Sergio Podgaec

Sergio Podgaec
University of São Paulo | USP · Department of Obstetrics and Gynecology

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125
Publications
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Publications

Publications (125)
Article
Introduction Endometriosis is an inflammatory disease that affects women of reproductive age, causing pain and the possibility of infertility. Endometriosis was associated to low life quality and research shows the impact of endometriosis in several areas of life, justifying how these patients are more likely to develop depression, anxiety, and str...
Article
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Endometriosis causes immunological and cellular alterations. Endometriosis lesions have lower levels of lamin b1 than the endometrium. Moreover, high levels of pro-inflammatory markers are observed in the peritoneal fluid, follicular fluid, and serum in endometriosis lesions. Thus, we hypothesized that the accumulation of senescent cells in endomet...
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Background Graft-versus-host disease (GVHD) is the main complication of allogeneic hematopoietic stem cell transplantation (HSCT). GVHD in the female genital tract can cause sinusorrhagia, dyspareunia, synechia, and even complete vagina occlusion.PurposeThis prospective study aimed to evaluate the clinical characteristics and effects of preventive...
Article
Objective: To answer the question if the freeze-all strategy and subsequent frozen embryo transfer is preferable to fresh embryo transfer for patients with normal response to ovarian stimulation (4 to 15 oocytes recovered) during in vitro fertilization treatments. Methods: A retrospective cohort from two human reproduction centers between 2013 a...
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IntroductionThe pathogen-associated molecular patterns and the danger-associated molecular patterns are possibly responsible for the activation of the inflammatory process in endometriosis through the activation of toll-like receptors (TLRs). Objective The aim of this systematic review was to critically analyze the findings of published articles on...
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Objective: The aim of the study was to assess the evidence on miRNAs as biomarkers for the diagnosis of endometriosis, as well as to provide insights into the challenges and strategies associated with the use of these molecules as accessible tools in clinical practice. Methods: Systematic review conducted on PubMed®, Latin American and Caribbean...
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Endometriosis is a chronic inflammatory hormone-dependent condition associated with pelvic pain and infertility, characterized by the growth of ectopic endometrium outside the uterus. Given its still unknown etiology, treatments usually aim at diminishing pain and/or achieving pregnancy. Despite some progress in defining mode-of-action for drug dev...
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It is estimated that around 28 million surgeries will be postponed or canceled worldwide as a result of this pandemic, causing a delay in the diagnosis and treatment of more than 2 million cancer cases. In Brazil, both the National Health Agency (ANS) and National Health Surveillance Agency (ANVISA) advised the postponement of elective and non-esse...
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Objective To analyze the applicability and efficiency of a multi-approach laparoscopic training in improving basic laparoscopic skills of obstetrics and gynecology (OBGYN) residents. Methods Cross-sectional, observational and descriptive study, developed at the Experimentation and Surgery Training Center (CETEC, in the Portuguese acronym) of the Ho...
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Objective The present study is a systematic review of the literature to assess whether the presence of endometriosis determines or contributes to adverse obstetric outcomes. Data Sources The present work was carried out at the Hospital Israelita Albert Einstein, São Paulo, state of São Paulo, Brazil, in accordance to the PRISMA methodology for syst...
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Objective: To analyze and compare the expression of Toll-like receptors by regulatory T cells present in the peritoneal fluid of patients with and without endometriosis. Methods: Regulatory T cells were isolated from peritoneal fluid of women with and without endometriosis, collected during surgery, and mRNA was extracted for analysis of Toll-li...
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There is increasing interest in the potential of natural compounds to treat diseases, such as endometriosis, a gynecological disorder that affects 10-15% of women of reproductive age, and it is related to severe pelvic pain and infertility. We have evaluated the in vitro effects of rutin and the aqueous bark, roots, and leaf extracts (ABE, ARE, and...
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This work aimed to identify and compare the bacterial patterns present in endometriotic lesions, eutopic endometrium and vaginal fluid from endometriosis patients with those found in the vaginal fluid and eutopic endometrium of control patients. Vaginal fluid, eutopic endometrium and endometriotic lesions were collected. DNA was extracted and the s...
Article
It is not yet clear whether regulatory T (Treg) cells are active, and whether they play a favorable or adverse effect on endometrial foci implantation. Our aim was to evaluate activation and memory surface markers in Treg isolated from peritoneal fluid (PF) and peripheral blood (PB) of women with deep endometriosis and to assess its cytokine mRNA e...
