Objective: To verify the profile of the presentation and the surgical treatment performed in a service in the state of Minas Gerais, Brazil. Methods: Descriptive prospective case series study, carried out based on cases handled by the same team from March 2001 to December 2019, archiving pre-defined information and analyzing data using the R and SPSS PC software. Results: 822 cases were diagnosed and treated at the service, with a mean age of 56.6 years + 14.1 (ranging from 24 to 96 years), with patients from 44 different cities, predominantly Ubá, Minas Gerais (31%). Infiltrating Ductal Carcinoma was the histopathological type of most cases (65%) with a mean tumor size of 21.8 mm + 20.8. The predominant immunohistochemical type was Luminal B HER negative (33%). Initial staging predominated, with 37% of patients in clinical stage IA. The surgical approach was conservative in most cases (73%), with sentinel lymph node surgery (183 cases) and oncoplasty surgery (278 cases). In the follow-up after treatment, we have 17% of the discharge after 10-year free survival, 15% of death, and 7% of metastatic disease in chemotherapy. Conclusion: There was a predominance of patients with initial tumors, which enabled a high rate of treatment with breast conservation and with a future expectation of reducing mortality from the disease.
Objective: To verify the response to CO2 laser therapy in vaginal dryness among women submitted to treatment in a service in the State of Minas Gerais, Brazil. Methods: Descriptive, prospective case series study based on cases that were treated by the same staff from January 2019 to December 2019, storing predefined information and analyzing the data using the software R and SPSS PC. Results: Thirty eight women with mean age of 62.5 years + 9.1 (ranging from 48 to 82 years of age) were treated in the service for vaginal dryness. We observed total improvement of vaginal dryness in 94% of the cases. Improvement in sexual activity was observed in 83% of the cases, and increase in sexual relations, 71%. The satisfaction with the treatment was of 95%. We did not find statistical significance for the use of tamoxifen, anastrozole, previous chemotherapy and interval between surgery and laser therapy (p>0.05). Conclusion: The study shows good results of CO2 laser therapy in the improvement of vaginal dryness and sexual activity; however, the sample is limited for the statistical analysis of subgroups.
Introdução: A epilepsia de lobo temporal é uma entidade clínica que responde pela maioria esmagadora das epilepsias farmacologicamente intratáveis. Estima-se que até 70% dos casos sejam refratários ao tratamento conservador. Essa baixa taxa de resposta, somada ao aprimoramento das técnicas diagnósticas para o sistema nervoso central, tornou o tratamento cirúrgico uma opção viável para esses pacientes. Atualmente, o tratamento neurocirúrgico para a maioria dos pacientes com crises intratáveis, dos quais cerca de 80% possuem foco demonstrável no lobo temporal anterior, é feito a partir da lobectomia temporal anterior (LTA) ou da amigdalohipocampectomia seletiva (AHS). Objetivo: Comparar o desfecho clínico-neurológico do tratamento neurocirúrgico das epilepsias de lobo temporal através das técnicas de lobectomia temporal anterior e amigdalohipocampectomia seletiva. Método: Foi realizada uma meta-análise de estudos clínicos comparando as duas técnicas a partir da revisão da literatura nas bases de dados Medline e Scielo. Foram incluídos no estudo artigos dos últimos 12 anos comparando as duas técnicas cirúrgicas em humanos e excluídos aqueles que não tratavam de estudos clínicos em humanos. Os dados foram estatisticamente analisados. Resultado: Foram encontrados 174 estudos nas bases de dados, dos quais seis preencheram os critérios para seleção. Ao todo, foram estudados 755 pacientes que se submeteram a procedimento neurocirúrgico, sendo 401 através da técnica de AHS e 354 através da LTA. Os desfechos analisados foram a presença ou ausência de convulsões, usando a classificação de Engel, e alterações na memória. Os pacientes tiveram follow-up médio de 11 meses. Dos pacientes submetidos a AHS, 371 (92,5%) tiveram desfecho favorável (Engel I ou II), enquanto esse número foi 329 (92,9%) para LTA; o valor de p foi de 0,824. Evidências de alteração da memória foram conflituosas entre os diversos estudos. Conclusão: Não houve diferença estatisticamente significativa entre os desfechos avaliados para as duas técnicas neurocirúrgicas. São necessárias mais avaliações abrangentes a respeito de outros desfechos, além dos avaliados, para formação da evidência sobre as técnicas que auxiliem na decisão clínico-cirúrgica.
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