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de Oliveira-Junior I, da Costa Vieira RA, Biller G, Sarri AJ, da Silva FCB, Nahás EAP. Factors associated with unsatisfactory cosmetic results in oncoplastic surgery. Front Oncol 2023; 13:1071127. [PMID: 37554162 PMCID: PMC10405917 DOI: 10.3389/fonc.2023.1071127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
INTRODUCTION Oncoplastic surgery (OS) has expanded the indications for breast-conserving surgery associated with an adequate aesthetic result. However, few studies have described the factors associated with unsatisfactory cosmetic outcomes from this surgical modality. MATERIALS AND METHODS This is a cross-sectional prospective study that included patients undergoing breast-conserving surgery (BCS) with or without OS. The patients self-evaluated the cosmetic results of the breasts posttreatment and had them photographed. The photos were analyzed by BCCT.core. Individual and treatment factors (local and systemic) for all patients were evaluated. These factors were dichotomized according to the use of OS and to the cosmetic result (satisfactory and unsatisfactory). Categorical variables were tested for association with surgical outcome using the chi-square test while numerical variables using the Mann-Whitney U test. Variables with p <0,2 were selected for multivariate analysis. RESULTS Of the 300 patients evaluated, 72 (24,0%) underwent OS. According to the patient self-evaluations, an unsatisfactory cosmetic result from OS was significantly associated with younger age at diagnosis, higher body mass index (BMI) at the time of evaluation, larger tumor size and greater weight of the surgical specimen. According to the BCCT.core, only the laterality of the tumor (left) was significantly associated with an unsatisfactory cosmetic result. In logistic regression, considering OS as a control variable, the risk of an unsatisfactory outcome according to patient self-evaluation was related to the tumor ≥ T2 odds ratio (OR) 1,85 (1,027-3,34) and age at diagnosis < 40 [OR 5,0 (1,84-13,95)]. However, according to the software, the variables were associated with an increased risk of an unsatisfactory outcome were the time interval between surgery and evaluation [OR 1,27 (1,16-1,39)], the presence of lymphedema [OR 2,97 (1,36-6,46)], surgical wound infection [OR 3,6 (1,22-11,16)], tumor location on the left side [OR 3,06 (1,69-5,53)], overweight [OR 2,93 (1,48-5,8)] and obesity [OR 2,52 (1,2-5,31)]. CONCLUSION There is no standard methodology for breast cosmesis evaluation, which influences the factors associated with unsatisfactory results. Younger patients and those with increased BMI, left breast cancer and extensive resections tend to present with unsatisfactory cosmetic results when OS is performed.
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Affiliation(s)
- Idam de Oliveira-Junior
- Postgraduate Program of Tocogynecology, Botucatu Medical School, Sao Paulo State University, UNESP, Sao Paulo, Brazil
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Nucleous of Mastology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - René Aloísio da Costa Vieira
- Postgraduate Program of Tocogynecology, Botucatu Medical School, Sao Paulo State University, UNESP, Sao Paulo, Brazil
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Gabriele Biller
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Faculty of Health Sciences of Barretos Dr. Paulo Prata (FACISB) School of Medicine, Sao Paulo, Brazil
| | - Almir José Sarri
- Nucleous of Mastology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Fabíola Cristina Brandini da Silva
- Postgraduate Program of Oncology, Barretos Cancer Hospital, Sao Paulo, Brazil
- Nucleous of Mastology, Barretos Cancer Hospital, Sao Paulo, Brazil
| | - Eliana Aguiar Petri Nahás
- Postgraduate Program of Tocogynecology, Botucatu Medical School, Sao Paulo State University, UNESP, Sao Paulo, Brazil
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Dallanezi G, Freire BFA, Nahás EAP, Nahás-Neto J, Corrente JE, Mazeto GMFDS. Physical Activity Level of Post-menopausal Women with Low Bone Mineral Density. Rev Bras Ginecol Obstet 2016; 38:225-30. [PMID: 27144804 PMCID: PMC10309406 DOI: 10.1055/s-0036-1583757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Introduction Proper physical activity is related to the prevention and the treatment of osteoporosis. Purpose To assess the level of physical activity (PA) in post-menopausal women with low bone mineral density (BMD). Methods This cross-sectional clinical study included 123 post-menopausal women. The inclusion criteria were: age of ≥ 45 years with last menses at least 12 months prior to the initiation of the study, and bone density scan (BDS) values measured over the preceding 12 months. Women with severe