Vaginal Dilator and Pelvic Floor Exercises for Vaginal Stenosis, Sexual Health and Quality of Life among Cervical Cancer Patients Treated with Radiation: Clinical Report.

This clinical report aimed to evaluate the effectiveness of the combination of vaginal dilator (VD) and pelvic floor muscle exercises (PFME) on vaginal stenosis, sexual health and quality of life among women undergoing radiotherapy treatment for cervical cancer; PFME were instructed prior to radiotherapy with six-month follow-up. An intention-to-treat analysis was performed for the 28 women. At four-months after radiotherapy, most of the women (90.9%) maintained/increased one size of the VD and were sexually active (81.8%). Adherence to VD was high. Regarding quality of life, there was more limitation in emotional functioning. VD and PFME were effective at preventing stenosis.

Effect of estradiol on the expression of angiogenic factors in epithelial ovarian cancer.

INTRODUCTION: Ovarian cancer presents a high angiogenesis (formation of new blood vessels) regulated by pro-angiogenic factors, mainly vascular endothelial growth factor (VEGF) and nerve growth factor (NGF). An association between endogenous levels of estrogen and increased risk of developing ovarian cancer has been reported. Estrogen action is mediated by the binding to its specific receptors (ERα and ERß), altered ERα/ERß ratio may constitute a marker of ovarian carcinogenesis progression. OBJECTIVE: To determine the effect of estradiol through ERα on the expression of NGF and VEGF in epithelial ovarian cancer (EOC). METHODOLOGY: Levels of phosphorylated estrogen receptor alpha (pERα) were evaluated in well, moderate and poorly differentiated EOC samples (EOC-I, EOC-II, EOC-III). Additionally, ovarian cancer explants were stimulated with NGF (0, 10 and 100 ng/ml) and ERα, ERß and pERα levels were detected. Finally, human ovarian surface epithelial (HOSE) and epithelial ovarian cancer (A2780) cell lines were stimulated with estradiol, where NGF and VEGF protein levels were evaluated. RESULTS: In tissues, ERs were detected being pERα levels significantly increased in EOC-III samples compared with EOC-I (p<0.05). Additionally, ovarian explants treated with NGF increased pERα levels meanwhile total ERα and ERß levels did not change. Cell lines stimulated with estradiol revealed an increase of NGF and VEGF protein levels (p<0.05). CONCLUSIONS: Estradiol has a positive effect on pro-angiogenic factors such as NGF and VEGF expression in EOC, probably through the activation of ERα; generating a positive loop induced by NGF increasing pERα levels in epithelial ovarian cells.

[Survival of patients with vulvar cancer]. / Análisis de sobrevida en pacientes con diagnóstico de Cáncer de Vulva en el Instituto Nacional del Cáncer.

BACKGROUND: Vulvar cancer corresponds to 3 to 5% of all female reproductive tract malignancies. Therefore it is classified as a low frequency disease. AIM: To estimate overall and conditional survival one and two years after diagnosing women with vulvar cancer. MATERIAL AND METHODS: Retrospective cohort study. The patient database ofan oncological hospital was revised and patients with vulvar cancer diagnosed between 1997 and 2006 were selected. The clinical records of these women were reviewed. RESULTS: Eighty six women aged 32 to 92 years, were identified. Eighty percent had a squamous carcinoma, 46% were in stage III, 48% received incomplete treatment, 40% consulted due to the presence of a vulvar mass and 18% had lesions in labia majora or minora. Overall five years survival at 5 years was 41.8%. There were statistically significant differences in survival depending on the initial stage of cancer (p = 0.02). Five year conditional survival, one and two years after the diagnosis, was 59 and 79%, respectively. CONCLUSIONS: Five years overall survival of these group of women with vulvar cancer was 41.8%. The figures increased to 59 and 79% in patients who had survived one and two years after the diagnosis. The stage of the lesion and the initial survival are survival prognostic factors for vulvar cancer.

Estudio de laboratório y clínico con un nuevo progestageno combinado con etinil estradiol usado en anticoncepción / Laboratory and clinical study with a new progestogen combined with estradiol used in contraception

Se usó un anticonceptivo hormonal oral combinado que contiene etinil estradiol 0,03 mg y desogestrel 0,15 mg en 78 multíparas. Se analizaron clinicamente 705 ciclos de tratamiento. Se midieron con técnica de radioinmunoensayo los niveles de HDL-colesterol, LDL-colesterol, SHBG y testosterona libre plasmática en todas las mujeres al inicio del programa, 6 meses y 12 meses de uso del preparado. Se hace evidente un aumento de HDL-colesterol y SHBG y disminución del LDL-colesterol y testosterona libre. Se destaca la muy baja incidencia de efectos secundarios sobre las características del ciclo menstrual. El resto de los parámetros clínicos no difiere fundamentalmente de otros anticonceptivos hormonales combinados de baja dosis. Se discute la importancia de las variaciones de algunos parámetros bioquímicos inducidas por estrogénos y progestágenos en la génesis de enfermedad cardiovascular. Se concluye que las variaciones bioquímicas y hormonales inducidas probablemente por desogestrel serían beneficiosas, en el sentido de disminuir, por lo menos teóricamente, la incidencia de enfermedad cardiovascular