Atualização científica relâmpago - Clamídia

Artigo do The New England Journal of Medicine ressalta a importância do screening de Clamídia em jovens e mulheres sujeitas a Doença Inflamatória Pélvica.  Gravidez tubária é outra consequência nefasta e muito comum. Homem é reservatório. 

"Chlamydia is caused by the gram-negative bacterium Chlamydia trachomatis and is the most common infection reported in the United States, with more than 1.5 million cases reported in 2015. All sexually active women younger than 25 years of age and older women at risk for chlamydia should be offered chlamydia screening annually. Studies have supported benefits of chlamydia screening to prevent pelvic inflammatory disease."

"A clamídia é causada pela bactéria Gram-negativa Chlamydia trachomatis e é a infecção mais comum relatada nos Estados Unidos, com mais de 1,5 milhões de casos relatados em 2015. Todas as mulheres sexualmente ativas menores de 25 anos de idade e mulheres mais velhas com risco de infecção pela  Clamídia, devem ser instadas aos exames de detecção daclamídia anualmente. Estudos têm apontado benefícios do rastreio de clamídia para prevenir a doença inflamatória pélvica e complicações de gravidez."

Editor Dr Homero Guidi

Convidado Internacional na Reunião Clínica do dia 5 de novembro de 2014

Departamento de Obstetrícia e Ginecologia recebe o Prof. Carlos Simón, MD. PhD de Valência, Espanha, na primeira quarta-feira de novembro, no dia 5/11/2014 as 9 horas. 

Tema   " RECEPTIVIDADE ENDOMETRIAL. ESTADO DA ARTE" 

LOCAL    CENTRO DE CONVENÇÕES REBOUÇAS  - ALA NOVA - SALÃO TURQUESA

O Prof. Simón é o Titular de Obstetricia e Ginecologia na Universidade de Valência e Professor Adjunto de Ob/Gyn da Escola de Medicina da Universidade de Stanford nos Estados Unidos, além de Diretor do Instituto Valenciano de Infertilidade. Suas linhas de pesquisa envolvem importantes conceitos e práticas relacionadas com a receptividade do endométrio, endometriose, e células-tronco. 

APOIO INSTITUCIONAL :  

Resumo do  C. V. 

Since 1991, his basic and clinical research has contributed to the advance of Reproductive Medicine, specifically in the understanding of human endometrial receptivity, embryo viability, embryonic implantation and endometriosis. He discovered the relevance of the interleukin-1 system in embryonic implantation (Simon et al., JCEM 1993; 1994; Endocrinology 1994; BOR 2006). He demonstrated the deleterious effect of high hormonal levels in patients with high response to gonadotrophins thus modifying the established clinical practice (HR1995; Fertil Steril 1996; 1998). He pioneered the concept that human oocytes are affected in endometriosis (HR 1994; Fertil Steril 2000) thus changing the clinical practice in oocyte donation. He proposed a new embryo coculture system, now successfully used worldwide (JCEM 1996; Fertil Steril 2003). His basic research on endometrial receptivity led him to create and patent a customized array named endometrial receptivity array (ERA) for the molecular diagnosis of endometrial receptivity (Fertil Steril 2011, 2013). He has been awarded “Prize Jaime I 2011 in Medical Investigation” for his pioneering work in human endometrial receptivity disorders.

In an independent bibliometric analysis considering publications in Reproductive Biology between 2003 and 2005, Carlos Simon was identified as the 9th most productive author in the world (Gonzalez-Alcaide G et al., Fertil Steril 90:941-56,2008).

