Edmund Chada Baracat’s research while affiliated with Hospital de Clínicas de Porto Alegre and other places

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Publications (562)


Pelvic congestion syndrome as a differential diagnosis of chronic pelvic pain in women
  • Article

October 2024

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1 Read

Clinics

Marcos de Lorenzo Messina

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Pedro Puech-Leão

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Ricardo Dos Santos Simões

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[...]

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Edmund Chada Baracat


Warm ischemia time (in min), by type of revascularization.
Example of the appearance of uterine perfusion (animal 5) in simultaneous revascularization at the initial (A), 30 s (B) and 60 s (C) moments after perfusion. Demonstrating the completely perfused uterus at 30 s post perfusion.
Example of the appearance of uterus perfusion (animal 02) in sequential revascularization at the initial (A), 30 s (B) and 60 s (C) moments after perfusion. Demonstrating the completely perfused uterus at 30 s post‐perfusion.
Analysis of two reperfusion techniques in uterine transplantation in an experimental model
  • Article
  • Full-text available

October 2024

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6 Reads

Introduction Uterine transplantation was developed for the treatment of absolute uterine factor infertility. As it is a new modality of transplantation, there is still room for technical improvement. A factor that impacts graft survival in organ transplantation is the warm ischemia time. In uterine transplantation specifically, at least two vascular anastomoses are performed on each side of the uterus, and the graft revascularization takes place when the vascular clamps of the arteries and veins are released on both sides simultaneously. For this reason, the warm ischemia time in uterine transplant is expected to be considerably long. The purpose of this study was to compare the sequential technique of uterine graft revascularization, which aims to reduce the warm ischemia time of the procedure, with the simultaneous revascularization technique. Material and Methods For the procedure, the uterine auto‐transplantation technique was performed using 10 non‐pregnant adult ewes weighing about 45 kg, divided into two groups: simultaneous revascularization group (5 animals) and sequential revascularization group (5 animals). To evaluate the groups, we analyzed the procedure and warm ischemia times, graft macroscopy, hemodynamic, laboratory, and histological parameters of the uterus. Results The sequential revascularization technique group had similar surgical procedure times, and the warm ischemia time was significantly shorter with medians of 32 min in the sequential group versus 72 min in the simultaneous group (p < 0.008). The graft macroscopy and hemodynamic, laboratory, and histological parameters evaluated were similar between the groups. Conclusions The sequential revascularization technique proved to reduce the warm ischemia time in the sheep uterine auto‐transplantation model without compromising graft viability.

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Classification of the DASS-21 domains according to the final scores
Sociodemographic characteristics
Presence of self-reported TMD-caused pain and degrees of severity among students and faculty
Degrees of severity in each DASS-21 domain of students and faculty
Relationship between self-reported TMD-caused pain and emotional states according to faculty and students within the context of the pandemic
Cross-sectional study of self-reported pain related to temporomandibular disorders and emotional state of medical school faculty and students: Post-COVID-19 pandemic

August 2024

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15 Reads

The social isolation imposed by the COVID-19 pandemic interrupted in-person activities, which were immediately followed by adaptations to ensure, for example, the continuity of teaching. This generated emotional impacts on the academic community. Emotional states may trigger or emphasize conditions such as temporomandibular dysfunction (TMD), causing pain and limiting masticatory function. This study aimed to compare the students and the faculty of a medical school first in terms of the TMD-caused pain they experienced during social isolation and reported two months later, according to their recollections, using the TMD-Pain Screener questionnaire. The second basis for comparison was the emotional state generated by social isolation and its connection with TMD symptoms assessed through the Depression, Anxiety and Stress Scale (DASS-21), which considers perceptions at the time of data collection. Both questionnaires were responded to in May 2022 after the end of social isolation. The data were analyzed by the IBM-SPSS software for Windows 22.0 with a 5% level of significance. The results show that the self-reported TMD symptoms were more widespread (p = 0.002) and intense (p = 0.013) among students than among faculty and that all of the former’s DASS-21 domains (depression, anxiety, and stress) were also more strongly evident (p<0.05). Only anxiety was more significant among the faculty (p = 0.027). Both groups pointed to social isolation as an aggravating factor of the symptoms (p<0.05). The conclusion is that the self-reported TMD-caused pain and all DASS-21 domains as experienced during social isolation were stronger and more prevalent among students than among faculty, and that only anxiety was statistically significant among faculty. Also, the emotional states resulting from social isolation may have aggravated TMD-caused pain in both groups.


