OBJECTIVE:To evaluate the influence of pain on quality of life in breast cancer patients.METHODS:A cross-sectional study of 400 patients, including 118 without metastasis, 160 with loco-regional metastasis and 122 with distant metastasis. The instruments used were the European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Core 30 and the Breast Cancer-specific 23 and short McGill Pain Questionnaire.RESULTS:In total, 71.7% of patients reported pain. The most frequent sensory descriptor used by patients was ‘jumping.’ In the evaluative dimension, the main descriptor chosen was troublesome. The Global Health self-assessment showed pain to be inversely correlated with quality of life: the group without metastasis had a mean score of 55.3 (SD=24.8) for those in pain, which rose to 69.7 (SD=19.2) for those without pain (p=0.001). Subjects with loco-regional metastasis had score of 59.1 (SD=21.3) when in pain, and those without pain had a significantly higher score of 72.4 (SD=18.6) (p<0.001). Patients from the distant metastasis group showed similar results with a mean score of 48.6 (SD=23.1) for those in pain and 67.6 (SD=20.4) for those without pain (p=0.002). Regarding the association of pain intensity and quality of life, patients with distant metastasis and intense pain had the worst scores for quality of life with a functional scale mean of 49.9 (SD=17.3) (p<0.009), a Symptom Scale score of 50.0 (SD=20.1) (p<0.001) and a Global Health Scale score of 39.7 (SD=24.7) (p<0.006).CONCLUSIONS:Pain compromises the quality of life of patients with breast cancer, particularly those with advanced stages of the disease.

To identify pregnancy as a causative factor of sexual dysfunction among expectant women. A prospective study with 225 expectant mothers seen in the prenatal clinic of a federal university. Sexual function was evaluated by means of the Female Sexual Function Index (FSFI), and all domains were analyzed (desire, arousal, lubrication, orgasm, satisfaction, and pain). Initially, a univariate analysis of the sample was done. The averages for each domain according to the risk of sexual dysfunction (FSFI ≤ 26.5) were compared using the Student's-test for independent samples. The strength of the correlation between sexual dysfunction and all sociodemographic, clinical and behavioral variables was measured by the Chi-Square (χ) test. Then, odds ratios (ORs) and their confidence intervals were assigned to perform a bivariate analysis. Any values less than 0.05 were considered significant. Approximately two-thirds of the women (66.7%) showed signs of risk of sexual dysfunction (FSFI ≤ 26.5). Within these cases, all sexual dysfunction domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were found to be statistically significant ( < 0.001). The domains most affected were desire (2.67), satisfaction (2.71) and arousal (2.78). Pregnancy appears to be an important causative factor of sexual dysfunction among pregnant women.

IntroductionThe number of patients taking oral chemotherapy is increasing around the world. It is essential to maximise the adherence to oral chemotherapy to improve the overall survival and life expectancy of the patients. In this systematic review and meta-analysis, we aim to evaluate the effectiveness of mobile applications in improving the adherence to oral chemotherapy and adjuvant hormonal therapy in cancer survivors.Methods and analysisMEDLINE, Embase, LILACS, clinicaltrials.gov, Scopus and the Cochrane Central Register of Controlled Trials will be searched for randomised or quasi-experimental studies published between January 2009 and July 2019. This systematic review and meta-analysis will include studies investigating the use of mobile applications by cancer survivors to aid adherence to oral chemotherapy and adjuvant hormonal therapy. Patient education, reminder tools, calendars, pillboxes and electronic reminders will not be evaluated. The primary outcome will be the improvement in adherence to anticancer drugs. The secondary outcomes will be an improvement in the overall survival and life expectancy, improved quality of life and control of cancer-related symptoms. Three independent reviewers will select the studies and extract data from the original publications. The risk-of-bias will be assessed using the Cochrane risk-of-bias tool. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will compute the I2 statistics. Additionally, a quantitative synthesis will be performed if the included studies are sufficiently homogenous.Ethics and disseminationThis study will be a review of the published data, and thus, ethical approval is not required. Findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018102172.

