SummaryObjective-To assess the sizes of intra-abdominal organs of adult subjects with untreated severe congenital isolated GH deficiency (IGHD) due to lack of functional GHRH receptor (GHRH-R), and to verify whether there is proportionality between size of organ and adult stature and body surface area (BSA).Subjects and methods-By using ultrasound, we studied the sizes (absolute and corrected by height, weight and BSA) of the intra-abdominal organs of 18 adult subjects with IGHD (eight females, IGHD group) who have never received GH replacement therapy. They were all homozygous for the same null mutation (IVS1 + 1G → A) in the GHRH receptor gene (GHRH-R). They were compared with normal controls from the same region.Results-After correction for BSA, subjects lacking a functional GHRH-R have normal prostate and ovaries size, small spleen and uterus, and large liver, pancreas and kidney.Conclusions-Size of individual abdominal organs is influenced in different ways by severe and congenital lack of GH due to a GHRH-R mutation.

Objective-To study the time, intensity of symptoms, hormonal profile, and related morbidity of climacteric in women with untreated isolated growth hormone (GH) deficiency (IGHD).Design-Women belonging to a large Brazilian kindred with IGHD due to a homozygous mutation in the GH-releasing hormone receptor gene were studied. None of them had ever received GH replacement therapy. A two-step protocol was performed. In the first case-control experiment, aimed to determine the age at climacteric, we compared eight women with IGHD and 32 normal women between 37 and 55 years of age. In the second cross-sectional experiment, aimed to determine the severity of climacteric symptoms, seven women with IGHD (aged 47-65 y) were compared with 13 controls (aged 44-65 y). The Kupperman Index scores, serum follicle-stimulating hormone, luteinizing hormone, prolactin, and estradiol levels were determined, and pelvic and mammary ultrasonography, mammography, and colpocytology were performed.Results-The number of women with follicle-stimulating hormone above 20 mIU/mL was higher in women with IGHD than controls. Kupperman's Index was not different between the two groups. Menarche had been delayed and parity was lower in women with IGHD. Hormonal profile was similar, but prolactin was lower in women with IGHD. Uterine volume was smaller in women with IGHD, and endometrial thickness and ovarian volume were similar in the two groups. No difference in breast images or in colpocytology was observed between the two groups.Conclusions-Menarche was delayed and the beginning of climacteric is anticipated in untreated lifetime IGHD, but menopausal symptoms and hormonal profile resemble the normal climacteric. KeywordsClimacteric; Growth hormone deficiency; Growth hormone; Releasing hormone receptor; Gene mutation Climacteric usually occurs between 40 and 55 years of age and is characterized by the exhaustion of the ovarian follicles with the reduction of serum inhibin and estradiol and an increase in serum follicle-stimulating hormone (FSH), with menstrual cycle abnormalities usually appearing when FSH is above 20 mIU/mL and menopause occuring when it is above 40 mIU/mL. Climacteric causes several genital, urinary, nervous, metabolic, and cardiovascular alterations. The relationships between growth hormone (GH) and menopause are not fully understood. In rodents, GH deficiency (GHD) reduces litter size and the number of primordial follicles, suggesting that GH is required for normal female reproductive function female. 2 In humans, the accomplishment of puberty requires a critical weight, 3 and individuals with untreated GHD reach this weight at a later age, and they usually therefore present with delayed puberty. GH has important modulatory effects on gonadotropin-dependent and -independent functions of the ovary, affecting gametogenesis and steroidogenesis. 4 Accordingly, GH therapy has been used in assisted reproduction with different outcomes. 5,6 However, the effects of lifetime untreated GHD on climacteric are not known.In Itabaia...

Growth hormone (GH) and prolactin share similarities in structure and function. We have previously shown that women with congenital isolated GH deficiency (IGHD) caused by a homozygous mutation in the GHRH receptor gene (GHRHR) (MUT/MUT) have a short reproductive life, with anticipated climacteric. At climacteric, they have lower prolactin levels than normal controls (N/N). Because they are able to breast feed, we hypothesized that this prolactin reduction is limited to climacteric, as result of lower estradiol exposure of the lactotrophs. The purposes of this work were to assess prolactin levels in broader age adults homozygous and heterozygous (MUT/N) for the mutation and in normal controls (N/N), and to correlate them to sex steroids levels. We enrolled 24 GH-naïve MUT/MUT (12 female), 25 MUT/N (14 female), and 25 N/N (11 female) subjects, aged 25-65 years. Anthropometric data and serum prolactin, estradiol, total testosterone, and sex hormone binding globulin (SHBG) were measured. Free testosterone was calculated. Prolactin levels were similar in the three groups. In males, testosterone and SHBG levels were higher in MUT/MUT in comparison to N/N. There was no difference in free testosterone among groups. In all 74 individuals, prolactin correlated inversely with age (p < 0.0001) and directly with serum estradiol (p = 0.018). Prolactin levels in subjects with IGHD due to a homozygous GHRHR mutation are similar to heterozygous and normal homozygous, but total testosterone and SHBG are higher in male MUT/MUT, with no difference in free testosterone. The reduced prolactin level is limited to climacteric period, possibly due to reduced estrogen exposure.