osteoarthritis were excluded. Women were allocated into three groups, according to BMD measured by BDS [osteoporosis (OP; 54 women), osteopenia (35 women), and normal bone density (NBD; 35 women)], and compared for general, clinical, and anthropometric data, and for PA level. The latter was assessed using the International Physical Activity Questionnaire (IPAQ), in metabolic equivalent of task (MET) units. Participants were classified as sedentary, active or very active. Quantitative variables were compared using ANOVA followed by Tukey's test. Associations between qualitative variables were tested by Chi-square (χ2) or Fisher's exact test. In order to check for differences among groups and IPAQ domains, a generalized linear model with Gamma distribution was adjusted for values in METs. Results The OP group differed from the NBD group regarding age (61.8 ± 10.1 and 52.9 ± 5.4 years), percentage of participants with self-declared white ethnicity (43.9 and 28.0%), body mass index (BMI - 25.7 ± 5.4 and 30.9 ± 5.1 kg/m(2)), and time since menopause (15.5 ± 7.5 and 5.8 ± 4.5 years). Smoking rates were higher in the OP (55.6%) and NBD groups (33.3%) than in the osteopenia group (11.1%). Within the OP group, the rate of subjects with sedentary lifestyles was higher (42.6%), and time spent sitting was greater (344.3 ± 204.8 METs) than in the groups with osteopenia (20.0% and 300.9 ± 230.6 METs) and NBD (17.7% and 303.2 ± 187.9 METs). Conclusions The rate of sedentary lifestyles was higher in post-menopausal women with OP than in those with either osteopenia or NBD. In order to change this physical inactivity profile, strategies should be created to address this group of patients.
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Affiliation(s)
- Glauber Dallanezi
- Department of Physical Education, Faculdade de Educação Física de Barra Bonita (Faefi), Barra Bonita, SP, Brazil
| | | | - Eliana Aguiar Petri Nahás
- Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - Unesp, Botucatu, SP, Brazil
| | - Jorge Nahás-Neto
- Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - Unesp, Botucatu, SP, Brazil
| | - José Eduardo Corrente
- Department of Biostatistics, Instituto de Biociências, Universidade Estadual Paulista - Unesp, Botucatu, SP, Brazil
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Bueloni-Dias FN, Spadoto-Dias D, Nahás EAP, Nahás-Neto J, Modotti WP, Dias R. Metabolic Syndrome: Predictive Factor for Endometrial Polyps in Postmenopausal Women. J Minim Invasive Gynecol 2015; 22:S91. [DOI: 10.1016/j.jmig.2015.08.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bueloni-Dias FN, Spadoto-Dias D, Nahás Neto J, Nahás EAP. [Predictive factors for occurrence of endometrial polyps in postmenopausal women.]. Rev Bras Ginecol Obstet 2014; 36:489-496. [PMID: 25493400 DOI: 10.1590/s0100-720320140005090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 09/12/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the predictive clinical factors for the development of endometrial polyps in postmenopausal women. METHODS Observational cohort study with postmenopausal women who had been at a public university hospital. Clinical, anthropometrical, laboratorial, and ultrasonographic data of 132 patients with a histopathological diagnosis of endometrial polyps and 264 women without endometrial alterations (control) were compared in order to evaluate the predictive factors of endometrial polyps. Women with amenorrhea ≥12 months and ≥45 years of age were included in the study at a proportion of 1 case for 2 controls. The Student's t, χ2, and logistic regression tests were used for statistical analysis - odds ratio (OR). RESULTS Patients with endometrial polyps were older and had been in menopause for a longer time compared to control (p<0.0001). The percentage of obese women with polyps (72.0%) was higher compared to the Control Group (39%; p<0.0001). The measurement of waist circumference was superior among patients with polyps (p=0.0001). We observed a higher incidence of diabetes, hypertension and dyslipidemia in patients with endometrial polyps (p<0.0001). According to the US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria, 48.5% of women with polyps and 33.3% of the Control Group were classified as having metabolic syndrome (p=0.004). Analysis of risk for endometrial polyps formation showed higher chances of occurrence of the disorder in patients with: BMI≥25 kg/m2 (OR=4.6; 95%CI 2.1-10.0); glucose ≥100 mg/dL (OR=2.8; 95%CI 1.3-5.9); dyslipidemia (OR=7.0; 95%CI 3.7-13.3); diabetes (OR=2.5; 95%CI 1.0-6.3), and metabolic syndrome (OR=2.7; 95%CI 1.1-6.4) compared to the Control Group. CONCLUSION In postmenopausal women, obesity, dyslipidemia, hyperglycemia and presence of metabolic syndrome were predictive factors for the development of endometrial polyps.
