Objective
Several controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility‐sparing treatment of ...cervical cancer.
Methods
The consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants.
Results
The questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti‐stenosis device, and uterine transposition).
Conclusions
As very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.
Background
Approximately 70% of cancer‐related deaths occur in low‐ and middle‐income countries. In addition to social and racial inequalities, treatment options in these countries are usually ...limited because of the lack of trained staff and equipment, limited patient access to health services, and a small number of clinical guidelines.
Objectives
The Brazilian Society of Surgical Oncology developed this guideline to address these barriers and guide physicians treating patients with endometrial cancer (EC) in regions with limited resources and few specialized centers.
Methods
The guideline was prepared from 10 January to 25 October 20192019 by a multidisciplinary team of 56 experts to discuss the main obstacles faced by EC patients in Brazil. Thirteen questions considered critical to the surgical treatment of these patients were defined. The questions were assigned to groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments for presentations in meetings, classified the level of evidence, and voted on the recommendations.
Results
For all questions including staging, fertility spearing treatment, genetic testing, sentinel lymph node use, surgical treatment, and other clinical relevant questions, major agreement was achieved by the participants, always using accessible alternatives.
Conclusions
It is possible to provide adequate treatment for most EC patients in resource‐limited areas, but the first option should be referral to specialized centers with more resources.
Peptic ulcer is considered a public health problem associated with loss of quality of life. Does not exist optimal therapeutic regimen. The search for alternative treatments using foods or plants ...that may assist in gastric protection may become marked in this population because of their easy access and low cost.
To study the antiulcerogenic activity of extracts of Orbignya phalerata (babaçu) and Euterpe edules (juçara) in Wistar rats after induction of peptic ulcer, compared with Omeprazole.
Forty Wistar rats were distributed into four groups: group I, II, III, IV (10 rats each) subjected to extract of Orbignya phalerata, Euterpe edules, Omeprazole and ethanol, respectively. Each group of 10 rats was divided into subgroups of five for prophylaxis and therapeutic study.
The pre-treatment with juçara extract has provided a significant protection against peptic ulcer induced by ethanol. In the prophylactic subgroup, Omeprazole resulted in protection. In addition to protection against peptic ulcer, inflammation and neocapillarization were also variables with a statistical significance in the prophylaxis subgroups using omeprazole and juçara. In the therapeutic subgroup, omeprazole, juçara and babaçu were statistically different as for protection against the presence of inflammation and the healing of ulcers.
The extracts of juçara and babaçu behaved as the omeprazole, evidencing the therapeutic activity of these extracts.
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