Oswaldo da Rocha Grassiotto

Leptin and adiponectin blood levels in women with premature ovarian failure and age- and weight-matched women with normal menstrual cycles

Objective: The aim of this study was to evaluate leptin and adiponectin blood levels in women with premature ovarian failure (POF) and women with a normal menstrual cycle. Methods: This was a cross-sectional study involving 60 women divided into two groups: the study group (G1) comprising 30 women with POF not receiving hormone therapy for at least 3 months and the control group (G2) comprising 30 women with a normal menstrual cycle. Both groups were age and body mass index (BMI) matched. Results: Study participants had a mean (±SD) age of 34.4 (±5.3) and 34.2 (±5.6) years and mean BMI (±SD) of 24.7 (±6.3) and 24.5 (±4.6) kg/m2 in G1 and G2, respectively. Serum leptin levels were significantly lower in G1 compared with G2 (8.8 ± 12.2 and 12.2 ± 9.7 ng/mL; P < 0.05). Serum adiponectin levels were similar in both groups. Leptin levels were positively correlated to weight (r = 0.38; P = 0.03) but were not correlated to BMI and age in women with POF (G1); in G2, they were positively correlated to BMI (r = 0.59; P = 0.0006), weight (r = 0.63; P = 0.0006), and age (r = 0.40; P = 0.02). Adiponectin levels did not correlate to weight, BMI, or age in both groups. Conclusions: These results suggest that gonadal function loss may decrease leptin circulating levels, independently from age and BMI. Adiponectin seems not to correlate to hormonal status.

A pituitary adenoma secreting follicle-stimulating hormone with ovarian hyperstimulation: treatment using a gonadotropin-releasing hormone antagonist

OBJECTIVE To describe the management of a patient with a pituitary adenoma secreting follicle-stimulating hormone (FSH) associated with ovarian hyperstimulation who was treated with a gonadotropin-releasing hormone (GnRH) antagonist. DESIGN Case report. SETTING University teaching hospital. PATIENT(S) A woman of reproductive age with secondary amenorrhea and ovarian hyperstimulation due to a pituitary adenoma secreting FSH, which persisted after transsphenoidal surgery. INTERVENTION(S) Clinical treatment with a GnRH antagonist. MAIN OUTCOME MEASURE(S) A decrease in serum estradiol levels. RESULT(S) During the treatment period, ovarian hyperstimulation decreased as shown by a reduction in estradiol levels and an improvement in the patients clinical condition and in the ultrasonography parameters. CONCLUSION(S) The GnRH antagonist was found to be effective for the short-term treatment of ovarian hyperstimulation secondary to a pituitary adenoma secreting FSH, thus representing a therapeutic option that should be taken into consideration in such cases.

Six new cases confirm the clinical molecular profile of complete combined 17α-hydroxylase/ 17,20-lyase deficiency in Brazil

In 2004, Costa-Santos and cols. reported 24 patients from 19 Brazilian families with 17α-hydroxylase deficiency and showed that p.W406R and p.R362C corresponded to 50% and 32% of CYP17A1 mutant alleles, respectively. The present report describes clinical and molecular data of six patients from three inbred Brazilian families with 17α-hydroxlyse deficiency. All patients had hypogonadism, amenorrhea and hypertension at diagnosis. Two sisters were found to be 46,XY with both gonads palpable in the inguinal region. All patients presented hypergonadotrophic hypogonadism, with high levels of ACTH (> 104 ng/mL), suppressed plasmatic renin activity, low levels of potassium (< 2.8 mEq/L) and elevated progesterone levels (> 4.4 ng/mL). Three of them, including two sisters, were homozygous for p.W406R mutation and the other three (two sisters and one cousin) were homozygous for p.R362C. The finding of p.W406R and p.R362C in the CYP17A1 gene here reported in additional families, confirms them as the most frequent mutations causing complete combined 17α-hydroxylase/17,20-lyase deficiency in Brazilian patients.

Job satisfaction of nursing staff in a university hospital

OBJECTIVE identify the determinants of job satisfaction of the nursing staff of a public university hospital. METHOD secondary study with mixed data approach and simple and multiple linear regression. A total of 115 subjects participated in the study, 41 nurses and 74 nursing assistants and technicians. The data collection occurred in 2013 using the QST-Caism questionnaire. RESULTS education, hierarchical level and workplace constitute job satisfaction determinants. However, age, gender, job and work period did not show this relationship. More educated workers held low job satisfaction if exercised not graduated nursing functions. CONCLUSION graduated workers who perform high school functions are more unsatisfied than those who have high school function and qualification.

Satisfação no trabalho da equipe de enfermagem em um hospital universitário

OBJECTIVE identify the determinants of job satisfaction of the nursing staff of a public university hospital. METHOD secondary study with mixed data approach and simple and multiple linear regression. A total of 115 subjects participated in the study, 41 nurses and 74 nursing assistants and technicians. The data collection occurred in 2013 using the QST-Caism questionnaire. RESULTS education, hierarchical level and workplace constitute job satisfaction determinants. However, age, gender, job and work period did not show this relationship. More educated workers held low job satisfaction if exercised not graduated nursing functions. CONCLUSION graduated workers who perform high school functions are more unsatisfied than those who have high school function and qualification.

Gravidez ectópica em cicatriz de cesariana: invasão da parede vesical detectada pela ressonância magnética

Although cesarean scar ectopic pregnancy continues to be the rarest form of ectopic pregnancy, its incidence is increasing because of the worldwide increase in the number of cesarean deliveries. If the diagnosis is delayed, there is a high risk of severe hemorrhage and death, whereas early diagnosis can minimize the complications associated with the condition. Here, we report a case in which invasion of the bladder wall was identified by magnetic resonance imaging.Although cesarean scar ectopic pregnancy continues to be the rarest form of ectopic pregnancy, its incidence is increasing because of the worldwide increase in the number of cesarean deliveries. If the diagnosis is delayed, there is a high risk of severe hemorrhage and death, whereas early diagnosis can minimize the complications associated with the condition. Here, we report a case in which invasion of the bladder wall was identified by magnetic resonance imaging.

Satisfacción en el trabajo del personal de enfermería en un hospital universitario

OBJECTIVE identify the determinants of job satisfaction of the nursing staff of a public university hospital. METHOD secondary study with mixed data approach and simple and multiple linear regression. A total of 115 subjects participated in the study, 41 nurses and 74 nursing assistants and technicians. The data collection occurred in 2013 using the QST-Caism questionnaire. RESULTS education, hierarchical level and workplace constitute job satisfaction determinants. However, age, gender, job and work period did not show this relationship. More educated workers held low job satisfaction if exercised not graduated nursing functions. CONCLUSION graduated workers who perform high school functions are more unsatisfied than those who have high school function and qualification.