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Affiliation(s)
- Flávia Neves Bueloni-Dias
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, SP, Brasil
| | - Daniel Spadoto-Dias
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, SP, Brasil
| | - Jorge Nahás Neto
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, SP, Brasil
| | - Eliana Aguiar Petri Nahás
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Botucatu, SP, Brasil
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Dias DS, Dias R, Nahás-Neto J, Nahás EAP, Leite NJ, Bueloni-Dias FN, Modotti WP. Clinical and psychological repercussions of videolaparoscopic tubal ligation: observational, single cohort, retrospective study. SAO PAULO MED J 2014; 132:321-31. [PMID: 25351752 PMCID: PMC10496775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 09/19/2013] [Accepted: 10/22/2013] [Indexed: 04/07/2023] Open
Abstract
CONTEXT AND OBJECTIVE Tubal ligation is one of the most commonly used contraceptive methods worldwide. Since the controversy over the potential effects of tubal sterilization still continues, this study aimed to evaluate the clinical and psychological repercussions of videolaparoscopic tubal ligation. DESIGN AND SETTING Observational, single cohort, retrospective study, conducted in a tertiary public hospital. METHODS A questionnaire was applied to 130 women aged 21-46 years who underwent videolaparoscopic tubal ligation by means of tubal ring insertion or bipolar electrocoagulation and sectioning, between January 1999 and December 2007. Menstrual cycle interval, intensity and duration of bleeding, premenstrual symptoms, dysmenorrhea, dyspareunia, noncyclic pelvic pain and degree of sexual satisfaction were assessed in this questionnaire. Each woman served as her own control, and comparisons were made between before and after the surgical procedure and between the two techniques used. RESULTS The clinical and psychological repercussions were significant, with increases in bleeding (P = 0.001), premenstrual symptoms (P < 0.001), dysmenorrhea (P = 0.019) and noncyclic pelvic pain (P = 0.001); and reductions in the number of sexual intercourse occurrences per week (P = 0.001) and in libido (P = 0.001). Women aged ≤ 35 years at the time of sterilization were more likely to develop menstrual abnormalities. The bipolar electrocoagulation method showed greater clinical and psychological repercussions. CONCLUSION Regardless of the technique used, videolaparoscopic tubal ligation had repercussions consisting of increased menstrual flow and premenstrual symptoms, especially in women aged ≤ 35 years, and also had a negative influence on sexual activity.
