Isadora Seganfredo - Academia.edu (original) (raw)

Papers by Isadora Seganfredo

Arthrogryposis multiplex congenita coexistent with isosexual idiopathic precocious puberty Classi... more Arthrogryposis multiplex congenita coexistent with isosexual idiopathic precocious puberty Classic arthrogryposis multiplex congenital is characterized by disabilitating joint contractures diagnosed at birth. A case of amyoplasia, the most frequent form of this disease, is described co-occurring with isosexual precocious puberty in a seven-year-old female patient. Association between amyoplasia and precocious puberty has not been previously reported in the literature. Although this association may be a casual phenomenon, this case is being reported due to its rarity.

Jornal Vascular Brasileiro, 2011

Paciente de 30 anos apresentou, apos vacinacao contra influenza comum, dor intensa, edema e erite... more Paciente de 30 anos apresentou, apos vacinacao contra influenza comum, dor intensa, edema e eritema em membro superior esquerdo no local da aplicacao e febre continua nao aferida. Foi hospitalizado, porem houve agravamento progressivo do quadro e resistencia ao tratamento com antiinflamatorios e antibioticos, culminando em queda do estado geral, formacao de colecao no local e convulsao febril. Optou-se por tratamento cirurgico preferencial, sendo o paciente submetido a procedimentos para fasciotomia, desbridamento, drenagem de colecao e sutura de extenso ferimento em membro superior esquerdo.

Reproductive Sciences, 2020

Melatonin plays an important role in the regulation of ovarian function including oocyte maturati... more Melatonin plays an important role in the regulation of ovarian function including oocyte maturation in different mammalian species. Many studies indicate that melatonin has an impact on the ovarian function of a variety of ovarian cells. However, the information on the exact mechanism and involved hormones is low. To evaluate inhibin beta-A (INHBA) and follistatin (FST) expression in the ovaries of pinealectomized rats treated with melatonin, thirty adult female Wistar rats were randomized into three groups of ten animals each: group 1 (GSh), sham-operated controls receiving vehicle; group 2 (GPx), pinealectomized animals receiving vehicle; and group 3 (GPxMe), pinealectomized animals receiving replacement melatonin (1.0 mg/kg body weight. It was assumed that each animal drank 6.5 ± 1.2 ml per night and weighs approximately 300 g.) for 60 consecutive days. The ovaries were collected for mRNA abundance and protein of INHBA and FST by qRT-PCR and immunohistochemical analyses, respectively. Treatment with melatonin resulted in the upregulation of INHBA and FST genes in the ovarian tissue of the melatonin-treated animals (GPxMe), when compared with GPx. These findings were then confirmed by analyzing the expression of protein by immunohistochemical analyses, which revealed higher immunoreactivity of INHBA and FST in GPxMe animals in the follicular cells compared with GSh and GPx rats. Melatonin increases the expression of INHBA and FST in the ovaries of pinealectomized female rats.

Brasilia Med, Apr 1, 2013

Os autores declaram não haver potencial conflito de interesses. rEsUMO A artrogripose múltipla co... more Os autores declaram não haver potencial conflito de interesses. rEsUMO A artrogripose múltipla congênita clássica é caracterizada por contraturas articulares incapacitantes diagnosticadas ao nascimento. Descreve-se um caso de amioplasia, a forma mais frequente dessa doença, coexistente com puberdade isossexual precoce que se iniciou em uma menina com sete anos e dez meses de idade. A associação de amioplasia com puberdade precoce não foi previamente relatada. Embora essa associação possa constituir um fenômeno casual, descreve-se o estudo de caso por sua raridade.

