Abstract Effective patient positioning is a critical factor influencing surgical outcomes, mainly in minimally invasive gynecologic surgery (MIGS) where precise positioning facilitates optimal access to the surgical field. This paper provides a comprehensive exploration of the significance of strategic patient placement in MIGS, emphasizing its role in preventing intraoperative injuries and enhancing overall surgical success. The manuscript addresses potential complications arising from suboptimal positioning and highlights the essential key points for appropriate patient positioning during MIGS, encompassing what the surgical team should or shouldn't do. In this perspective, the risk factors associated with nerve injuries, sliding, compartment syndrome, and pressure ulcers are outlined to guide clinical practice. Overall, this paper underscores the critical role of precise patient positioning in achieving successful MIGS procedures and highlights key principles for the gynecological team to ensure optimal patient outcomes. outcomes (MIGS field success shouldnt shouldn t do perspective sliding syndrome practice Overall

SUMMARY OBJECTIVE: Intraoperative complications of hysteroscopy, such as the creation of a false passage, cervix dilatation failure, and uterine perforation, may require suspension of the procedure. Some patients refuse a new procedure, which delays the diagnosis of a possible serious uterine pathology. For this reason, it is essential to develop strategies to increase the success rate of hysteroscopy. Some authors suggest preoperative use of topical estrogen for postmenopausal patients. This strategy is common in clinical practice, but studies demonstrating its effectiveness are scarce. The aim of this study was to evaluate the effect of cervical preparation with promestriene on the incidence of complications in postmenopausal women undergoing surgical hysteroscopy. METHODS: This is a double-blind clinical trial involving 37 postmenopausal patients undergoing surgical hysteroscopy. Participants used promestriene or placebo vaginally daily for 2 weeks and then twice a week for another 2 weeks until surgery. RESULTS: There were 2 out of 14 (14.3%) participants with complications in the promestriene group and 4 out of 23 (17.4%) participants in the placebo group (p=0.593). The complications were difficult cervical dilation, cervical laceration, and vaginal laceration. CONCLUSION: Cervical preparation with promestriene did not reduce intraoperative complications in postmenopausal patients undergoing surgical hysteroscopy. OBJECTIVE hysteroscopy passage failure perforation procedure pathology reason practice scarce METHODS doubleblind double blind 3 surgery RESULTS 1 14.3% 143 (14.3% 17.4% 174 17 (17.4% p=0.593. p0593 p p=0.593 . 0 593 (p=0.593) dilation laceration CONCLUSION 14.3 (14.3 17.4 (17.4 p059 p=0.59 59 (p=0.593 14. (14. 17. (17. p05 p=0.5 5 (p=0.59 (14 (17 p0 p=0. (p=0.5 (1 p=0 (p=0. ( p= (p=0 (p= (p

Resumo Objetivo Comparar os padrões de resposta inflamatória sistêmica em mulheres com câncer epitelial de ovário (CEO) ou sem evidência de doença maligna, bem como avaliar o perfil de respostas inflamatórias sistêmicas em tumores dos tipos 1 e 2. Esta é uma forma não invasiva e indireta de avaliar tanto a atividade tumoral quanto o papel do padrão inflamatório durante as respostas pró- e antitumorais. Métodos Ao todo, 56 pacientes foram avaliados prospectivamente: 30 mulheres sem evidência de doença maligna e 26 mulheres com CEO. A quantificação plasmática de citocinas, quimiocinas e micropartículas (MPs) foi realizada por citometria de fluxo. Resultados Os níveis plasmáticos das citocinas pró-inflamatórias interleucina-12 (IL12), interleucina-6 (IL-6), fator de necrose tumoral alfa (tumor necrosis factor alpha, TNF-α, em inglês), interleucina-1 beta (IL-1β), e interleucina-10 (IL-10), e da quimiocina de motivo C-X-C 9 (CXCL-9) e da quimiocina de motivo C-X-C 10 (CXCL-10) foram significativamente maiores em pacientes com EOC do que nos controles. Os níveis plasmáticos da citocina interleucina-17A (IL17A) e MPs derivados de células endoteliais foram menores em pacientes com CEO do que no grupo de controle. A frequência de leucócitos e de MPs derivadas de células endoteliais foi maior nos tumores de tipo 2 do que naqueles sem malignidade. Observou-se um número expressivo de citocinas e quimiocinas inflamatórias/regulatórias nos casos de CEO, além de correlações negativas e positivas entre elas, o que leva a uma maior complexidade dessas redes. Conclusão Este estudo mostrou que, por meio da construção de redes compostas por citocinas, quimiocinas e MPs, há maior resposta inflamatória sistêmica em pacientes com CEO e correlação mais complexa desses biomarcadores em tumores de tipo 2. (CEO pró antitumorais todo 5 prospectivamente 3 (MPs fluxo próinflamatórias interleucina12 interleucina 12 IL12, IL12 IL , (IL12) interleucina6 6 interleucina- IL6, IL6 (IL-6) tumor alpha TNFα, TNFα TNF α, α TNF-α inglês, inglês inglês) interleucina1 IL1β, IL1β ILβ 1β β (IL-1β) interleucina10 IL10, IL10 (IL-10) CXC C X CXCL9 CXCL (CXCL-9 CXCL10 (CXCL-10 controles interleucina17A interleucinaA 17A IL17A ILA (IL17A controle malignidade Observouse Observou se inflamatóriasregulatórias regulatórias elas IL1 (IL12 (IL-6 (IL-1β (IL-10 (CXCL- CXCL1 (CXCL-1 (IL1 (IL- (IL-1 (CXCL (IL

