Fasting Glucose for the Diagnosis of Gestational Diabetes Mellitus (GDM) during the COVID-19 Pandemic.

Background: During the COVID-19 pandemic, different non-validated tests were proposed to simplify the diagnosis of gestational diabetes (GDM). Aim: To analyse the effects of replacing the two-step approach for Early-GDM and GDM diagnosis, with a fasting plasma glucose test. Material and Methods: This is a cohort study consisting of 3200 pregnant women: 400 with Early-GDM, 800 with GDM and 2000 with Non-GDM diagnosed using the two-step approach. Using fasting plasma glucose for Early-GDM and GDM diagnosis, according to the recommendations of Spain, Australia, Italy and the UK during the pandemic, the rates of missed and new Early-GDM and GDM were calculated and perinatal outcomes were analysed. Results: Using fasting plasma glucose in the first trimester >100 mg/dL for Early-GDM diagnosis, the rates of post-COVID missed and new Early-GDM were 79.5% and 3.2%, respectively. Using fasting plasma glucose at 24−28 weeks <84 or >92, 95 or 100 mg/dL for GDM diagnosis, the rates of missed GDM were 50.4%, 78%, 82.6% and 92.4%, respectively, and 8.6%, 5.6% and 2.3% women with Non-GDM were diagnosed with new GDM. Conclusion: Fasting plasma glucose is not a good test for the diagnosis of GDM either in the first trimester or at 24−28 weeks.

Adenocarcinoma villoglandular de cerviz / Villoglandular adenocarcinoma of the uterine cervix

El adenocarcinoma villoglandular de cérvix uterino es una neoplasia poco frecuente, con unas características histológicas y clínicas diferentes de otros tipos de adenocarcinomas de cérvix. No fue introducido en la clasificación de la Organización Mundial de la Salud hasta 1994. El tratamiento de este tipo de tumor debe ser, en la medida de lo posible, conservador si la paciente desea preservar su fertilidad, pues presenta buen pronóstico. Los hallazgos microscópicos son típicos e incluyen: crecimiento exofítico, superficie de aspecto papilar y de leve a moderada atipia nuclear. Presentamos 4 casos clínicos de esta entidad, uno de ellos con progresión y comportamiento agresivo (AU)

Villoglandular adenocarcinoma of the uterine cervix is a rare neoplasm, with histological and clinical features that distinguish it from other types of cervical adenocarcinomas. Until 1994, this entity was not included with the cervical carcinoma classification of the World Health Organization. The prognosis of this tumor is favorable and consequently treatment should be conservative as far as possible if the patient wishes to preserve fertility. Microscopic findings are typical and include exophytic growth, papillary surface and small-to-moderate nuclear atypia. We describe four cases of villoglandular adenocarcinoma, one of which showed aggressive progression (AU)

Enfermedad de Bowen vulvar. Relación con el virus del papiloma humano / Bowen's disease of the vulva: association with human papillomavirus

La enfermedad de Bowen vulvar o neoplasia vulvar intraepitelial (VIN) es una lesión preinvasora en los genitales externos. La VIN de etiología viral está relacionada con la infección por virus del papiloma humano (VPH) (principalmente los serotipos 16 y 18), sobre todo a edades tempranas y en relación con cambios en la conducta sexual. Presentamos el caso clínico que corresponde a una paciente joven, portadora del VPH 16 y en control por neoplasia intraepitelial de cuello uterino tipo III (CIN III) tras una conización, que desarrolló una VIN extensa. Se realizó tratamiento quirúrgico (ninfectomía) sin recidiva a los 3 años y con buen resultado estético (AU)

Bowen’s disease of the vulva, also called vulvar intraepithelial neoplasia (VIN), is considered a premalignant lesion of the external genitalia. VIN of viral etiology is most often associated with human papillomavirus (HPV) subtypes 16 and 18 and typically occurs in younger premenopausal women. The main risk factor for HPV acquisition is sexual activity. We report the case of a young patient, a carrier of HPV subtype 16, with cervical intraepithelial neoplasia grade 3, who developed severe VIN. Wide local excision of the labia minora was performed. The cosmetic results were satisfactory and the patient has had no relapses after 3 years of follow-up (AU)