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Affiliation(s)
- Daniel Spadoto Dias
- PhD. Attending Physician, Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual de São Paulo (Unesp), Botucatu, São Paulo, Brazil
| | - Rogério Dias
- PhD. Adjunct Professor and Chairman of the Gynecological Endoscopy and Family Planning Sector, Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual de São Paulo (Unesp), Botucatu, São Paulo, Brazil
| | - Jorge Nahás-Neto
- PhD. Clinical Assistant Professor, Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual de São Paulo (Unesp), Botucatu; and Clinical Vice-Director of the Clinics Hospital (HC) of Botucatu, Botucatu, São Paulo, Brazil
| | - Eliana Aguiar Petri Nahás
- PhD. Adjunct Professor, Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual de São Paulo (Unesp), Botucatu, São Paulo, Brazil
| | - Nilton José Leite
- PhD. Attending Physician, Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual de São Paulo (Unesp), Botucatu, São Paulo, Brazil
| | - Flávia Neves Bueloni-Dias
- PhD. Attending Physician, Department of Gynecology and Obstetrics, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual de São Paulo (Unesp), Botucatu, São Paulo, Brazil
| | - Waldir Pereira Modotti
- PhD. Collaborating Professor of Postgraduate Program on Gynecology, Obstetrics and Mastology, Faculdade de Medicina de Botucatu (FMB), Universidade Estadual de São Paulo (Unesp), Botucatu; and Clinical Director of Instituto de Atendimento à Mulher (IAM), Assis, São Paulo, Brazil
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Orsatti CL, Nahás EAP, Nahas-Neto J, Orsatti FL, Linhares IM, Witkin SS. Mannose-binding lectin gene polymorphism and risk factors for cardiovascular disease in postmenopausal women. Mol Immunol 2014; 61:23-7. [PMID: 24861434 DOI: 10.1016/j.molimm.2014.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 04/24/2014] [Accepted: 05/02/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Inflammatory responses may be altered in postmenopausal women and predispose to cardiovascular disease (CVD). Genetic factors can also influence susceptibility to CVD. Mannose-binding lectin (MBL) is a component of the innate immune system and an activator of the complement cascade. We evaluated the association of genetic polymorphism of MBL (MBL2) on risk factors for CVD in postmenopausal women. METHODS In this cross-sectional study, 311 Brazilian women (age ≥45 years and amenorrhea ≥12 months) were included. EXCLUSION CRITERIA presence of previous or current CVD, insulin dependent diabetes, chronic kidney disease, autoimmune diseases and cancer. Clinical, anthropometric and biochemical assessments were performed to evaluate the cardiovascular risk factors. DNA was extracted from buccal cell and polymorphisms at codons 54 and 57 in the MBL2 were determined by polymerase chain reaction (PCR). For statistical analysis, the chi-square and logistic regression (odds ratio, OR) were used. RESULTS The presence of the polymorphic allele for codon 54 was found in 25.8% of women (A/B=22.6%, B/B=3.2%) and for codon 57 in 12.2% (A/C=10.8%, C/C=1.4%). The polymorphism at codon 54 was significantly associated with the presence of hypertension (OR 0.55, 95% CI 0.31-0.99, p=0.044) and insulin resistance assessed by HOMA-IR (OR 0.46, 95% CI 0.24-0.91, p=0.025). No significant associations were observed between the polymorphism at codon 57 with risk factors for CVD. CONCLUSION In postmenopausal women, the polymorphism at codon 54 of the MBL2 was associated with lower risk for hypertension and insulin resistance that are important risk factors for CVD.
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Affiliation(s)
- Claudio Lera Orsatti
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University- UNESP, Botucatu, São Paulo, Brazil.