Flow diagram for inclusion and exclusion of the participants in the study
ROC curve for determining the best TIL cutoff point for predicting relapse in DCIS patients
Relapse-free survival according to TIL count
Relapse-free survival according to the presence of necrosis
Evaluation of tumor infiltrating lymphocytes as a prognostic biomarker in patients with ductal carcinoma in situ of the breast

August 2024

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5 Reads

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1 Citation

Breast Cancer Research and Treatment

Purpose To assess the association between tumor-infiltrating lymphocytes (TILs) in ductal carcinoma in situ (DCIS) samples and disease recurrence. Methods This retrospective cohort study included women aged 18 years and older who underwent treatment between January 2007 and December 2020. Male patients, individuals diagnosed with invasive or microinvasive disease based on anatomopathological examination of surgical specimens, and those with a personal history of any other cancers were excluded. Additionally, the presence of “touching TILs” (lymphocytes in direct contact with tumor cells) and periductal desmoplasia were evaluated as complementary methods to represent the immunological microenvironment. The primary outcome was relapse-free survival based on TIL quantification adjusted for potential confounders. Pathologists assessed TILs in the sample with the highest tumor representation and quantified them as a percentage. Survival was evaluated using Kaplan‒Meier curves, log-rank tests, and Cox regression models. Results A total of 191 patients met the eligibility criteria. The mean follow-up duration was 77.2 months, with a recurrence rate of 9.2%. Patients with TILs ≥ 17% had a greater risk of recurrence (HR 2.97, 95% CI 1.17–7.51; p = 0.02). Additionally, focal necrosis (HR 6.4, 95% CI 1.39–34.71; p = 0.018) or comedonecrosis (HR 4.53, 95% CI 1.34–15.28; p = 0.015) were associated with increased recurrence risk. According to the multivariate model, comedonecrosis and TILs ≥ 17% were significantly associated with recurrence (p = 0.034 and p = 0.035, respectively). Regarding the evaluations of “touching TILs” and periductal desmoplasia, no statistical significance was found when assessing their association with disease recurrence. Conclusion In our cohort, a high percentage of TILs (≥ 17%) and the presence of comedonecrosis were independently associated with DCIS recurrence.


Brazilian Portuguese Translation and Validation of the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-IUGA revised

August 2024

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13 Reads

International Urogynecology Journal

Condition-specific sexual questionnaires are important patient-reported outcome measures. The aim of this study was to translate and validate the Pelvic Organ Prolapse/Incontinence Sexual Questionnaire-International Urogynecology Association Revised (PISQ-IR) into Brazilian Portuguese and to clinically validate it in a Brazilian Portuguese-speaking population. Translation and validation of the PISQ-IR was performed according to the International Urogynecological Association-recommended process and guidelines. For external validity, PISQ-IR subscales were compared with the clinical measures, Pelvic Organ Prolapse Quantification system (POP-Q) stage, pelvic floor muscle tone, and Oxford Grading Scale (Pearson correlations). Descriptive statistics, internal consistency (Cronbach’s alpha coefficient), and test–retest reliability (interclass correlation coefficient) were calculated for all PISQ-IR subscales. A total of 120 sexually active and 106 not sexually active women were enrolled in the study between March 2015 and July 2019. Internal consistency was acceptable, with Cronbach’s alpha values 0.60–0.80, except for the sexual arousal and orgasm, sexual arousal and partner-related issues, sexual arousal and condition-specific issues, global rating of sexual quality and condition impact subscales. PISQ-IR demonstrated good reliability (α > 0.6, CIC = 0.996). The agreement for each individual questionnaire item also individually presented substantial agreement between the assessments (κ 0.61–0.8). There was a correlation between PISQ-IR and POP, mixed, stress and fecal incontinence diagnosis and a positive correlation with pelvic floor muscle function according to the Oxford Scale in sexually active women. For sexually inactive women there was a correlation between PISQ-IR and mixed urinary symptoms. The Brazilian Portuguese version of PISQ-IR is a reliable and valid tool that can be easily used for the identification and assessment of sexual function in Brazilian Portuguese-speaking women with pelvic floor disorders.