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Objective: To evaluate the prevalence of group B Streptococci in pregnant women of a corporate health program, as well as the epidemiological correlations. Methods: This retrospective study used medical records of patients who participated of the prenatal care program at a private hospital in the city of São Paulo (SP), Brazil, from 2015 to 2016...
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Background and Objectives: The presence of endometrial-like tissue outside the uterine cavity is a key feature of endometriosis. Although endometriotic lesions appear to be histologically quite similar to the eutopic endometrium, detailed studies comparing both tissues are required because their inner and surrounding cellular arrangement is distinc...
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Objective: To standardize the investigation and clinical management of women with laboratory and/or clinical abnormalities suggestive of thrombophilia, in order to optimize antithrombotic approach and indication of laboratory tests. Methodology: A discussion was carried out among 107 physicians (gynecologists/obstetricians, hematologists and vas...
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Objective To compare the Latin American and European assisted reproductive technology (ART) registries regarding data accessibility and quality, treatment utilization, effectiveness, safety, and quality of services. Methods We performed an ecological study using data from scientific publications of Latin American and European registries that report...
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Objective: To evaluate clinical features and complications in patients with bowel endometriosis submitted to hormonal therapy. Methods: Retrospective study based on data extracted from medical records of 238 women with recto-sigmoid endometriosis treated between May 2010 and May 2016. Results: Over the course of follow-up, 143 (60.1%) women re...
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The objective is to study the significance of altered interleukin levels in endometriosis-related infertility or pelvic pain. The present systematic review and meta-analysis includes a discussion on interleukin roles in the physiopathology of endometriosis-associated infertility and/or pelvic pain. We included all studies in which interleukins in p...
Article
Objective: The objective of this study was to evaluate cytokines related to natural killer and T-regulatory cells in endometriotic lesions, peritoneal fluid (PF) and the peripheral blood (PB) of patients with deep infiltrative endometriosis. Study design: A case-control study was conducted in a tertiary referral hospital. Sixty-four consecutive...
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Objective: Rapidly dividing cells in multiple types of cancer and inflammatory diseases undergo high low density lipoprotein (LDL) uptake for membrane synthesis, and coupling an LDL-like nanoemulsion, containing lipid nanoparticles (LDE) to a chemotherapeutic agent efficiently targets these cells without significant systemic effects. This was a pr...
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AimLipschütz ulcers (LU) were first described as rare vulvar ulcerations that affect adolescents without previous history of sexual contact. However, more LU patients have been identified in acute genital ulcers (AGU) services in Europe. PurposeTo review cases of AGU and analyze the occurrence of LU in the Ob/Gyn Emergency Department of a Brazilian...
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Graft-versus-host disease is one of the main causes of morbidity and mortality in patients submitted to hematopoietic stem cell transplantation. This study reviewed the prevalence of lower female genital tract graft-versus-host disease following hematopoietic stem cell transplantation. A systematic search of the literature for articles published be...
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Propose: Endometriosis is a benign disease characterized by implantation and the growth of endometrial tissue outside the uterine cavity and it shares similarities with cancer. Lamin B1, p16 and p21 play a role on cell cycle regulation, development, cell repair and its activities are related to cancers. Considering the similarities between endomet...
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Purpose: Polymorphisms in the control region of mitochondrial DNA (mtDNA) can affect generation of reactive oxygen species and impact in the pathogenesis of endometriosis. This study investigated the association of mtDNA polymorphisms with endometriosis. Methods: Patients were divided in two groups: endometriosis (n = 90) and control (n = 92). I...
Article
The aim of this study was to evaluate Treg and NK cells related cytokines in deep infiltrating endometriosis lesions and its relationship with clinical symptoms of the disease. mRNA expression of Transforming Growth Factor Beta (TGFB), Interleukin (IL)10, Interferon Gamma (IFNG), IL7, and IL15 was analyzed by Real-Time PCR in eutopic endometrium an...
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Resumo Objetivo: Avaliar a eficácia e a segurança do estrogênio potencializado em comparação com o placebo no tratamento homeopático da dor pélvica associada à endometriose (DPAE). Desenho do estudo: Ensaio randomizado, duplo-cego e placebo-controlado de 24 semanas de duração, que incluiu 50 mulheres com idade entre 18-45 anos de idade, diagnóstico...
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Objective: This article presents the first series of robotic single-port hysterectomy cases performed at a hospital in Brazil. Methods: From November 2014 to October 2016, 11 patients were indicated to undergo, and nine of them were submitted to single-port hysterectomy using da Vinci Single-Site® platform. However, in two patients, due to multi...
