Introduction: Usual-type vulvar intraepithelial neoplasia, associated with HPV, accounts for approximately 20% of vulvar squamous cell carcinoma cases. In 2020 alone, 45,240 new cases of vulvar carcinoma were diagnosed, leading to 17,427 deaths, according to a study on the global incidence and mortality of 36 cancer types. The treatment aims to eradicate the affected tissue while preserving its appearance and functionality as much as possible. Traditional and well-established treatments primarily involve surgical techniques, which, despite enabling histological tissue analysis, may exacerbate symptoms due to anatomical alterations, scarring, and sensory changes. These outcomes can negatively impact quality of life and female sexual function. In this context, less invasive approaches such as ablative procedures and topical agents have been investigated to expand treatment alternatives, particularly for extensive and multifocal lesions. However, these approaches may not always be equally effective or well-tolerated due to adverse effects. Objectives: This study primarily aimed to assess the efficacy of various treatments and, secondarily, their adverse effects and tolerability to evaluate adherence rates. Methods: The systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The protocol was pre-registered in the PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42023442818). A comprehensive search was conducted across PubMed, Scopus, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials databases without restrictions on publication date or language. The search was performed on February 5, 2024. Randomized clinical trials comparing any treatment for high-grade vulvar intraepithelial lesions to placebo or other treatments were included. Data were extracted independently by two authors. Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 2.0). Data synthesis was conducted using RevMan 5.4. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach was used to evaluate the strength of evidence. Results: The search yielded 10,306 studies, and eight met the inclusion criteria for this review. According to the meta-analysis, which included two studies comparing 5% imiquimod to placebo, total lesion resolution was observed in 55.3% of women in the intervention group and in none of the placebo group (RR 18.21, 95% CI 2.60–127.69), with moderate-quality evidence. Compared to 1% cidofovir, 5% imiquimod demonstrated similar tolerability and adverse effect profiles, with vulvar pain, pruritus, fatigue, and headache being the most common. The complete response rate was 57% (90% CI 47–67) for cidofovir and 61% (90% CI 50–71) for imiquimod. When compared to ablative and excisional surgical treatments, 5% imiquimod was well-tolerated and showed a strong trend toward non-inferiority. Ultrasonic surgical aspiration resulted in less scarring compared to CO2 laser vaporization, with similar efficacy between the techniques. The 10% sinecatechins ointment (Veregen®) was well-tolerated and did not produce significant adverse effects. Compared to placebo, sinecatechins demonstrated clinical efficacy in lesion resolution (p = 0.002). The natural compound indole-3-carbinol (I3C) and omiganan, while well-tolerated and achieving good adherence to protocols, did not prove effective in lesion resolution.

There is evidence that situations of infection and inflammation are related to vitamin A deficiency (VAD), especially in children and pregnant women. Therefore, the objective of this research was to evaluate the influence of SARS-CoV-2 (COVID-19) infection on the vitamin A (retinol) status of pregnant women treated at a referral hospital for high-risk pregnancies. This is a case-control study comprising 60 pregnant women hospitalized with symptoms of COVID-19 between February 2021 and February 2022, and grouped according to the diagnosis of infection (with COVID-19, n=29 and symptomatic without COVID -19, n= 31). For comparative purposes, 63 low-risk pregnant women analyzed in a period prior to the emergence of COVID-19 in the same maternity hospital were included. The diagnosis of COVID-19 was made using RT-PCR for SARS-CoV-2 in a combined nasopharyngeal swab. Data collection comprised socioeconomic, demographic, clinical, biochemical information and retinol analysis in the women's serum. Retinol was analyzed by Ultra Performance Liquid Chromatography and VAD was determined when serum retinol <20 μg/dL. For statistical analysis, JASP and IBM SPSS software were used. The average age of pregnant women was 26 years old, practically half of them lived in Natal-RN (51.2%), and only two pregnant women had VAD (1.80%). The mean serum retinol was higher in pregnant women diagnosed with COVID-19 (54.50 μg/dL) than in the other groups (p<0.001). Linear regression analysis adjusted for gestational age at birth confirmed the positive association between retinol levels and the presence of COVID-19 (β= 17.22, 95%CI= 9.670 - 24.77, p<0.001). The data demonstrated that the presence of SARS-CoV-2 infection appears to maintain circulating serum retinol levels, which differs from data in the literature in situations of infection with other viruses and at other stages of life. Given this result and the limitations of the literature on retinol metabolism in pregnant women, it is noteworthy that this is the first study that verified the influence of COVID-19 on retinol in pregnant women, and it is therefore necessary to verify the behavior of retinol in this population during COVID-19, and whether serum retinol is the most appropriate biomarker in this situation. This study was approved by the Research Ethics Committee of the Hospital Universitário Onofre Lopes.