Citations (55)


... In a study of 534 DCIS cases, dense TILs accompanied DCIS of larger size, with comedo necrosis, of intermediate and high grade, with concomitant Paget's disease and lack of estrogen receptor expression, occurring at younger age and were associated with shorter recurrence-free interval [54]. A similar correlation was obtained in the group of 283 DCIS cases in which patients with TILs > 17% had a higher risk of recurrence [55]. In another study of 1488 DCIS patients, higher TILs correlated with HER2+ phenotype, higher grade, and necrosis, with no impact on ipsilateral DCIS or invasive tumor recurrence, irrespective of the treatment method [56]. ...

Reference:

Tumor-Infiltrating Lymphocytes (TILs) in Breast Cancer: Prognostic and Predictive Significance across Molecular Subtypes
Abstract PO4-26-02: Evaluation of Tumor Infiltrating Lymphocytes as a predictive biomarker of recurrence in patients with Ductal Carcinoma In Situ of the breast
  • Citing Article
  • May 2024

Cancer Research

... The present study showed that the Jordanian OBGYNs preferred that the first-line treatment options follow the National Institute for Health and Care Excellence (NICE) 2023 guidelines [10], with 43.6% favoring lifestyle/behavioral therapy and 40.4% preferring pelvic floor muscle physiotherapy [9]. This preference is corroborated through research demonstrating improved quality of life and decreased urinary leakage measured by a 1 h pad test, Incontinence Quality of Life (IQOL), quality of life questionnaires, and King's health questionnaire using pelvic floor physiotherapy [17]. Furthermore, 14.9% of our target population preferred an initial surgical procedure instead of conservative measures. ...

A randomized trial comparing vaginal laser therapy and pelvic floor physical therapy for treating women with stress urinary incontinence
  • Citing Article
  • September 2023

Neurourology and Urodynamics

... Melatonin is a potent antioxidant that directly scavenges free radicals and upregulates antioxidant enzymes. This action may protect against both cuproptosis and ferroptosis by reducing oxidative stress [40,41]. It regulates metal homeostasis by modulating transporters and binding proteins, potentially affecting copper and iron metabolism crucial in these pathways [42,43]. ...

Antioxidant Actions of Melatonin: A Systematic Review of Animal Studies

Antioxidants

... No studies examined anxiety. Recently, a randomized controlled trial by Donatti et al. [24] found that a CBT intervention focused on improving coping strategies resulted in individuals with endometriosis being 13 times more likely to experience a reduction in depressive symptoms to moderate or mild levels compared to untreated controls. ...

Efficacy of Cognitive Behavioral Therapy in treating women with endometriosis and chronic pelvic pain: A randomized trial
  • Citing Article
  • April 2024

Journal of Health Psychology

... Among androgen excess disorders, PCOS has been the most well studied in the context of possible influence by EDs. Higher levels of bisphenol A (BPA) in women with PCOS have already been reported by multiple groups including ours (e.g., [12,[35][36][37]), as reviewed in Urbanetz et al. [38]. The roles of other less well-known EDs have been less explored. ...

Bisphenol A and polycystic ovary syndrome in human: A systematic review

... Some studies show that Cymbopogon schoenanthu has anti-inflammatory properties, which also confirm the improvement of the clinical symptoms of patients, including burning and itching 20 . Other similar studies have investigated the effect of other herbs or probiotics 21,22 on BV. In the study of Baery et al., vaginal suppositories comprising the plants of Tribulus terrestris, Myrtus commuis, Foeniculum vulgare, and Tamarindus indica were used for treatment. ...

Oral probiotics and vaginal microbiome in post-menopause women: an opinion for the improvement of natural therapies in gynecology

Revista da Associação Médica Brasileira

... The prevalence of obesity varies between 12.5 and 100% in publications 2 . In addition, there is an increase in the risk of type 2 diabetes, cardiovascular diseases, and metabolic syndrome (MS) with advancing age 3,4 . ...