Abstract Objective To compare the patterns of systemic inflammatory response in women with epithelial ovarian cancer (EOC) or no evidence of malignant disease, as well as to evaluate the profile of systemic inflammatory responses in type-1 and type-2 tumors. This is a non-invasive and indirect way to assess both tumor activity and the role of the inflammatory pattern during pro- and antitumor responses. Materials and Methods We performed a prospective evaluation of 56 patients: 30 women without evidence of malignant disease and 26 women with EOC. The plasma quantification of cytokines, chemokines, and microparticles (MPs) was performed using flow cytometry. Results Plasma levels of proinflammatory cytokines interleukin-12 (IL12), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α) interleukin-1 beta (IL-1β), and interleukin-10 (IL-10), and C-X-C motif chemokine ligand 9 (CXCL-9) and C-X-C motif chemokine ligand 10 (CXCL-10) were significantly higher in patients with EOC than in those in the control group. Plasma levels of cytokine interleukin-17A (IL-17A) and MPs derived from endothelial cells were lower in patients with EOC than in the control group. The frequency of leukocytes and MPs derived from endothelial cells was higher in type-2 tumors than in those without malignancy. We observed an expressive number of inflammatory/regulatory cytokines and chemokines in the cases of EOC, as well as negative and positive correlations involving them, which leads to a higher complexity of these networks. Conclusion The present study showed that, through the development of networks consisting of cytokines, chemokines, and MPs, there is a greater systemic inflammatory response in patients with EOC and a more complex correlation of these biomarkers in type-2 tumors. (EOC type1 type 1 type- type2 2 noninvasive non invasive pro 5 3 (MPs cytometry interleukin12 interleukin 12 IL12, IL12 IL , (IL12) interleukin6 6 interleukin- IL6, IL6 (IL-6) TNFα TNF α (TNF-α interleukin1 IL1β, IL1β ILβ 1β β (IL-1β) interleukin10 IL10, IL10 (IL-10) CXC C X CXCL9 CXCL (CXCL-9 CXCL10 (CXCL-10 group interleukin17A interleukinA 17A A IL17A ILA (IL-17A malignancy inflammatoryregulatory regulatory them that IL1 (IL12 (IL-6 (IL-1β (IL-10 (CXCL- CXCL1 (CXCL-1 (IL1 (IL- (IL-1 (CXCL (IL