The imbalance of cellular expressions mediating the immune response resulting from HPV infections in high-grade lesions and cervical carcinoma, such as the profile of Th1, Th2, and Th17 cells from peripheral blood, has been extensively studied in recent research. From this, the need for a better understanding of the immune response through the in situ cytokine profile of HPV-mediated lesions has emerged. We quantified cytokines of the Th1, Th2, and Th17 profiles in cervical-vaginal scraping (CVS) samples using flow cytometry, correlating them with clinical and immunological findings. Through a cross-sectional study, CVS samples were collected at the Lower Genital Tract Pathology (LGTP) outpatient clinic from patients with High-Grade Intraepithelial Lesion (CIN 3) and Cervical Cancer (CC), while patients with no intraepithelial lesion were included as the control group. We assessed the levels of Th1, Th2, and Th17 cytokines in the CVS and compared the levels between the study groups and the control group. Higher cytokine levels (TNF- α, IFN-γ, IL-10, and IL-2) were observed in patients with CC compared to those with CIN 3 and the control group. Therefore, the persistence of lesions and the development of CC may lead to an immunological imbalance that worsens the progression of the disease.

Hypertensive syndromes in pregnancy (HGS) are characterized by changes in blood pressure levels during the gestational period. For children of women with HGS, premature birth is one of the main consequences, which can impact neonatal outcomes. The objective of this research was to compare the nutritional outcomes of preterm newborns (PTNB) born to women with HGS to children of normotensive women. The study was a prospective cohort study with a quantitative approach. The study participants were PTNBs born at the Januário Cicco Maternity School, in Natal-RN, from October 2021 to November 2023 who were hospitalized in the neonatal intensive care unit (NICU). PTNBs with gestational age between ≥23 and &lt;37 weeks and weight less than 2500g were included, and neonates diagnosed with severe congenital malformation or inborn errors of metabolism were excluded. The PTNBs were divided into 2 groups, according to exposure to HGS. Data collection was performed using electronic medical records and statistical analysis was performed using SPSS version 28.0. Of the 220 pregnant women monitored, half had GHS. There was a significant statistical association between GHS and maternal age &gt;35 years (p=0.013) and cesarean delivery (p&lt;0.01). Preterm infants born to women with GHS had a greater need for parenteral nutrition (p=0.017) and a higher risk of inadequate enteral nutrition (p=0.020). Furthermore, children born to women with GHS had a higher prevalence of being classified as small for gestational age at birth (p&lt;0.001) and, upon discharge from the NICU, with extrauterine growth restriction (p=0.018), when compared to children born to normotensive women. The results confirm that GHS are associated with unfavorable nutritional outcomes in preterm infants. Children of women with GHS had difficulty maintaining adequate nutritional status, with lower Z-scores at birth and at discharge from the NICU. Therefore, children of women with GHS require early and individualized nutritional interventions to improve recovery and growth during their stay in the NICU.

Preeclampsia (PE) occurs in pregnancy with hypertension and proteinuria, or target organ failure, and is associated with maternal and fetal morbidity and mortality. Among the risk factors for PE is maternal obesity. In pathophysiology, vascular and placental inflammatory dysfunction occurs, altering serum and biophysical markers. Acetyl Salicylic Acid (AAS) can prevent the disease by reducing the inflammatory process. The objective of the study was to analyze, in pregnant women in the second trimester of pregnancy, whether the use of AAS interferes with the Doppler of the uterine arteries and serum PE markers, and observe how they behave in obese pregnant women. This was a cross-sectional study, involving 71 pregnant women between 20 and 24 weeks and 06 days of gestation, recruited in two municipalities in Rio Grande do Norte between December 2022 and October 2023. Questionnaires were applied to characterize the population; morphological ultrasound of the 2nd trimester with Doppler assessment of the uterine arteries and measurement of serum PlGF (Placental Growth Factor) levels. The data were tabulated in SPSS (Statistical Package for the Social Sciences – version 4.2.2) to perform descriptive analysis, Shapiro-Wilk test and Spearman correlation. The significance level was 5%. The average body mass index (BMI) of the sample was 31.02. 38 pregnant women confirmed the use of AAS and in this group the mean pulsatility index (PI) values of the uterine arteries were 1.03 and PlGF 307.80, and in those who did not use it, the values were 0.95 and 325. 3, respectively. In this study, using AAS did not contribute to reducing the PI of the uterine arteries and there was no significant difference in the mean PIGF. Larger studies are important to confirm these results. 

