attempts to identify an effective screening program for tamoxifen-related endometrial cancer, which have led to the use of transvaginal ultrasound and invasive procedures. The use of a 5mm endometrial cut-off in vaginal ultrasound is known to raise the number of endometrial biopsies with no gain in early cancer diagnosis. A review of the scientific literature was performed in order to establish the best available evidence for endometrial evaluation of asymptomatic breast cancer patients on tamoxifen

Genital Tuberculosis: a Rare Cause of Postmenopausal Bleeding

Introdução: A tuberculose continua um problema de saúde pública emergente. A incidência da tuberculose genito-urinária tem vindo a aumentar sendo o segundo local mais comum de infecção a seguir aos pulmões. Caso clínico: Os autores apresentam dois casos de mulheres com hemorragia vaginal pós-menopausa. O exame clínico não revelou alterações. A ecografia pélvica endocavitária detectou a presença de uma lâmina líquida na cavidade endometrial em ambos os casos. A histeroscopia identificou espessamentos focais do endométrio que foram biopsados. O exame anatomopatológico revelou granulomas de células epitelióides sem atipia celular. O exame cultural do endométrio foi positivo para Mycobacterium tuberculosis. Não foi detectado envolvimento de outros órgãos tendo as doentes iniciado terapêutica antibacilar. Conclusão: A tuberculose genital é rara na mulher pós-menopausa sendo responsável por cerca de 1% da hemorragia vaginal pós-menopausa. No entanto, é uma doença curável cujo diagnóstico precoce é importante, prevenindo a utilização de procedimentos invasivos desnecessários

Paleoenvironmental evolution of estuarine systems during the last 14000 years - the case of Douro Estuary (NW Portugal)

Proceedings of the 8th International Coastal Symposium, ICS 2004, Itajaí/Itapema, Santa Catarina, Brazil, 14 to 19 March 200

Chronology of the sedimentary processes during the postglacial sea level rise in two estuaries of the Algarve coast, Southern Portugal

Four profiles of estuarine sediments obtained from boreholes drilled in the Algarve, Southern Portugal were studied in order to reconstruct the process of sediment accumulation driven by the postglacial sea level rise. In addition to the sedimentological analysis, the Foraminifera Index of Marine Influence (FIMI) permitted assessment of the nature and organization of sedimentary facies in the BelicheeGuadiana and Gilão-Almargem estuaries. The Beliche- Guadiana CM5 and Almargem G2 profiles accumulated in a sheltered environment, with the former presenting an almost continuous record of the sea level rise since ca 13 000 cal yr BP. The G1 and G3 profiles from the Gilão-Almargem area represent a more discontinuous record of the last 8000 years, which accumulated in the more dynamic environment of an outer estuary. The integration of all radiocarbon ages of dated levels, led to an estimate of sediment accumulation rates. Assuming a constant position of the sediment surface with respect to the tidal range and a negligible compaction of sediment, the sea level rose at the rate of 7 mm yr ^-1 in the period from 13 000 to 7500 cal yr BP. This process slowed down to ca 0.9 mm yr 1 from 7500 cal yr BP until the present. The marked historical change in the rate of sediment accumulation in these estuaries also occurred with the accumulation of organic matter and is, therefore, important data for global biogeochemical models of carbon. The main obstacle to obtain higher temporal resolution of the sedimentary processes was the intense anaerobic respiration of organic matter via sulphate reduction, which did not allow any accumulation of peat and, furthermore, led to erasure of the palaeontological record by acid formed from the subsequent oxidation of sulphides.FORMOSE- Sources and Retention of Organic Matter in the Estuarine Zones, PRAXIS XXI program of Portuguese Science and Technology Foundation and project MEGASIG, INTERREG IIIa program of the European Union

Anticoagulação e Cirurgia Ginecológica

Os acidentes tromboembólicos são uma das causas de maior morbilidade pós-cirúrgica. Com esta revisão os autores pretendem recordar alguns conceitos sobre hemóstase, são ainda abordadas as indicações e o perfil dos fármacos mais utilizados para profilaxia de tromboembolismo venoso em doentes submetidas a cirurgia ginecológica. As doentes cirúrgicas que fazem anticoagulação com Varfarina levantam algumas questões aquando do momento da cirurgia pelo que, por fim, se propõe um protocolo de actuação em doentes cirúrgicas sob anticoagulação de longa duração

Ooforectomia Profilática Associada a Histerectomia...Sim ou Não?

Os autores pretenderam fazer uma revisão da literatura sobre as vantagens, desvantagens e indicações da ooforectomia profiláctica associada a histerectomia

Tamoxifen and Assymptomatic Endometrial Thickness

Tamoxifen is a first-line agent for adjuvant treatment of estrogen-receptor positive breast cancer, and is used to reduce the risk of this condition in high-risk individuals. Retrospective studies established an association between tamoxifen use, endometrial thickness and endometrial cancer. There have been many attempts to identify an effective screening program for tamoxifen-related endometrial cancer, which have led to the use of transvaginal ultrasound and invasive procedures. The use of a 5mm endometrial cut-off in vaginal ultrasound is known to raise the number of endometrial biopsies with no gain in early cancer diagnosis. A review of the scientific literature was performed in order to establish the best available evidence for endometrial evaluation of asymptomatic breast cancer patients on tamoxifen

Ooforectomia Profilática Associada a Histerectomia...Sim ou Não?

Os autores pretenderam fazer uma revisão da literatura sobre as vantagens, desvantagens e indicações da ooforectomia profiláctica associada a histerectomia