Introduction: twin-to-twin transfusion syndrome (TTTS), defined by combination of polyhydramnios-oligohydramnios, is the most prevalent (5%-35%) of the abnormalities due to placental vascular anastomoses and the most lethal (80%-100% mortality) if untreated. Fetoscopic laser ablation of abnormal vasculature using the Solomon technique is the gold standard approach. It consists of interrupting the intertwin blood flow. Objectives: to present our initial experience at the Fetal Surgery Service of the Hospital de Clinicas of the Federal University of Parana (HC-UFPR) and to compare our results with those reported in the literature. Methods: we conducted a retrospective analysis of pregnancies who had undergone laser ablation, assessing data on Quintero’s staging, gestational age at diagnosis and at the time of the procedure, placental position, immediate post-procedure survival, and survival after the neonatal period. We then compared these data with the most recent data available in the literature. Results: we analyzed ten TTTS cases. The diagnosis was performed before the 26th week of pregnancy (median 20.8 weeks) and treatment occurred in a median of 9.5 days later. The distribution by the Quintero’s staging was of three cases in stage II, five in stage III, and two in stage IV. In 50% of the gestations, at least one of the fetuses survived through the neonatal period. Conclusion: the treatment of TTTS in the HC-UFPR had a positive impact in the survival of the affected fetuses, although the results were worse than the ones reported in the literature, probably due to the delay in referencing the patients to our service, leading to a prolonged interval between diagnosis and treatment.
European Journal of Breast Health (Eur J Breast Health) is an international, scientific, open access periodical published by independent, unbiased, and double-blinded peer-review principles. It is the official publication of the Turkish Federation of Breast Diseases Societies, and Senologic International Society is the official supporter of the journal.
O gene IFNG codifica o Interferon-γ (IFN-γ), molécula que exerce papel de destaque na defesa imunológica e atua como citocina, ativando células fagocíticas que destroem agentes invasores. Camundongos com a deleção do gene que codifica para o seu receptor, assim como a sua deficiência de IFN-γ, são muito mais susceptíveis a micobactérias e outros patógenos intracelulares. Sua expressão tem de ser estritamente regulada, para que a resposta proinflamatória não cause a destruição dos próprios tecidos. Esta regulação ocorre pela metilação do DNA na região promotora do gene, e por variantes alélicas, que modulam a afinidade por proteínas reguladoras. Dentre estas últimas, destaca-se uma variante intrônica, associada com a susceptibilidade à tuberculose e hanseníase, duas doenças que ainda representam, no Brasil, grave problema de saúde pública.
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