| | - Eliana Aguiar Petri Nahás
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University- UNESP, Botucatu, São Paulo, Brazil
| | - Jorge Nahas-Neto
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University- UNESP, Botucatu, São Paulo, Brazil
| | - Fabio Lera Orsatti
- Department of Sports Science, Institute of Health Sciences - UFTM, Uberaba, Minas Gerais, Brazil
| | - Iara Moreno Linhares
- Department of Gynecology and Obstetrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Steven Sol Witkin
- Department of Obstetrics and Gynecology, Division of Immunology and Infectious Diseases, Weill Cornell Medical College, New York, NY, USA
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Dias DS, Bueloni-Dias FN, Dias R, Nahás-Neto J, Petri Nahás EA, Leite NJ, Custódio Domingues MA, Bueno Angela SP, Padovani CR. Usefulness of Clinical, Ultrasonographic, Hysteroscopic, and Immunohistochemical Parameters in Differentiating Endometrial Polyps From Endometrial Cancer. J Minim Invasive Gynecol 2014; 21:296-302. [DOI: 10.1016/j.jmig.2013.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 09/25/2013] [Accepted: 09/27/2013] [Indexed: 10/26/2022]
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Petri Nahás EA, Pontes A, Nahas-Neto J, Borges VTM, Dias R, Traiman P. Effect of total abdominal hysterectomy on ovarian blood supply in women of reproductive age. J Ultrasound Med 2005; 24:169-174. [PMID: 15661947 DOI: 10.7863/jum.2005.24.2.169] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effect of total abdominal hysterectomy on ovarian blood supply using transvaginal color Doppler ultrasonography in women of reproductive age. METHODS This prospective study included 61 women aged 40 years or younger who were divided into 2 groups: group 1, comprising 31 patients who underwent total abdominal hysterectomy (TAH); and group 2, comprising 30 women with no abnormalities. Inclusion criteria included normal ovarian function at baseline, with basal follicle-stimulating hormone levels of less than 15 mUI/mL, normal body weight, no tobacco use, and no history of laparotomy or ovarian disease. Ovarian arterial blood supply by determination of the pulsatility index (PI) on Doppler analysis and ovarian volume on transvaginal ultrasonography were assessed at baseline and at 6 and 12 postoperative months. The Student t test, profile analysis, and Friedman and Mann-Whitney tests were used in the statistical analysis of data. RESULTS Statistical analysis of baseline data revealed that both groups were homogeneous. At months 6 and 12, greater ovarian volumes and lower PI values were observed in patients who underwent TAH (P < .05). By the end of the study, in 8 of the 31 patients who underwent TAH (25.5%), benign ovarian cysts were observed. In the control group, all the parameters studied remained unchanged. CONCLUSIONS The reduced PI values observed on Doppler ultrasonography suggested a decrease in the resistance flow in the ovarian arteries in women of reproductive age who underwent TAH.
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Affiliation(s)
- Eliana Aguiar Petri Nahás
- Department of Gynecology and Obstetrics, Botucatu Medical School, São Paulo State University, Rubião Júnior, Botucatu, São Paulo, Brazil.
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Nahás EAP, Nahás Neto J, De Luca LA, Traiman P, Pontes A, Dalben I. Efeitos da isoflavona sobre os sintomas climatéricos e o perfil lipídico na mulher em menopausa. Rev Bras Ginecol Obstet 2003. [DOI: 10.1590/s0100-72032003000500006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Nahás EAP, Pontes A, Traiman P, Nahás Neto J, De Luca LA, Borges VTM, Carvalho LRD. Efeitos da Histerectomia Total Abdominal sobre o Fluxo Sangüíneo Ovariano. Rev Bras Ginecol Obstet 2002. [DOI: 10.1590/s0100-72032002000500007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Nahás EAP. Avaliação da Função Ovariana Pós-histerectomia Total Abdominal em Mulheres no Menacme. Rev Bras Ginecol Obstet 2002. [DOI: 10.1590/s0100-72032002000100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Pontes A, Traiman P, Franco M, Nahás EAP, Dias R, De Luca LA. Tratamento Clínico e Seguimento das Hiperplasias de Endométrio. Rev Bras Ginecol Obstet 2000. [DOI: 10.1590/s0100-72032000000600002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Nahás EAP. Influência da tibolona e do exercício físico aeróbio sobre a antropometria e o perfil lipídico na menopausa. Rev Bras Ginecol Obstet 1998. [DOI: 10.1590/s0100-72031998000600012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Dias R, Nahás EAP, Rogenski OM, De Luca LA, Viscomi FA, Lopes RGC. Síndrome pós-laqueadura: repercussões clínicas e psíquicas da pós-laqueadura. Rev Bras Ginecol Obstet 1998. [DOI: 10.1590/s0100-72031998000400005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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