Jornal Vascular Brasileiro, 2011

Paciente de 30 anos, do sexo masculino, apresentou, após vacinação contra influenza comum, dor in... more Paciente de 30 anos, do sexo masculino, apresentou, após vacinação contra influenza comum, dor intensa, edema e eritema em membro superior esquerdo no local da aplicação e febre contínua não aferida. Foi hospitalizado, porém houve agravamento progressivo do quadro e resistência ao tratamento com anti-inflamatórios e antibióticos, culminando em queda do estado geral, formação de coleção no local e convulsão febril. Optou-se por tratamento cirúrgico, submetendo-se o paciente a procedimentos para fasciotomia, desbridamento, drenagem de coleção e sutura de extenso ferimento em membro superior esquerdo.

Clinics, 2021

Genitourinary syndrome (GUS) is a very frequent disease after menopause and is caused by a sharp ... more Genitourinary syndrome (GUS) is a very frequent disease after menopause and is caused by a sharp decline in estrogen levels (1). According to the North American Menopause Society, the current concept of the syndrome includes a set of signs observed during a physical examination and associated symptoms due to estrogen deficiency, involving the labia majora, labia minora, vestibule, clitoris, urethra, and bladder (2). Classical therapy consists of long-term use of topical estrogen (1,2). However, adherence to treatment is reduced over time, resulting in frequent relapses (1). New alternatives have also been sought for patients with contraindications to hormone therapy. Studies are being conducted using physical energies, such as laser, radio frequency, and ultrasonography, aimed at mitigating the consequences of hypoestrogenism in the lower genital tract (LGT) (3). The US Food and Drug Administration (FDA) has licensed the CO2 laser systems for ‘‘incision, excision, ablation, vaporization, and coagulation of soft tissues in the body,’’ which have been used in specialties such as dermatology, otorhinolaryngology, neurosurgery, urology, and gynecology, including genitourinary surgery since 2010 (3). Specifically, energy-based devices (EBDs), such as the more commonly used radio frequency and laser, are authorized by the FDA for general indications of gynecological instrument use, including the destruction of abnormal cervical or vaginal tissue, condylomata, and precancerous lesions (3). Such indications have always been followed in gynecology (4). In 2018, the FDA issued a warning about the indiscriminate utilization of the laser and other EBDs for cosmetic purposes, which could result in serious adverse events, such as vaginal burns, scarring, painful sexual intercourse, and recurrent/chronic pain (5). The warning was brought on mainly by the concern that the exaggerated expansion occurring in the United States and worldwide (6) has led many health professionals, physicians, and nonphysicians to use such devices without a precise indication, with the promise of genital rejuvenation. In 2020, the North American Menopause Society issued a norm regarding the use of EBDs (4). Although they have not yet been approved by the FDA for use in GUS and are still considered an experimental treatment, several clinical studies have shown them to be effective in the treatment of the syndrome (7-11). In general, the main benefits of EBD use in the LGT are as follows: a) thickening of the non-keratinized epithelium, b) increase in local angiogenesis, c) improvement in lubrification, d) normalization of the genital microbioma, e) decline in vaginal pH, f) development of new collagen fibers and restoration of vaginal architecture, improving elasticity and decreasing the frequency of microtraumas, and g) improvement in genitourinary symptoms (7-11). The latter was highlighted by the North American Menopause Society; however, it warned that training with an EBD should be provided with care and that inadequate use of the device poses a risk (4). In a recent meta-analysis (12), the authors reported improvements in both genitourinary symptoms and their repercussions of urinary incontinence, quality of life, the vaginal health index, and sexuality. In all parameters, analysis of the treatments showed that the laser was beneficial for women in the control group (12). The authors also reported low rates of non-severe side effects. However, it should be noted that the number of participants was small, and follow-up was short (12); therefore, the long-term effects of such therapies cannot be assessed. It is recommended that the indication of the procedure be conveyed in a clear and transparent way to the patients who should be instructed on the limitations of the method. For the successful application of EBDs, it is also important and necessary that qualified health professionals receive adequate practical training before using the devices. Despite being promising, the techniques involving EBDs are still in the experimental stage; thus, further studies are necessary to evaluate the long-term benefits and risks for patients with GUS. DOI: 10.6061/clinics/2021/e3066 Copyright & 2021 CLINICS – This is an Open Access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/ 4.0/) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