SUMMARY OBJECTIVE: The aim of this study was to describe the anthropometric characteristics, eating habits, and lifestyle of non-village indigenous women living in Manaus, AM, and their association with hypertension. METHODS: This cross-sectional (descriptive-analytical) study was carried out from January 2020 to December 2021 using a questionnaire for clinical, sociodemographic, and behavioral data. Non-pregnant women who belonged to Parque das Tribos for more than a year, declared themselves indigenous, and were over 18 years of age were included in the study. RESULTS: In total, 21 ethnicities were identified, and 95 indigenous women were evaluated. The average age group was 36±12.1 years, the average height was 157 cm, and the body mass index was 28.8 kg/m2. The prevalence of systemic arterial hypertension was ±40%, and 68.5% had excess weight, with 29.1% having class I obesity. In all, 35.8% consumed a lot of salt, sugar, and industrialized foods, and 88.4% were sedentary. CONCLUSION: Much of the sample presented excess weight, and almost all were sedentary. More than one-third had unappropriated eating habits. Hypertension was present in more than one-third of these indigenous women. There was an association between higher body mass index and hypertension. Knowing the characteristics of this group of non-village indigenous women may help determine the best health approach. The data demonstrate the necessity of preventive measures. OBJECTIVE habits nonvillage non village Manaus AM METHODS crosssectional cross sectional descriptiveanalytical descriptive analytical (descriptive-analytical 202 clinical sociodemographic Nonpregnant Non pregnant year 1 RESULTS total 2 identified 9 evaluated 36121 36 12 36±12. 15 cm 288 28 8 28. kgm2 kgm kg m2 m kg/m2 40 ±40% 685 68 5 68.5 weight 291 29 29.1 obesity 358 35 35.8 salt sugar foods 884 88 4 88.4 sedentary CONCLUSION onethird one third approach measures 20 3612 3 36±12 kg/m ±40 6 68. 29. 35. 88. 361 36±1 ±4 36± ±

Resumo Objetivo O presente estudo avaliou o perfil de mutações germinativas presentes em pacientes submetidas a aconselhamento genético para avaliação de risco para câncer de mama (CM), câncer de ovário (OC) e câncer de endométrio (CE) com possível padrão hereditário. Métodos Foram analisados os prontuários de 382 pacientes que realizaram aconselhamento genético após consentimento informado. Um total de 55,76% dos pacientes (213/382) eram sintomáticos (história pessoal de câncer), e 44,24% (169/382) eram assintomáticos (ausência da doença). As variáveis analisadas foram idade, sexo, naturalidade, história pessoal ou familiar de CM, OC, CE bem como outros tipos de câncer associados a síndromes hereditárias. As diretrizes de nomenclatura da Human Genome Variation Society (HGVS) foram usadas para nomear as variantes e seu significado biológico foi determinado pela comparação de 11 bancos de dados. Resultados Identificamos 53 mutações distintas: 29 variantes patogênicas, 13 variantes de significado indeterminado e 11 benignas. As mutações mais frequentes foram BRCA1 c.470_471delCT, BRCA1 c.4675 + 1G > T e BRCA2 c.2T > G. Além disso, 21 variantes parecem ter sido descritas pela primeira vez no Brasil. Além das mutações BRCA1/2, foram encontradas variantes em outros genes relacionados a síndromes hereditárias que predispõem a cânceres ginecológicos. Conclusão Este estudo permitiu conhecer melhor as principais mutações identificadas nas famílias do estado de Minas Gerais e demonstra a necessidade de avaliar a história familiar de câncer não ginecológico para avaliação do risco de CM, OC e CE. Além disso, é um esforço que contribui com estudos populacionais para avaliar o perfil de mutações de risco para câncer no Brasil. CM , (CM) (OC (CE hereditário 38 informado 5576 55 76 55,76 213/382 213382 213 (213/382 câncer, câncer) 4424 44 24 44,24 169/382 169382 169 (169/382 ausência doença. doença . doença) idade sexo naturalidade HGVS (HGVS 1 dados 5 distintas 2 patogênicas benignas BRCA c470471delCT cdelCT c 470 471delCT delCT c.470_471delCT c4675 4675 c.467 G c2T cT 2T disso Brasil BRCA12 BRCA1/2 ginecológicos (CM 3 557 7 55,7 213/38 21338 (213/38 442 4 44,2 169/38 16938 16 (169/38 47 c467 467 c.46 BRCA1/ 55, 213/3 2133 (213/3 44, 169/3 1693 (169/3 c46 46 c.4 213/ (213/ 169/ (169/ c4 c. (213 (169 (21 (16 (2 (1 (

