Background: The risk of recurrence of early-stage cervical cancer (CC) is associated with prognostic factors such as tumor size, lymphovascular space invasion (LVSI), and deep stromal invasion (DSI). However, the adjuvant pelvic radiotherapy (RT) following surgery to reduce the risk of recurrence in “intermediate risk” remains controversial. This study aims to evaluate the role of adjuvant RT in the recurrence and identify prognostic factors. Methods: A systematic search of PubMed, Embase, and Cochrane databases was performed to identify studies comparing adjuvant RT versus no adjuvant treatment in early-stage CC patients with intermediate-risk factors defined by GOG-92 criteria. Outcomes were recurrence, local recurrence, death, 5-year overall survival (5y-OS), and 5-year disease-free survival (5y-DFS). Tumor size ≥ 4 cm, LVSI, and DSI were also evaluated as prognostic factors for recurrence. Statistical analysis was performed using Review Manager 7.2.0. Heterogeneity was assessed with I² statistics. Results: A total of 1504 patients from nine studies were included; only one study was a randomized controlled trial, while the others were retrospective cohorts. Adjuvant RT was used to treat 781 patients (52%). Median follow-up ranged from 48 to 120 months. Recurrence (OR 0.75; 95% CI 0.38–1.46; p = 0.39), local recurrence (OR 0.73; 95% CI 0.44–1.20; p = 0.22), death (OR 0.97; 95% CI 0.52–1.80; p = 0.91), 5y-OS (OR 1.22; 95% CI 0.36–4.18; p = 0.75), and 5y-DFS (OR 0.78; 95% CI 0.42–1.43 p = 0.42) revealed no statistically significant differences between adjuvant RT and observation groups. TS ≥ 4 cm was an independent prognostic risk factor for recurrence (HR 1.83; 95% CI 1.12–2.97; p = 0.02). Conclusions: Our findings suggest that adjuvant RT does not reduce recurrence risk in early-stage cervical cancer. Consider TS ≥ 4 cm as a significant prognostic factor for recurrence. Adjuvant RT in intermediate-risk patients should be considered with caution due the lack of significant improvement in recurrence until the CERVANTES and GOG-0263 trial results become available.

OBJECTIVE: Psychological effects of the coronavirus disease 2019 (COVID-19) pandemic on pregnant women with diabetes and hypertension are not yet studied. Besides the pregnancy, these women have additional risk factors for severe acute respiratory syndrome due to COVID-19 and are considered a particularly vulnerable, unique population. We aimed to assess their mental health during this pandemic. METHODS: This is a cross-sectional study carried out at a Brazilian tertiary hospital. Women with pregnancies complicated by hypertension and/or diabetes were evaluated. The primary outcome was anxiety, and depressive symptoms evaluated with the State-Trait Anxiety Inventory and Patient Health Questionnaire. Perception of changing habits during quarantine was evaluated as a secondary outcome. RESULTS: Seventy-nine patients were included. The prevalence of State-Trait Anxiety Inventory >= 40 was 79.7% and that of Patient Health Questionnaire >= 10 was 59.2%. Lower social support was correlated with higher scores on both scales. Time spent with electronic devices was perceived as greater by 62% of the women. CONCLUSIONS: Pregnant women with diabetes and hypertension presented high levels of anxiety and depressive symptoms during the COVID-19 pandemic. Considering that these symptoms can affect both the mother's and offspring's health, it is necessary to implement tools to improve their mental health.

Background Obesity and overweight in childhood can increase the risk of developing cardiovascular disease throughout live. Objectives This study provides an update of a meta-analysis of randomized clinical trials (RCT) published in 2014, to assess the effects of physical activity interventions on preventing cardiovascular risk factors in childhood. Methods This update combines data from the previous search with new data obtained from June 2013 to June 2020. Searches were performed on PubMed, EMBASE and Cochrane CENTRAL. The RCTs enrolled [...] Abstract Background Obesity and overweight in childhood can increase the risk of developing cardiovascular disease throughout live. Objectives This study provides an update of a meta-analysis of randomized clinical trials (RCT) published in 2014, to assess the effects of physical activity interventions on preventing cardiovascular risk factors in childhood. Methods This update combines data from the previous search with new data obtained from June 2013 to June 2020. Searches were performed on PubMed, EMBASE and Cochrane CENTRAL. The RCTs enrolled

Objective: Placenta accreta spectrum (PAS) describes the failure of placental detachment. PAS is a pregnancy-associated life-threatening condition which increases hemorrhage risk. We evaluated safety and efficacy of internal iliac artery balloon occlusion (IIABOC) on bleeding volume among pregnant women with diagnosis or suspicion of PAS. Data source: We searched PubMed, Embase and Cochrane databases. […] Abstract Objective: Placenta accreta spectrum (PAS) describes the failure of placental detachment. PAS is a pregnancy-associated life-threatening condition which increases hemorrhage risk. We evaluated safety and efficacy of internal iliac artery balloon occlusion (IIABOC) on bleeding volume among pregnant women with diagnosis or suspicion of PAS. Data source: We searched PubMed, Embase and Cochrane databases. […]

Objective: Preterm birth is a leading global cause of neonatal mortality and morbidity, with oxidative stress playing a role in its pathogenesis. Vitamin C, a powerful antioxidant, may help reduce this risk. This study assessed the effectiveness of vitamin C supplementation, both alone and with vitamin E, in preventing preterm birth compared to a […] Abstract Objective: Preterm birth is a leading global cause of neonatal mortality and morbidity, with oxidative stress playing a role in its pathogenesis. Vitamin C, a powerful antioxidant, may help reduce this risk. This study assessed the effectiveness of vitamin C supplementation, both alone and with vitamin E, in preventing preterm birth compared to a […]