Arthrogryposis multiplex congenita coexistent with isosexual idiopathic precocious puberty Classi... more Arthrogryposis multiplex congenita coexistent with isosexual idiopathic precocious puberty Classic arthrogryposis multiplex congenital is characterized by disabilitating joint contractures diagnosed at birth. A case of amyoplasia, the most frequent form of this disease, is described co-occurring with isosexual precocious puberty in a seven-year-old female patient. Association between amyoplasia and precocious puberty has not been previously reported in the literature. Although this association may be a casual phenomenon, this case is being reported due to its rarity.

Jornal Vascular Brasileiro, 2011

Paciente de 30 anos apresentou, apos vacinacao contra influenza comum, dor intensa, edema e erite... more Paciente de 30 anos apresentou, apos vacinacao contra influenza comum, dor intensa, edema e eritema em membro superior esquerdo no local da aplicacao e febre continua nao aferida. Foi hospitalizado, porem houve agravamento progressivo do quadro e resistencia ao tratamento com antiinflamatorios e antibioticos, culminando em queda do estado geral, formacao de colecao no local e convulsao febril. Optou-se por tratamento cirurgico preferencial, sendo o paciente submetido a procedimentos para fasciotomia, desbridamento, drenagem de colecao e sutura de extenso ferimento em membro superior esquerdo.

Reproductive Sciences, 2020

Melatonin plays an important role in the regulation of ovarian function including oocyte maturati... more Melatonin plays an important role in the regulation of ovarian function including oocyte maturation in different mammalian species. Many studies indicate that melatonin has an impact on the ovarian function of a variety of ovarian cells. However, the information on the exact mechanism and involved hormones is low. To evaluate inhibin beta-A (INHBA) and follistatin (FST) expression in the ovaries of pinealectomized rats treated with melatonin, thirty adult female Wistar rats were randomized into three groups of ten animals each: group 1 (GSh), sham-operated controls receiving vehicle; group 2 (GPx), pinealectomized animals receiving vehicle; and group 3 (GPxMe), pinealectomized animals receiving replacement melatonin (1.0 mg/kg body weight. It was assumed that each animal drank 6.5 ± 1.2 ml per night and weighs approximately 300 g.) for 60 consecutive days. The ovaries were collected for mRNA abundance and protein of INHBA and FST by qRT-PCR and immunohistochemical analyses, respectively. Treatment with melatonin resulted in the upregulation of INHBA and FST genes in the ovarian tissue of the melatonin-treated animals (GPxMe), when compared with GPx. These findings were then confirmed by analyzing the expression of protein by immunohistochemical analyses, which revealed higher immunoreactivity of INHBA and FST in GPxMe animals in the follicular cells compared with GSh and GPx rats. Melatonin increases the expression of INHBA and FST in the ovaries of pinealectomized female rats.

Brasilia Med, Apr 1, 2013

Os autores declaram não haver potencial conflito de interesses. rEsUMO A artrogripose múltipla co... more Os autores declaram não haver potencial conflito de interesses. rEsUMO A artrogripose múltipla congênita clássica é caracterizada por contraturas articulares incapacitantes diagnosticadas ao nascimento. Descreve-se um caso de amioplasia, a forma mais frequente dessa doença, coexistente com puberdade isossexual precoce que se iniciou em uma menina com sete anos e dez meses de idade. A associação de amioplasia com puberdade precoce não foi previamente relatada. Embora essa associação possa constituir um fenômeno casual, descreve-se o estudo de caso por sua raridade.

Jornal Vascular Brasileiro, 2011

Paciente de 30 anos, do sexo masculino, apresentou, após vacinação contra influenza comum, dor in... more Paciente de 30 anos, do sexo masculino, apresentou, após vacinação contra influenza comum, dor intensa, edema e eritema em membro superior esquerdo no local da aplicação e febre contínua não aferida. Foi hospitalizado, porém houve agravamento progressivo do quadro e resistência ao tratamento com anti-inflamatórios e antibióticos, culminando em queda do estado geral, formação de coleção no local e convulsão febril. Optou-se por tratamento cirúrgico, submetendo-se o paciente a procedimentos para fasciotomia, desbridamento, drenagem de coleção e sutura de extenso ferimento em membro superior esquerdo.

