Browsing by Author "Areia, AL"
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- Adenocarcinoma In Situ do Endocolo: a propósito de um caso clínicoPublication . Areia, AL; Frutuoso, C; Dias, I; Mota, F; Oliveira, CF
- Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-AnalysisPublication . Pinheiro, RL; Areia, AL; Mota Pinto, A; Donato, HINTRODUCTION: The risks of pregnancy in women of advanced maternal age are not consensual amongst studies. The aim of this metaanalysis was to determine whether women of advanced maternal age (≥ 35 years old) had worse obstetrical and perinatal outcomes than non- advanced maternal age women (20 - 34 years old) in singleton, naturally-conceived pregnancies. MATERIAL AND METHODS: We searched PubMed/ MEDLINE, IndexRMP and the Cochrane Database of Systematic Reviews. Ten studies were included according to the following criteria: population of > 1000 nulliparous and/or multiparous women with singleton gestations who did not undergo any type of infertility treatment. Using Review Manager v. 5.3, two meta-analysis were performed: one comparing the outcomes of 20 - 34-year-old vs 35 - 40-year-old women, and another comparing the outcomes of 35 - 40-year-old women vs > 40-year-old women. RESULTS: Women aged 35 - 40 years old were more likely to have > 12 years of education than 20 - 34 years old and > 40 years old women. Advanced maternal age women (35 - 40 and > 40 years old) were more likely to be overweight and having gestational diabetes and gestational hypertension. They were also more likely to undergo induced labour and elective caesarean deliveries. Furthermore, they had worse perinatal outcomes such as preterm delivery, low birthweight babies, higher rates of Neonatal Intensive Care Unit admission and worse Apgar scores. Advanced maternal age women had higher rates of perinatal mortality and stillbirth. DISCUSSION: Most authors present similar results to our study. Although the majority of adverse outcomes can be explained through the physio-pathological changes regarding the female reproductive apparatus that come with aging and its inherent comorbidities, according to the existing literature advanced maternal age can be an independent risk factor per se. In older pregnant women without comorbidities such as gestational hypertension or diabetes there are still worse obstetric and perinatal outcomes, which indicate that advanced maternal age is an independent strong risk factor alone. CONCLUSION: Advanced maternal age women are at a higher risk of adverse obstetrical and perinatal outcomes. In both comparisons, worse outcomes were more prevalent in the older group, suggesting that poorer outcomes are more prevalent with increasing age.
- Diabetes Mellitus insulinodependente que se manifesta como cetoacidose diabética durante a gravidezPublication . Areia, AL; Marta, E; Moura, P
- Endometrial adenocarcinoma after endometrial ablation. A case reportPublication . Areia, AL; Branco, M; Frutuoso, C; Oliveira, CFThe authors present a case of endometrial adenocarcinoma after endometrial ablation, emphasizing the importance of close surveillance of these patients, patient selection and education. Even patients with none of the risk factors for endometrial cancer or contraindications to endometrial ablation should be checked carefully.
- Endometrioid adenocarcinoma arising in endometriosis foci six years after estrogen replacement therapy: a case reportPublication . Areia, AL; Sousa, V; Frutuoso, C; Martins, MI; Oliveira, CFWe present a case of a 53-year-old woman who developed an endometrioid adenocarcinoma six years after total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO), who was on estrogenic-only hormone replacement therapy (HRT).
- Paraovarian tumor of borderline malignancy: a case reportPublication . Areia, AL; Frutuoso, C; Amaral, N; Dias, I; Oliveira, CFA case of a 23-year-old woman with a paraovarian tumor is presented. The patient complained of pelvic pain and abdominal swelling. Cystectomy was the initial surgical treatment, but after the histological diagnosis, a staging surgery was carried out. The clinical aspects and subsequent management of related cases are discussed, and a literature review is made.
- Primary breast lymphomaPublication . Areia, AL; Dias, M; Alves, MM; Oliveira, CFOBJECTIVES: Retrospective evaluation of the clinical behavior, treatment and prognosis in five cases of primary breast lymphoma. METHODS: From 1999 to 2003, five patients with primary breast lymphoma were diagnosed in our department. RESULTS: Primary breast lymphoma (PBL) was diagnosed in five patients, whose median age was 63.4 (41-79) years. In four out of five patients, a diagnosis of lymphoma was made after the evaluation of a palpable breast mass measuring 1.5 to 6 cm. All of them were classified as non-Hodgkin's B cell lymphomas and three of five cases were diffuse large cell lymphomas. All patients were submitted to chemotherapy; in only one patient was surgery performed. CONCLUSIONS: A relatively high rate of PBL was observed in our department compared with other oncology centers. Beyond its scarce appearance, PBL is very difficult to distinguish from primary breast carcinoma. Histology remains the major diagnostic tool.