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BackgroundThe complications inherent to conization include vaginal bleeding, cervical stenosis, amenorrhea, dysmenorrhea, and deep dyspareunia. Cervical stenosis is the most important complication due to the clinical repercussions. Studies show rates of cervical stenosis ranging from 1.3 to 19% after the Loop Electrosurgical Excision Procedure (LEEP).ObjectiveOur primary outcome was to compare the role of a new endocervical device to prevent cervical stenosis after LEEP in patients with high-grade squamous intraepithelial lesions (HSILs).MethodsA randomized clinical trial was performed including phases II and III for evaluation of a new device for cervical stenosis prevention. In Phase II, we included 25 patients who underwent LEEP and placement of the device to assess its toxicity and efficacy. In phase III, we compared two groups (with and without the use of an anti-stenosis device) to evaluate its efficacy and safety.ResultsFrom August 2015 to June 2018, 265 participants were randomized (Phase II: 25, Phase III: 120 with DUDA and 120 without DUDA). The toxicity during phase II was observed in only one patient (4%) with pain grade > 7. There were 7 cases of toxicity during Phase III, 2 in the DUDA group (1.8%), and 5 in the No DUDA group (4.5%). The complications rate was numerically higher in the No DUDA group (2.5x higher) than the DUDA group, but this difference did not reach statistical significance (p = 0.52). The rate of cervical stenosis in DUDA group was (4-7,3%), and in No DUDA group was (4.3-5.8%) (p = 0.5). We did not find a significant difference when comparing the evolution at 3, 6, and 12 months in terms of cervical patency and visualization of the squamocolumnar junction (SCJ) during colposcopy. The DUDA group exhibited 15% to 19% nonvisualization of the SCJ, whereas that rate ranged from 10 to 12% in the No DUDA group.ConclusionsThe rate of cervical stenosis was not different comparing the use of a new device, specifically produced to prevent cervical stenosis, compared to no use after LEEP procedure. This clinical trial opens up space for a discussion of the utility of using cervical stenosis devices after LEEP. Perhaps in another type of conization it can be evaluated to avoid cervical stenosis.

GoalTo assess the impact of chemoradiation on pelvic floor (PF) muscle function after the treatment of cervical cancer (CC).MethodsWe performed a prospective cohort study of women between the ages of 20 and 70 years old who had a diagnosis of CC. Patients were treated with chemoradiation at the Barretos Cancer Hospital (BCH), between August 2016 and July 2017. We performed three evaluations at different time points after chemoradiation treatment to compare changes in muscle function. Pelvic floor muscle function was assessed through perineometry (PNM) and surface electromyography (EMG) at the following time points: Pretreatment Moment 1 (M1): evaluated before chemoradiation; Moment 2 (M2): at the first follow-up medical visit (usually 3 to 4 months after treatment); and Moment 3 (M3): at the second follow-up medical visit (usually after 6 to 9 months after treatment). Mean vaginal squeeze pressure levels were determined by PNM and muscle electromyographic activity by EMG and the results were evaluated by Generalized Linear Model comparisons.ResultsForty-nine patients were evaluated at M1; 35 at M2; and 32 at M3, so that 32 patients had all three muscle evaluations performed. There was a statistically significant increase in the frequency of women with urgency urinary incontinence at the M2 evaluation time (41.9%), compared to pretreatment M1 (18.6%), pConclusionThese results show that chemoradiation causes reduction of muscle function of the pelvic floor, especially in the late phase after the end of treatment. Both the high BMI and urgent urinary incontinence symptoms were related to decreased muscle strength.

Cervical cancer is a significant public health problem, especially in low- and middle-income countries, where women have little access to cervical cancer screening; consequently 80% of cervical cancer related mortality occurs in these regions. The development of screening methods that need less infrastructure thus represents an urgent medical need. The study aims to compare the detection rates of high-risk human papillomavirus 16 and 18 E6 oncoprotein in urine, vaginal self-collected, and cervical scrapes of women using the OncoE6™ Cervical Test and compare the HPV16 and/or HPV18 E6 detection rates with the HPV DNA testing. Paired urine, vaginal self-collected and cervical specimens were collected from 124 women who participated in cervical cancer screening or treatment in this proof-of-concept study and underwent to HPV16/18-E6 testing and high-risk HPV DNA testing prior to treatment of cervical neoplasia or cancer. Concordance between urinary, vaginal and cervical HPV16/18-E6 and HPV-DNA testing was evaluated for patients classified as negative group (