Clinics, 2021

Genitourinary syndrome (GUS) is a very frequent disease after menopause and is caused by a sharp ... more Genitourinary syndrome (GUS) is a very frequent disease after menopause and is caused by a sharp decline in estrogen levels (1). According to the North American Menopause Society, the current concept of the syndrome includes a set of signs observed during a physical examination and associated symptoms due to estrogen deficiency, involving the labia majora, labia minora, vestibule, clitoris, urethra, and bladder (2). Classical therapy consists of long-term use of topical estrogen (1,2). However, adherence to treatment is reduced over time, resulting in frequent relapses (1). New alternatives have also been sought for patients with contraindications to hormone therapy. Studies are being conducted using physical energies, such as laser, radio frequency, and ultrasonography, aimed at mitigating the consequences of hypoestrogenism in the lower genital tract (LGT) (3). The US Food and Drug Administration (FDA) has licensed the CO2 laser systems for ‘‘incision, excision, ablation, vaporization, and coagulation of soft tissues in the body,’’ which have been used in specialties such as dermatology, otorhinolaryngology, neurosurgery, urology, and gynecology, including genitourinary surgery since 2010 (3). Specifically, energy-based devices (EBDs), such as the more commonly used radio frequency and laser, are authorized by the FDA for general indications of gynecological instrument use, including the destruction of abnormal cervical or vaginal tissue, condylomata, and precancerous lesions (3). Such indications have always been followed in gynecology (4). In 2018, the FDA issued a warning about the indiscriminate utilization of the laser and other EBDs for cosmetic purposes, which could result in serious adverse events, such as vaginal burns, scarring, painful sexual intercourse, and recurrent/chronic pain (5). The warning was brought on mainly by the concern that the exaggerated expansion occurring in the United States and worldwide (6) has led many health professionals, physicians, and nonphysicians to use such devices without a precise indication, with the promise of genital rejuvenation. In 2020, the North American Menopause Society issued a norm regarding the use of EBDs (4). Although they have not yet been approved by the FDA for use in GUS and are still considered an experimental treatment, several clinical studies have shown them to be effective in the treatment of the syndrome (7-11). In general, the main benefits of EBD use in the LGT are as follows: a) thickening of the non-keratinized epithelium, b) increase in local angiogenesis, c) improvement in lubrification, d) normalization of the genital microbioma, e) decline in vaginal pH, f) development of new collagen fibers and restoration of vaginal architecture, improving elasticity and decreasing the frequency of microtraumas, and g) improvement in genitourinary symptoms (7-11). The latter was highlighted by the North American Menopause Society; however, it warned that training with an EBD should be provided with care and that inadequate use of the device poses a risk (4). In a recent meta-analysis (12), the authors reported improvements in both genitourinary symptoms and their repercussions of urinary incontinence, quality of life, the vaginal health index, and sexuality. In all parameters, analysis of the treatments showed that the laser was beneficial for women in the control group (12). The authors also reported low rates of non-severe side effects. However, it should be noted that the number of participants was small, and follow-up was short (12); therefore, the long-term effects of such therapies cannot be assessed. It is recommended that the indication of the procedure be conveyed in a clear and transparent way to the patients who should be instructed on the limitations of the method. For the successful application of EBDs, it is also important and necessary that qualified health professionals receive adequate practical training before using the devices. Despite being promising, the techniques involving EBDs are still in the experimental stage; thus, further studies are necessary to evaluate the long-term benefits and risks for patients with GUS. DOI: 10.6061/clinics/2021/e3066 Copyright & 2021 CLINICS – This is an Open Access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/ 4.0/) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.