Since 2001, he has expanded his research into the field of stem cells, resulting in the derivation, characterization, and registration in the Spanish National Stem Cell Bank (BNLC) of ten human embryonic stem cell (hESC) lines (http://www.isciii.es/ISCIII/es/contenidos/fd-investigacion/fd-ejecucion/fd-programas-investigacion/fd-investigacion-terapia-celular-medicina-regenerativa/banco-nacional-lineas-celulares.shtml). He derived the first two hESC in Spain (Fertil Steril 2005) and described a new system for freezing hESC in the absence of animal contaminants. He derived VAL-6M, the first line with a monogenic disorder (Myotonic Dystrophy Type I) in Spain. Also, he obtained the first two hESC lines without destroying the human embryo using blastomere biopsy and demonstrated the lack of genetic diversity in the most common used hESC in the world (Mosher JT et al. N Engl J Med 2010). Finally, he reported the identification and characterization of human endometrial stem cells (Cervelló et al., PLoS ONE. 2010, 2011, 2012)

As Principal Investigator, his work has been funded through 16 projects sponsored by the Spanish Government, 4 by the Valencian Government, including 2 PROMETEO (granted to prestigious scientists) and 16 projects by international organizations, American Universities and private companies.

Metrics: At ISI Web of Knowledge (http://apps.isiknowledge.com) Prof. Carlos Simon is author of 348 publications in international peer-review journals, adding up to an accumulated impact factor of 1,541.47. His papers have received a total of 11,139 cites with an average of 32 cites/paper. His H-Index is 60 and he is editor of 15 books. He has been Director of 28 PhD Thesis all qualified with "Cum Laude", including 4 PhD Awards of Excellence and 3 European PhD. As inventor, his research has originated 13 Patent Applications, leading to the creation of IVIOMICS a biotech company http://iviomics.com. 

He has been Director of 28 PhD Thesis all qualified with "Cum Laude", including 4 PhD Awards of Excellence and 3 European PhD.

As inventor, his research has originated 13 Patent Applications, leading to the creation of IVIOMICS a biotech company http://iviomics.com.  

Atualização Científica Relâmpago

Letrozole parece ser superior ao Clomifeno no tratamento da infertilidade de mulheres portadoras de ovários policísticos. Resultados finais são superiores.  Trabalho foi publicado no New England Journal of Medicine  em julho de 2014 e tem como principal autor o Dr. Richard Legro, que esteve em evento da Clínica Ginecológica. 

Confira o artigo

Letrozole versus Clomiphene for Infertility in the Polycystic Ovary Syndrome

R.S. Legro and Others

N Engl J Med 371:119, July 10, 2014

Atualização relâmpago

****** Atenção esse é um artigo médico. Recomenda-se critério do leitor na leitura******

Publicação no New England Journal of Medicine - 2 de setembro de 2010.

Infertilidade

Teaching Topic
Infertility
Clinical Problem-Solving
Hard to Conceive
J.H. Levison and Others

In the United States, approximately 10% of women of reproductive age have received infertility treatment. Among these cases of infertility, about 50% are attributed to female factors, and 25% to male factors; 25% are unexplained.

Clinical Pearls

How is infertility diagnosed?

Infertility is defined as the inability to conceive after 1 year of regular unprotected intercourse. Within the first year of attempted conception, 80 to 90% of couples conceive, and after 2 years 95% conceive.

What are the most common causes of infertility?

Three quarters of infertility cases have an identifiable cause; the rest are designated as “unexplained.” The majority of cases of female infertility result from disorders of ovulation or the fallopian tubes; other causes include endometriosis, cervical defects, and uterine abnormalities. The predominant cause of male infertility is a low number of functional sperm in the ejaculate.

Morning Report Questions

Q. What initial diagnostic evaluation is recommended for the infertile couple?

A. The initial diagnostic evaluation should include semen analysis, documentation of ovulation, and hysterosalpingography to evaluate the uterine cavity and tubal patency.

Q. What is the most common cause of fallopian tube blockage?

A. Distal tubal blockage most commonly results from pelvic inflammatory disease and salpingitis; the most common causes include infection with C. trachomatis or N. gonorrhea, but blockage can also result from mixed infection with mycoplasma, ureaplasma, and fecal coliform species and from mycobacterial infections — notably, Mycobacterium tuberculosis.