BackgroundEndometrial cancer presents well-defined risk factors: myometrial invasion, histological subtype, tumor grade, lymphovascular space invasion (LVSI). Some low and intermediate-risk endometrioid endometrial cancer patients exhibited unexpected outcomes. This study aimed to investigate other clinical-pathological factors that might influence the recurrence rates of patients diagnosed with low and intermediate-risk endometrioid endometrial cancer.MethodsA case-control study from a cohort retrospective of 196 patients diagnosed with low and intermediate-risk endometrioid endometrial cancer at a single institution from 2009 to 2014 was conducted. Medical records were reviewed to compare clinical (race, smoking, menopause age, body mass index) and pathological (endometrioid vs endometrioid with squamous differentiation, tumor differentiation grade, tumor location, endocervical invasion, LVSI) features of patients with recurrence (case) and without recurrence (control) of disease. Three controls for each case were matched for age and staging.ResultsTwenty-one patients with recurrence were found (10.7%), of which 14 were stage IA, and 7 were stage IB. In accordance, 63 patients without recurrence were selected as controls. There were no significant differences in any clinical characteristics between cases and controls. Among pathological variables, presence of squamous differentiation (28.6% vs. 4.8%, p = 0.007), tumor differentiation grade 2 or 3 (57.1% vs. 30.2%, p = 0.037) and presence of endocervical invasion (28.6% vs. 12.7%, p = 0.103) were associated with disease recurrence on a univariate analysis. On multivariable analysis, only squamous differentiation was a significant risk factor for recurrence (p = 0.031).ConclusionOur data suggest that squamous differentiation may be an adverse prognostic factor in patients with low and intermediate-risk endometrioid endometrial cancer, that showed a 5.6-fold increased risk for recurrence.

O produtor de milho verde busca a profissionalização de sua produção, a fim de fornecer produtos de alta qualidade e em quantidade suficiente para suprir os mercados mais exigentes. Para se alcançar esse objetivo, devem ser adotadas técnicas de manejo que proporcionem altas produtividades sem que sejam afetadas negativamente as características comerciais. Com o objetivo de avaliar a aptidão de cultivares e o efeito da população de plantas na produção de milho verde, foi conduzido um experimento em Ponta Grossa, Estado do Paraná.Adotou-se o delineamento de blocos ao acaso, em esquema de parcelas subdivididas, sendo os tratamentos principais as cultivares (Penta, 30P34, DKB 214 e SWB 551) e os secundários as populações de plantas (3,5; 5,0; 6,5; 8,0 e 9,5 plantas m-2). Foram caracterizados a forma da espiga, o comprimento da espiga empalhada, o comprimento de granação, o diâmetro da espiga despalhada, a massa fresca da espiga despalhada, a profundidade de grãos, a porcentagem de espigas comerciais e o número de espigas comerciais. Os resultados demonstraram que as cultivares 30P34, DKB 214 e SWB 551 são aptas à produção de espigas verdes, suas maiores produtividades são esperadas nas populações de 38.983, 59.866 e 43.591 plantas ha-1, e o aumentoda população de 3,5 para 9,5 plantas m-2 influencia negativamente todas as características da espiga que foram avaliadas, excetuando-se a forma. Entre as cultivares, a DKB 214 apresentou a maior porcentagem e o maior número de espigas comerciais ha-1. The producers of green corn aim at the professionalization of their production, providing highquality products and in sufficient quantity to supply the most demanding markets. To achieve this goal, management techniques must be adopted to provide high yields without negatively affecting commercial traits. Aiming at evaluate the aptitude of cultivars and plant population effect on green corn yield, an assay was carried out in Ponta Grossa, Paraná State. Randomized blocks in a split-plot scheme were adopted as the experimental design. Cultivars (Penta, 30P34, DKB 214 and SWB 551) were primary and plant populations (3.5, 5.0, 6.5, 8.0 and 9,5 plants m-2) were secondary treatments. Ear shape, length of unhusked ear, length of kernel set, diameter of husked ear, fresh weight of husked ear, kernel size, percentage of marketable husked ears, andnumber of marketable husked ears were characterized. The results demonstrated that 30P34, DKB 214, and SWB 551 are able to yield green ears and their higher yields are expected when grown in plant populations of 38,983, 59,866 and 43,591 plants ha-1, respectively. Increasing plant population negatively influences all evaluated ear traits, except shape. DKB 214 cultivar had higher percentage and number of marketable husked ears.