Understanding the intricate relationship between pregnancy and the pelvic floor is crucial to managing potential problems related to pelvic floor dysfunction during and after pregnancy. Appropriate prenatal care, including exercises and interventions to support pelvic health, can help mitigate complications and promote overall well-being for pregnant women. The objective of this case series was to analyze the function of the pelvic floor muscles of pregnant women after pelvic mobility exercises using surface electromyography (EMG). The methodology was a cross-sectional, case series observational study, which evaluated seven (7) pregnant women in the third trimester. Data collection consisted of functional assessment of the pelvic floor through surface electromyography, with the following protocol: thirty seconds of rest to record basal activity, three maximal voluntary contractions maintained for two seconds, with a one-minute interval between each one. and three sustained contractions, maintained for six seconds, with a one-minute interval between each one. After the evaluation, pelvic exercises of lateral hip tilt, pelvic antero- and retroversion and circumduction were performed and, subsequently, all were reevaluated by EMG following the same evaluation protocol. The collected data were analyzed using SPSS software, version 13.0. The results indicated a significant improvement in maximum voluntary contraction, in the adjusted mean variable (p 0.040). In the other parameters evaluated, although there was no significant statistical difference, the values found may indicate an improvement in the functionality of the pelvic floor muscles after pelvic movement exercise. The pelvic exercise applied in this series of cases caused changes in all variables evaluated in the studied group, considering the myoelectric response and the functionality of the pelvic floor muscles in pregnant women in the third trimester. Studies with a larger sample and higher level of evidence are needed to confirm these results.

Introduction: The gestational period is marked by physiological changes that seek to meet the demands of mother-baby interaction for the balanced development of the baby. A pregnancy accompanied by Diabetes Mellitus enhances oxidative stress mediated by the inflammatory response that culminates in the production of reactive oxygen and nitrogen species, generating a maternal and placental imbalance characterized by damaging molecules such as DNA and RNA. Therefore, the impact caused by Diabetes Mellitus on cells and its outcomes have been investigated in pregnant women. Objective: To analyze the cellular profile and characteristics together with the inflammatory process of Diabetes Mellitus during pregnancy in a teaching maternity hospital. Methodology: This is an observational and descriptive study, with a quantitative approach, operationalized in two stages: cross-sectional study and case-control study. 240 diabetic and 12 non-diabetic pregnant women were characterized sociodemographically. Of the 240 diabetic pregnant women, 23 were analyzed for the degree of apoptosis in the lymphocyte, monocyte and granulocyte populations of whole blood, incubated with the fluorochromes annexin V FIT-C and/or propidium iodide and characterized by Cytoflex flow cytometry (Beckman Coulter) for detection of apoptosis. Results: Of the population studied, 46.25% were between 30 and 39 years old, 57.08% were brown, 50% had a salary income ≤ 01 minimum wage, 57.08% had high school education, 62.92% lived in rural areas; 65.83% had sanitation, 97.92% had electricity and 71.25% lived on paved streets. 67.74% did not notice symptoms of diabetes before diagnosis, 77.41% were diagnosed during pregnancy, 57.14% had a family history of diabetes and 67.86% had a family history of hypertension. Of the 240 pregnant women, 79.17% had GDM, 5.83% had DM1 and 15.00% had DM2. In addition, 40.42% had hypertension and 19.58% reported having other associated comorbidities. The characterization of the cellular profile in the study population showed a greater quantity of live cells in the distribution of lymphocytes and granulocytes between the control population and women with GDM (p=0.001/p=0.04) and with DM1/DM2 (p=0.04). Also in the lymphocyte population, early apoptosis showed a greater statistical difference than late apoptosis. