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IntroductionThe aim of this study was to evaluate the dimensions of the vaginal canal in patients undergoing gynaecological brachytherapy and the effect of the use of vaginal dilators (VD) used in the follow-up of pelvic physiotherapy.MethodsA total of 88 patients were randomly allocated to the control group (CG) and intervention group (IG). Three evaluations were performed: pre-brachytherapy, post-brachytherapy and follow-up of 3 months. The CG received standard guidance from the health team while the IG was instructed to use VD for 3 months. The dimensions of the vaginal canal (main outcome) were defined by the length of the vagina (centimetres), width (number of full clockwise turns of the opening thread of a gynaecological speculum) and area (defined by the size of the VD). Quality of life and pelvic floor (PF) functionality were also evaluated.ResultsThere was no effect of the VD on vaginal length, width and area among the intention-to-treat (ITT) population. However, in the analysis stratified by adhesion, the CG had a significant decrease in the vaginal area. PF was predominantly hypoactive throughout the follow-up. Quality of life improved in both groups, but the reduction of constipation, vaginal dryness and stress urinary incontinence manifested only in the IG.ConclusionThe use of VD did not alter the dimensions of the vaginal canal within the first 3 months after the end of radiotherapy treatment. However, there was a large sample loss during follow-up so studies with a larger sample number and longer follow-up time need to be conducted.Trial RegistrationClinicalTrials.gov Identifier NCT03090217.Electronic Supplementary MaterialThe online version of this article (10.1007/s12325-019-01006-4) contains supplementary material, which is available to authorized users.

Introdução: A obesidade tem provocado diversos agravos à saúde, impulsionada pela industrialização, avanços tecnológicos, urbanização e estilo de vida; esses aspectos estão relacionados com disfunções cardiovasculares. Diversos fatores estão associados aos problemas saúde da população, os quais podem ser previamente identificados com técnicas simples, como medidas antropométricas e escores de risco, usadas para determinar possíveis riscos. Objetivo: Relacionar variáveis antropométricas com o Escore de Risco de Framingham (ERF) em trabalhadores rurais. Métodos: Estudo transversal com 138 trabalhadores rurais, submetidos ao questionário de estilo de vida, avaliação antropométrica, bioquímica, cardiovascular e determinação do ERF. A antropometria foi estimada com os indicadores índice de massa corporal, circunferência da cintura (CC), relação cintura-quadril (RCQ), índice de conicidade (IC) e razão circunferência cintura-estatura (RCEst); o perfil bioquímico identificou colesterol total, colesterol HDL, colesterol LDL, triglicerídeos e glicemia; a função cardiovascular foi avaliada pela pressão arterial sistólica e pressão arterial diastólica em repouso. A partir das informações, os sujeitos foram classificados segundo o ERF em G1 (baixo risco), G2 (risco intermediário) e G3 (alto risco). As análises estatísticas constaram de frequência e percentual, comparação de médias pelo teste Kruskal-Wallis, e correlação de Pearson ou Spearman, considerando p < 0,05. Resultados: Com relação aos ERF, 81,4% sujeitos do sexo feminino e 51,9% do masculino apresentaram baixo risco cardiovascular, com mais da metade dos trabalhadores com respostas inadequadas nos parâmetros RCQ (58,7%), RCEst (67,4%), CT (58,0%) e LDL (52,9%). Na relação do total de pontos absolutos do ERF com as variáveis antropométricas, CC e RCEst demonstraram correlações fracas (0,293 e 0,175, respectivamente) e RCQ e IC, correlações moderadas (0,475 e 0,459, respectivamente (0.293 and 0.175, respectively) and WHR and CI showed moderate correlations (0.475 and 0.459, respectively

Introduction:Ovarian cancer is the leading cause of death among gynecological malignancies. Its usual clinical manifestation is at advanced stages, with nutritional impairment, weight loss, and a consequent decline in skeletal muscle mass and strength (defined as sarcopenia). The relationship between sarcopenia and decreased survival was demonstrated not only in ovarian cancer but also in other cancer types, such as hepatocellular, pancreatic, lung, colon, cervical, metastatic breast, and renal cancer. The aim of this study is to review the current evidence regarding the relationship between sarcopenia and the surgical and oncological outcomes in ovarian cancer patients.Methods:The systematic search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRSIMA) statement. The terms “SARCOPENIA” AND “OVARIAN CANCER” were systematically used to search PubMed and Scopus databases. Original reports in English language were identified, with the purpose to include all relevant papers regarding the role of sarcopenia and indicators of skeletal muscle quality assessment in gynecological ovarian cancer.Results:A total of 9 studies were considered eligible for the present review. The strength of recommendation was moderate and the level of evidence was low in all selected articles. No prospective studies were conducted and most of the papers were case-control series comparing ovarian cancer sarcopenic population vs. non sarcopenic population.Conclusion:Sarcopenia appears to have an important role in oncological outcomes of ovarian cancer patients. However, sarcopenia occurrence during disease history and mechanisms underlying the possible impairment in prognosis should be better investigated. Prospective trials are awaited in order to obtain a better insight in this topic.

Although female sexual dysfunctions are common among women with urogynecological conditions, they have not been thoroughly studied and there are still many questions without an answer. The recent evidence on sexual disorders in women with urogynecological diseases shows a quite wide spectrum of therapeutic approaches, which require the physicians to take into account not only the primary symptoms, but also all the associated factors negatively affected. It has been widely underlined that gynecological diseases are often associated with high stress and have a negative impact on quality of life and psychological well-being of women affected. For this reason, a multidisciplinary approach for the management of these diseases is highly recommended. Also in the case of urogynecological disorders, it is important to take into account psychological outcomes throughout the diagnostic and therapeutic process. In the light of these considerations, the aim of this short review is to evaluate the impact of the main urogynecological diseases and the currently available therapeutic options in order to improve quality of life and sexuality of these patients and to stress the need for a multidisciplinary approach in order to minimize the negative consequences of these diseases for the sexual well-being of women and their partners.

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