O produtor de milho verde busca a profissionalização de sua produção, a fim de fornecer produtos de alta qualidade e em quantidade suficiente para suprir os mercados mais exigentes. Para se alcançar esse objetivo, devem ser adotadas técnicas de manejo que proporcionem altas produtividades sem que sejam afetadas negativamente as características comerciais. Com o objetivo de avaliar a aptidão de cultivares e o efeito da população de plantas na produção de milho verde, foi conduzido um experimento em Ponta Grossa, Estado do Paraná. Adotou-se o delineamento de blocos ao acaso, em esquema de parcelas subdivididas, sendo os tratamentos principais as cultivares (Penta, 30P34, DKB 214 e SWB 551) e os secundários as populações de plantas (3,5; 5,0; 6,5; 8,0 e 9,5 plantas m-2). Foram caracterizados a forma da espiga, o comprimento da espiga empalhada, o comprimento de granação, o diâmetro da espiga despalhada, a massa fresca da espiga despalhada, a profundidade de grãos, a porcentagem de espigas comerciais e o número de espigas comerciais. Os resultados demonstraram que as cultivares 30P34, DKB 214 e SWB 551 são aptas à produção de espigas verdes, suas maiores produtividades são esperadas nas populações de 38.983, 59.866 e 43.591 plantas há-1, e o aumento da população de 3,5 para 9,5 plantas m-2 influencia negativamente todas as características da espiga que foram avaliadas, excetuando-se a forma. Entre as cultivares, a DKB 214 apresentou a maior porcentagem e o maior número de espigas comerciais há-1.

Abstract Objective To describe a series of cases of ovarian Sertoli-Leydig cell tumors (SLCTs). Methods Retrospective review of 12 cases of SLCT treated at the Hospital do Câncer de Barretos, Barretos, state of São Paulo, Brazil, between October 2009 and August 2017. Results The median age of the patients was 31 years old (15-71 years old). A total of 9 patients (75.0%) presented symptoms: 8 (66.7%) presented with abdominal pain, 5 (41.7%) presented with abdominal enlargement, 2 (16.7%) presentedwith virilizing signs, 2 (16.7%) presented with abnormal uterine bleeding, 1 (8.3%) presented with dyspareunia, and 1 (8.3%) presented with weight loss. The median preoperative lactate dehydrogenase (LDH) was 504.5 U/L (138-569 U/L), alpha-fetoprotein (AFP) was 2.0 ng/ml (1.1-11.3 ng/ml), human chorionic gonadotropin (β-hCG) was 0.6 mUI/ml (0.0-2.3 mUI/ml), carcinoembryonic antigen (CEA) was 0.9 ng/ml (0.7-3.4 ng/ml), and cancer antigen 125 (CA-125) was 26.0 U/ml (19.1-147.0 U/ml). All of the tumors were unilateral and surgically treated. Lymphadenectomy was performed in 3 (25.0%) patients, but none of the three patients submitted to lymphadenectomy presented lymph node involvement. In the anatomopathological exam, 1 (8.3%) tumor was well-differentiated, 8 (66.7%) were moderately differentiated, and 3 (25.0%) were poorly differentiated. A total of 5 (55.6%) tumors were solid-cystic, 2 (22.2%) were purely cystic, 1 (11.1%) was cystic with vegetations, and 1 (11.1%) was purely solid, but for 3 patients this information was not available. The median lesion size was 14.2 cm (3.2-23.5 cm). All of the tumors were at stage IA of the 2014 classification of the International Federation ofGynecology andObstetrics (FIGO). A total of 2 (16.7%) patients received adjuvant treatment; 1 of themunderwent 3 cycles of paclitaxel and carboplatin every 21days, and the other underwent 4 cycles of ifosfamide, cisplatin and etoposide every 21 days. None of all of the patients had recurrence, and one death related to complications after surgical staging occurred. Conclusion Abdominal pain was the most frequent presentation. There was no ultrasonographic pattern. All of the SLCTs were at stage IA, and most of them were moderately differentiated. Relapses did not occur, but one death related to the surgical staging occurred.