CONTEXT AND OBJECTIVE: The Wnt pathway is involved in tumorigenesis of several tissues. RESULTS: Regarding Wnt1, FZD1 and Wnt5a expression, no significant association was observed between the groups. A significant association was observed between the groups in relation to FZD5 expression (P = 0.001). The proportion of FZD5-positive samples was significantly higher in group A (80.0%) than in group B (31.1%). Regarding the survival curve for FZD5 in group B, we did not find any significant association between atrophic endometrium and endometrial adenocarcinoma. We also did not find any significant association regarding beta-catenin expression (P = 1.000 Comparamos a expressão imunoistoquímica de Wnt 1, Frizzled-1 (FZD1), Wnt 5a, Frizzled-5 (FZD 5) e betacatenina entre câncer endometrial tipo I e endométrio atrófico. RESULTADOS: Na expressão do Wnt1, FZD1 e Wnt5a, não observamos associação significante entre os grupos. Na expressão do FZD5, encontramos associação significante entre os grupos (P = 0,001). A proporção de positividade do FZD5 foi significantemente maior no grupo A comparado ao grupo B (31,1%). Em relação à curva de sobrevida para o FZD5 no grupo B, não tivemos associação significante entre endométrio atrófico e adenocarcinoma do endométrio. Também não observamos associação significante na expressão da beta-catenina (P = 1,000). CONCLUSÃO: FZD5 é downregulated no adenocarcinoma endometrial quando comparado ao endométrio atrófico.

Objetivo: Avaliação da dor em pacientes com câncer de colo uterino atendidos no Hospital de Urgência de Sergipe (HUSE), tanto do ponto de vista qualitativo quanto quantitativo. Métodos: Estudo quantitativo, descritivo, tipo exploratório, de corte transversal, realizado no ambulatório de Oncologia do HUSE, no município de Aracaju, entre 2010 e 2014. A pesquisa foi realizada em 53 pacientes diagnosticadas e tratadas com câncer de colo de útero e a coleta de dados foi realizada por meio de questionários, como o de Mcgill e a Escala Visual Analógica. Resultados: A queixa álgica foi um fenômeno relatado por 34 pacientes (64,1%), seja no diagnóstico, no tratamento, na reabilitação ou em mais de uma dessas etapas. Quanto à intensidade da dor, 22 entrevistadas (41,5%) apresentaram dor intensa e 19 (35,8%) não apresentaram dor. Ao analisar os descritores da dor, observou-se que dentre as 34 pacientes que referiam a queixa álgica, a categoria sensorial foi preponderante, seguida pela afetiva. O descritor sensitivo mais utilizado foi dor fina com 10,6%, já no caráter afetivo foi dor enjoada com 22,9%. Conclusão: A dor intensa esteve presente na maioria das pacientes em algum estágio da doença e o caráter sensorial da queixa álgica foi predominante no estudo.

Direitos para esta edição cedidos à Atena Editora pelos autores. Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição-Não-Comercial-NãoDerivativos 4.0 Internacional (CC BY-NC-ND 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores, inclusive não representam necessariamente a posição oficial da Atena Editora. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais. A Atena Editora não se responsabiliza por eventuais mudanças ocorridas nos endereços convencionais ou eletrônicos citados nesta obra. Todos os manuscritos foram previamente submetidos à avaliação cega pelos pares, membros do Conselho Editorial desta Editora, tendo sido aprovados para a publicação.

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Direitos para esta edição cedidos à Atena Editora pelos autores. Todo o conteúdo deste livro está licenciado sob uma Licença de Atribuição Creative Commons. Atribuição-Não-Comercial-NãoDerivativos 4.0 Internacional (CC BY-NC-ND 4.0). O conteúdo dos artigos e seus dados em sua forma, correção e confiabilidade são de responsabilidade exclusiva dos autores, inclusive não representam necessariamente a posição oficial da Atena Editora. Permitido o download da obra e o compartilhamento desde que sejam atribuídos créditos aos autores, mas sem a possibilidade de alterá-la de nenhuma forma ou utilizá-la para fins comerciais. A Atena Editora não se responsabiliza por eventuais mudanças ocorridas nos endereços convencionais ou eletrônicos citados nesta obra. Todos os manuscritos foram previamente submetidos à avaliação cega pelos pares, membros do Conselho Editorial desta Editora, tendo sido aprovados para a publicação.