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Objective: To evaluate the efficacy and safety of potentized estrogen compared to placebo in homeopathic treatment of endometriosis-associated pelvic pain (EAPP). Study design: The present was a 24-week, randomized, double-blind, placebo-controlled trial that included 50 women aged 18-45 years old with diagnosis of deeply infiltrating endometriosis...
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Introduction: Sexual dysfunction is highly prevalent, affecting 40% of the female population. The incidence of such dysfunction is known to be higher among women with malignant breast disease and in patients with depression or anxiety. However, there are few data regarding the prevalence of sexual dysfunction among women with benign breast disease...
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Purpose: Based on the assumption that genetic factors are involved in the etiology of endometriosis, this study aimed to investigate the possibility of rs498679 (TLR4 gene), rs1799964 (TNF-α gene), rs3024496 (IL-10 gene), and rs2294021 (CCDC22 gene) polymorphisms being associated with the occurrence of this disease in a sample of Brazilian women....
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Resumo Objetivo: Avaliar a eficácia e a segurança do estrogênio potencializado em comparação com o placebo no tratamento homeopático da dor pélvica associada à endometriose (DPAE). Desenho do estudo: Ensaio randomizado, duplo-cego e placebo-controlado de 24 semanas de duração, que incluiu 50 mulheres com idade entre 18-45 anos de idade, diagnóstico...
Article
Endometriosis is a benign, chronic inflammatory disease that presents alterations in immune response that can be detected in eutopic endometrium, peritoneal fluid and peripheral blood of affected women. Regulatory T (TReg) cells are a subpopulation of T lymphocytes specialized in immune regulation that seem to participate in the development of endo...
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Objective To determine the correlations between coping strategies, depression, stress levels and pain perception in patients with endometriosis. Methods This prospective and exploratory study included 171 women undergoing treatment for endometriosis between April and August 2014. The questionnaires used were Brief COPE, Beck Depression Inventory,...
Article
Objective: To evaluate the efficacy and safety of potentized estrogen compared to placebo in homeopathic treatment of endometriosis-associated pelvic pain (EAPP). Study design: The present was a 24-week, randomized, double-blind, placebo-controlled trial that included 50 women aged 18-45 years old with diagnosis of deeply infiltrating endometriosis...
Thesis
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Background: Endometriosis is a chronic inflammatory disease that causes difficult-to-treat pelvic pain. Thus being, many patients seek help in complementary and alternative medicine, including homeopathy. The effectiveness of homeopathic treatment for endometriosis is controversial due to the lack of evidences in the literature. The aim of the pres...
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Study question: Is mRNA expression of LDL receptors altered in deep bowel endometriotic foci? SUMMARY ANSWER: mRNA expression of LDL receptors is up-regulated in deep bowel endometriotic foci of patients with endometriosis. What is known already: Several studies have demonstrated the overexpression of low-density lipoprotein receptors in various...
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Purpose: This study investigated the possibility of K469E (rs5498) and G241R (rs1799969) polymorphisms, in ICAM-1 gene, and G634C (rs1800796), in IL-6 gene, being associated with the occurrence of endometriosis in a sample of Brazilian women. Methods: We genotyped 200 women (100 in control group and 100 in endometriosis group) by PCR-RFLP techni...
Article
Background: Endometriosis is a chronic inflammatory disease that causes difficult-to-treat pelvic pain. Thus being, many patients seek help in complementary and alternative medicine, including homeopathy. The effectiveness of homeopathic treatment for endometriosis is controversial due to the lack of evidences in the literature. The aim of the pre...
Article
Background: Ovarian endometriosis is present in 17%-44% of women with endometriosis. The main treatment is surgery, but ultrasonography-guided aspiration is a less invasive alternative. Objectives: To evaluate the effectiveness of this alternative treatment in recurrent ovarian endometrioma. Search strategy: Multiple databases were searched fo...
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We report a case of uterine artery rupture in a woman at 14 weeks’ gestation who presented with abdominal pain, tachycardia, and hypotension and underwent a diagnostic laparoscopy. During this procedure, a spontaneous rupture of the left uterine artery was diagnosed and the surgery was converted into a laparotomy. The artery was bound to its origin...
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Objective: To evaluate the epidemiological profile and the operative complications of patients undergoing gynecological operations for benign diseases in a tertiary public hospital in the state of Roraima, Brazil. Methods: We conducted a retrospective survey through the analysis of 518 records of patients submitted to gynecological operations be...
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Endometriosis is occasionally found in the appendix, particularly in severe forms of deep infiltrating disease. Carcinoid tumor is the most common neoplasm of the appendix and may be overlooked or misdiagnosed when there are multiple endometriosis lesions in the pelvis. We describe two cases of carcinoid tumor diagnosed in patients who underwent su...