Abstract Objective The present study evaluated the profile of germline mutations present in patients who underwent genetic counseling for risk assessment for breast cancer (BC), ovarian cancer (OC), and endometrial cancer (EC) with a possible hereditary pattern. Methods Medical records of 382 patients who underwent genetic counseling after signing an informed consent form were analyzed. A total of 55.76% of patients (213/382) were symptomatic (personal history of cancer), and 44.24% (169/382) were asymptomatic (absence of the disease). The variables analyzed were age, sex, place of birth, personal or family history of BC, OC, EC, as well as other types of cancer associated with hereditary syndromes. The Human Genome Variation Society (HGVS) nomenclature guidelines were used to name the variants, and their biological significance was determined by comparing 11 databases. Results We identified 53 distinct mutations: 29 pathogenic variants, 13 variants of undetermined significance (VUS), and 11 benign. The most frequent mutations were BRCA1 c.470_471delCT, BRCA1 c.4675 + 1G > T, and BRCA2 c.2T> G. Furthermore, 21 variants appear to have been described for the first time in Brazil. In addition to BRCA1/2 mutations, variants in other genes related to hereditary syndromes that predispose to gynecological cancers were found. Conclusion This study allowed a deeper understanding of the main mutations identified in families in the state of Minas Gerais and demonstrates the need to assess the family history of non-gynecological cancer for risk assessment of BC, OC, and EC. Moreover, it is an effort that contributes to population studies to evaluate the cancer risk mutation profile in Brazil. BC , (BC) OC (OC) EC (EC pattern 38 5576 55 76 55.76 213/382 213382 213 (213/382 cancer, cancer) 4424 44 24 44.24 169/382 169382 169 (169/382 absence disease. disease . disease) age sex birth HGVS (HGVS 1 databases 5 2 VUS, VUS (VUS) benign BRCA c470471delCT cdelCT c 470 471delCT delCT c.470_471delCT c4675 4675 c.467 G T c2T cT 2T c.2T Furthermore Brazil BRCA12 BRCA1/ found nongynecological non Moreover (BC (OC 3 557 7 55.7 213/38 21338 (213/38 442 4 44.2 169/38 16938 16 (169/38 (VUS 47 c467 467 c.46 55. 213/3 2133 (213/3 44. 169/3 1693 (169/3 c46 46 c.4 213/ (213/ 169/ (169/ c4 c. (213 (169 (21 (16 (2 (1 (

SUMMARY OBJECTIVE: This study aimed to assess the sociodemographic and clinical profile of women deprived of their liberty and to identify the prevalence of sexually transmitted diseases and human papillomavirus through self-sampling samples. METHODS: This is an epidemiological, cross-sectional, observational, and descriptive study of the prevalence and correlation of the diagnosis of human papillomavirus infection in 268 encarcered women in Amazonas submitted to self-sampling from June 2019 to September 2020 using the genotyping analysis. Patients with positive and inconclusive results were evaluated by commercialized PCR to detect pathogens causing sexually transmitted diseases. The sample size used was based on a convenience sample. RESULTS: In 268 women, human papillomavirus DNA was detected in 87 (32.5%) of them. Sexually transmitted diseases were detected in 30 (34.48%) of the 87 women with a positive or inconclusive result for human papillomavirus. Women with more than three pregnancies had a higher risk of human papillomavirus detection (p=0.004). CONCLUSION: The prevalence of human papillomavirus and other sexually transmitted diseases in encarcered women in Amazonas is 32.5 and 34.48%, respectively. Most women were single (60.4%) and reported having had more than 15 partners (90.8%). OBJECTIVE selfsampling self sampling samples METHODS epidemiological crosssectional, crosssectional cross sectional, sectional cross-sectional observational 26 201 202 analysis RESULTS 8 32.5% 325 32 5 (32.5% them 3 34.48% 3448 34 48 (34.48% p=0.004. p0004 p p=0.004 . 0 004 (p=0.004) CONCLUSION 32. respectively 60.4% 604 60 4 (60.4% 1 90.8%. 908 90.8% 90 (90.8%) 2 20 (32.5 34.48 344 (34.48 p000 p=0.00 00 (p=0.004 60.4 6 (60.4 90.8 9 (90.8% (32. 34.4 (34.4 p00 p=0.0 (p=0.00 60. (60. 90. (90.8 (32 34. (34. p0 p=0. (p=0.0 (60 (90. (3 (34 p=0 (p=0. (6 (90 ( p= (p=0 (9 (p= (p