Influence of Phenotypes on the Metabolic Syndrome of Women with Polycystic Ovary Syndrome over a Six-Year Follow-Up in Brazil

... Subsequently, the sections were dewaxed with xylene, hydrated with gradient ethanol solution, rinsed with distilled water. Hematoxylin stain for 5 min, rinsed well with running water, l% hydrochloric acid ethanol fractionation, 1% ammonia wash for 10 s, eosin stain for 30-60 s, rinsed with running water, dehydrated with gradient ethanol: 80% ethanol, 95% ethanol and anhydrous ethanol 16 . Xylene transparent, sections were air-dried, sealed with neutral gum, and histological changes were observed under light microscopy (BA210Digital, McAudi Industries Group Ltd.). ...

Effects of estrogen and raloxifene on synaptic density in the hippocampal CA1 region of ovariectomized rats

Clinics

... This rapid excretion has been the foundation for some public health authorities worldwide to provide reassuring safety assessments and declarations. However, in various tissues, especially the lungs, liver, kidneys, and placenta, enzymes such as β-glucuronidase and steroid sulfatase, which are present at detectable levels, can de-conjugate BPA, thereby reactivating its biologically active form [29,38]. During pregnancy, the conjugated form of BPA passes through the placenta, where it undergoes deconjugation, leading to fetal exposure in utero. ...

Does bisphenol A (BPA) participates in the pathogenesis of Polycystic Ovary Syndrome (PCOS)?

Clinics

... Liposomal 2-ME nanoparticle Uterine Leiomyoma Lipid-based [23] PEGy-PLGA nanoparticles loaded with 2-ME Uterine Leiomyoma Polymeric [9] Simvastatin-loaded liposomal nanoparticles Uterine Leiomyoma Lipid-based [24] Peptide-based vectors for suicide gene therapy Uterine Leiomyoma Polymeric [25] Silicon naphthalocyanine loaded PEG-PCL Endometriosis Polymeric [26] Ultra-small Super-magnetic iron oxide nanoparticles Endometriosis Metal-based [27] Hyaluronic acid modified iron oxide nanoparticles Endometriosis Metal-based with Polymeric modification [28] NaGdF4@PEG@bevacizumab-Cy5.5 nanoparticles Endometriosis Metal-based with Polymeric modification [29] Gold nanoparticles conjugated with a fluorescein isothiocyanate dye Endometriosis Metal-based [30] Iron oxide-based magnetic nanoparticles encapsulated into PEG-PCL-based nanocarriers targeting VEGF 2 Endometriosis Metal-based with Polymeric modification [10] SiRNA RGD1-R6 nanoparticle carriers Endometriosis Polymeric [31] Cerium oxide nanoparticles Endometriosis Metal-based [32] Methotrexate carried in lipid nanoparticles Endometriosis Lipid-based [33] Albumin-glucose oxidase-nanoparticles Endometriosis Lipid-based [34] NiCosO4/rGO modified indium tin oxide nanomaterial PCOS Metal-based [35] CS/copper-NPs/Fe3O4-NPs/GrO-NPs nanocomposite PCOS Metal-based [36] Silver nanoparticles derived from Cinnamomum zeylanicum PCOS Metal-based [37] Curcumin-encapsulated arginine and N-acetyl histidine-modified CS PCOS Polymeric [11] Micellar nanoparticle estradiol emulsion Menopause Polymeric [38] Nanostructured transdermal hormone replacement therapy Menopause Lipid-based [12] E2-loaded PLGA nanoparticles Menopause Polymeric [40] Solid lipid nanoparticles Menopause Lipid-based [41] CS nanoparticles loaded with RLX Menopause Metal-based [42] RLX-loaded polymeric nanoparticles Menopause Polymeric [43] Human serum albumin-based nanoparticles Menopause Polymeric [44] RLX bio adhesive nanoparticles Menopause Polymeric [45] 3. Uterine Leiomyoma ...

Pilot study of treatment of patients with deep infiltrative endometriosis with methotrexate carried in lipid nanoparticles

Archives of Gynecology and Obstetrics