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Endometriosis is a prevalent disease that affects 5-15 % of women of reproductive age. The aim of this study is to assess the effect of dienogest in the treatment of endometriosis. The search was applied to electronic databases PubMed, Cochrane, EMBASE and Lilacs until September 2014, in a public tertiary hospital. We performed a systematic literat...
Article
The aim of this study was to analyze cell kinetics through expression and apoptosis of topoisomerase 2-α (TOP2A), p53, and c-erb2 in rectosigmoid endometriotic lesions and in healthy endometrial tissue and to establish correlations between such findings and clinical data in patients with rectosigmoid endometriosis. Sixty patients with rectosigmoid...
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despite endometriosis being a common disease, where early detection is key to preventing its progression, it is a condition often overlooked in adolescents. The aim of this study was to report the clinical characteristics of adolescent patients with endometriosis monitored in a tertiary hospital. a retrospective study of 394 patients undergoing sur...
Article
Endometriosis is a benign gynecological disease that is related to immune response alterations. T regulatory cells modulate immune response, and Foxp3 seems to be the best marker of these cells. This study evaluated Foxp3 mRNA expression in eutopic endometrium from women with endometriosis and healthy controls, and its expression in deep rectosigmo...
Article
Endometriosis, defined as the presence of endometrial glands and/or stroma outside the uterine cavity, is an estrogen-dependent disease that affects about 10% of reproductive age women. Theories to explain the etiology of endometriosis abound. These include the alteration of epithelial cells on peritoneal surface, metaplasia of embryonic remnants o...
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Endometriosis is characterized by the presence of endometrial-like tissue located outside the uterine cavity. Recent evidence suggests that endometriosis may be an epigenetic disease, as well as an estrogen-dependent disease. Based on the unique steroid hormone receptor expression profile observed in endometriotic lesions as compared to eutopic end...
Research Proposal
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Objective: To evaluate the efficacy and safety of potentized estrogen compared to placebo in homeopathic treatment of endometriosis-associated pelvic pain (EAPP). Study design: The present was a 24-week, randomized, double-blind, placebo-controlled trial that included 50 women aged 18-45 years old with diagnosis of deeply infiltrating endometriosi...
Article
To evaluate serum and peritoneal concentrations of amyloid protein A in women with endometriosis and to compare them with those of women without endometriosis. A prospective study evaluated 76 women suspected of having pelvic endometriosis. Fifty-seven women (group A) were confirmed by videolaparoscopy and had their serum and peritoneal amyloid A c...
Article
Objective: To evaluate the expression of chemokines that regulate natural killer (NK) and T-regulatory (T-reg) cell activity in eutopic and ectopic endometrial tissue samples from endometriosis patients. Design: Case-control study (Canadian Task Force classification II-2). Setting: Tertiary referral hospital. Patient(s): Sixty-four consecuti...
Article
This study seeks to analyze the association between adenomyosis diagnosed by magnetic resonance imaging (MRI) and endometriosis. This is a prospective study of consecutive patients. One hundred fifty-two patients with histologically confirmed endometriosis. Patients were submitted to MRI, then divided into Group A (with adenomyosis) and Group B (wi...
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To evaluate CD4(+) CD25(high) Foxp3(+) cells and IL-6, IL-10, IL-17, and TGF-β in the peritoneal fluid of women with endometriosis. A total of ninety-eight patients were studied: endometriosis (n = 70) and control (n = 28). First, peritoneal fluid lymphocytes were isolated, and CD4(+) CD25(high) cells were identified using flow cytometry. Then, RT-...
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Context: Interstitial pregnancy is a rare form of ectopic pregnancy for which the best therapeutic course of action has yet to be determined. Surgical intervention entails a high risk of hemorrhage due to the great vascularization of the cornual region of the uterus. Case descriptions facilitate the analysis of results and aid clinicians in determ...
Article
To estimate the concentration of natural killer (NK) cells in the peripheral blood in patients with and without endometriosis. Case-control study (Canadian Task Force classification II-2). Tertiary referral hospital. One hundred fifty-five patients who had undergone videolaparoscopy were divided into 2 groups: those with endometriosis (n = 100) and...
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To evaluate serum concentrations of CA-125 and soluble CD-23 and to correlate them with clinical symptoms, localization and stage of pelvic endometriosis and histological classification of the disease. Blood samples were collected from 44 women with endometriosis and 58 without endometriosis, during the first three days (1st sample) and during the...