This prospective observational study was designed to determine the percentage of hysterectomies avoided following insertion of a levonorgestrel-releasing intrauterine system (LNG-IUS) in perimenopausal women with uterine fibroids and a prior indication for surgery. The study also compared the progress of patients using the LNG-IUS with those submitted to hysterectomy, with particular emphasis on the patient's satisfaction with treatment. Sixty perimenopausal patients with uterine fibroids and excessive bleeding referred for hysterectomy were included. After counseling on the possibility of non-surgical treatment, 39 patients opted to use an LNG-IUS while 21 opted for hysterectomy. Continuation of LNG-IUS use and the patient's satisfaction with the chosen procedure were assessed. A secondary analysis evaluated hemoglobin levels, clinical complications, bleeding patterns and uterine volume at ultrasonography over time. After 24 months of follow-up, four of the patients who had opted to use an LNG-IUS were submitted to surgery, while 35 continued using the device, thus avoiding hysterectomy in 89.5% of cases. LNG-IUS users were more satisfied with treatment (p = 0.02) compared to those submitted to hysterectomy. In conclusion, the use of the LNG-IUS enables the number of hysterectomies to be reduced in women with uterine fibroids and is associated with greater satisfaction compared to surgical treatment.

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Providing information on breast cancer risk using examples that quantify the incidence of the disease provokes less concern in users and candidate users of HT. Changes of opinion occur when explanations regarding the risk are provided as RR, AbR and AR.

This study evaluated patients' knowledge on the risk of venous thromboembolism (VTE) associated with combined oral contraceptives (COCs) and their perception of this risk when it is presented as a relative risk (RR), absolute risk (AbR) or attributable risk (AR). This was a cross-sectional study involving 159 users or potential users of COCs. The participants answered a self-administered questionnaire in which the risk of VTE associated with COCs was presented as RR, AbR and AR. The degree of concern expressed regarding this risk and the women's changes of opinion when the information was communicated through a different risk model were evaluated. Most of the women (67.9%) expressed concern when the risk was presented as an RR. Conversely, they showed no concern when the risk was presented as an AbR (14.5%) or AR (10.7%). A significant number of women changed their opinion regarding their level of concern when the risk was presented as an AbR or AR (p < 0.001). In conclusion, concerns about thrombotic complications from the use of combined hormonal contraception is reduced when incidence rather than relative risk is presented. Presentation of thrombosis complications in terms of incidence rather than RR may improve communication of side effects during counseling for combined hormonal contraception initiation.

Objetivo: Analisar e revisar os principais artigos disponíveis sobre a colangiorressonância no diagnóstico da coledocolitíase. Revisão bibliográfica: A colangiorressonância tem sido usada com maior frequência no diagnóstico das complicações da colelitíase. É útil na avaliação do ducto biliar intra e extra-hepático, bem como do ducto pancreático. Além disso, é fundamental no diagnóstico de colangite esclerosante primária ou secundária. Estudos apontaram a acurácia da colangiorressonância na avaliação das doenças que acometem a via biliar, sobretudo, dos segmentos biliares anatomicamente mais proximais, isto é, daqueles que estão juntos ao hilo hepático e a árvore intra-hepática. A ausência da necessidade rotineira de sedação e da exposição à radiação, faz com que esse método seja uma opção atrativa no diagnóstico da coledocolitíase. Considerações finais: A partir deste estudo, foi possível identificar que a colangiorressonância é uma opção efetiva com sensibilidade e especificidade elevadas para avaliar o ducto biliar intra e extra-hepático, bem como o ducto pancreático. Além de ser fundamental no diagnóstico de colangite esclerosante primária ou secundária. Por conseguinte, quando bem indicada, permite um diagnóstico preciso e melhora a qualidade de vida do paciente.