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Introdução: O rabdomiossarcoma de órbita é uma neoplasia essencialmente de crianças e adultos jovens, que ocorre na maioria dos vezes em pessoas com menos de 15 anos. Há poucos casos descritos na literatura do diagnóstico durante gestação. Relato de caso: Paciente de 16 anos, encaminhada para realizar o pré-natal de alto risco em razão do diagnóstico de rabdomiossarcoma em órbita direita, com metástase para linfonodos e parótida. Foi diagnosticada com 14,2 semanas de gestação no hospital de infectologia, quando foi admitida por lacrimejamento, aumento de volume ocular, dor ocular direita e alteração visual (diminuição da acuidade e diplopia) havia um mês. Prescreveram-se ceftriaxona, oxacilina e dexametasona por sete dias, sem melhora. Realizaram-se tomografia de crânio, que visualizou lesão expansiva em região de órbita direita, com proptose ocular e destruição óssea adjacente, e biópsia com imuno-histoquímica que demonstrou rabdomiossarcoma alveolar. A paciente foi encaminhada para seguimento no serviço de oncologia e obstetrícia de alto risco. Na primeira consulta estava com 22,4 semanas e havia realizado três sessões de quimioterapia semanal com vincristina + carboplatina + doxorrubicina desde 5 de novembro de 2020 em hospital de oncologia, e havia proposta de fazer mais cinco sessões antes da interrupção da gestação, programada inicialmente para 28 semanas pela equipe da oncologia. A paciente realizou ultrassonografia morfológica em 2 de dezembro de 2020, que mostrou morfologia normal e exames laboratoriais sem alterações. Durante o acompanhamento pré-natal, houve crescimento fetal adequado, assim como boa vitalidade fetal em exames clínicos e ultrassonográficos. O último ciclo de quimioterapia deu-se em 25 de janeiro de 2021, e foi programada a interrupção da gravidez para 12 de fevereiro de 2021, quando seriam completadas 34 semanas. Prescreveu-se betametasona para corticoterapia anteparto para amadurecimento pulmonar em 9 de fevereiro de 2021, e a paciente foi internada no dia 10 de fevereiro para a programação de cesárea, que foi efetuada no dia 12, com recém-nascido vivo, do sexo masculino, Apgar 9/9, com cuidados de pediatra imediatos após clampeamento oportuno do cordão umbilical. Apresentou peso de 2150 g, estatura de 44 cm e perímetro cefálico de 31 cm. A paciente evoluiu bem durante puerpério imediato e referia estar emocionalmente estável, com estratégias de enfrentamento adaptativas. Foi contraindicada a amamentação. O recém-nascido estava adequado para a idade gestacional, inicialmente sem alterações ao exame físico, com baixo peso, e apresentou icterícia durante os primeiros dias de vida, necessitando de realização de fototerapia. Realizou teste do coraçãozinho normal em 14 de fevereiro de 2021. Após sete dias mãe e filho receberam alta, com programação de nova sessão de quimioterapia para 22 de fevereiro. Conclusão: A presença de proptose acompanhada de sinais de inflamação de início agudo é comumente causada na infância e adolescência por celulite orbitária, porém deve sempre ser considerada a hipótese diagnóstica de rabdomiossarcoma, haja vista a dificuldade de diferenciar ambos os diagnósticos com base em achados clínicos.

IntroductionSexual dysfunction in the postpartum period is a very common and relevant clinical problem, which has a significant adverse impact on the health of women. We aim to analyse the efficacy and safety of non-pharmacological interventions for treating sexual dysfunction in postpartum women. Our review aims to provide accurate data for effective policy-making and improve our understanding of the treatment of postpartum sexual dysfunction with non-pharmacological therapies.Methods and analysisThe Cochrane Central Register of Controlled Trials in The Cochrane Library, clinicaltrials.gov, Medline/PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), LILACS (Literatura Latino-americana e do Caribe em Ciências da Saúde) and Embase will be used to search for articles dated from database inception to July 2019. Randomised controlled clinical trials and large prospective cohorts with control groups using non-pharmacological treatments for sexual dysfunction in postpartum women will be included. Sexual problems are directly linked to sexual dysfunction; thus, the primary outcome will be the absolute number or percentage of sexual issues in each treatment group. The secondary outcomes will be assessed by decreased sexual problems, such as lack of lubrication, decreased libido and difficulty reaching orgasm. Three reviewers will independently select trials and extract data from the original publications. The citations will be screened independently by reviewers in duplicate. The risk of bias of the included studies will be assessed according to the Cochrane risk of bias tool. Data synthesis will be performed using Review Manager (RevMan) software V.5.2.3. In the event that a meta-analysis is possible, we will assess the heterogeneity across the studies by computing the I2statistic.Ethics and disseminationAs the design of this study includes a review of published data, the need to obtain ethical approval was waived by our institutional review committee. We intend to publish the findings of this systematic review in a peer-reviewed journal.PROSPERO registration numberCRD42018103077.

IntroductionThe use of social networks has been increasing worldwide. Mobile websites and applications (apps) allow people to network more quickly and have more partners for sex. This can facilitate risky sexual behaviours, such as having multiple partners and unprotected sex, which can lead to a higher incidence of sexually transmitted infections. This systematic review/meta-analysis will assess the effects of the use of dating sites and apps by women on their level of engagement in risky sexual behaviours and their incidence of sexually transmitted infections.Methods and analysisThe Cochrane Central Controlled Trials Registry, ClinicalTrials.gov, MEDLINE, Embase, SciELO, Web of Science, Scopus and Cumulative Index to Nursing & Allied Health Literature will be searched for cross-sectional studies, clinical trials and observational studies published between January 1990 and July 2020. This systematic review and meta-analysis will include studies investigating the use of mobile apps by women, risky sexual behaviour and sexually transmitted infections. The outcome will be an increase in new cases of sexually transmitted infections and HIV among women using dating sites and apps. Three independent reviewers will select the studies and extract data from the original articles. The risk of bias will be assessed using the Cochrane risk of bias tool and Risk Of Bias in Non-randomized Studies of Interventions. Data synthesis will be performed using Review Manager software (RevMan V.5.2.3). To assess heterogeneity, we will compute the I2 statistic. In addition, a quantitative synthesis will be carried out if the included studies are sufficiently homogeneous.Ethics and disseminationThis study will be a review of the published data, and thus ethical approval is not required. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019120494.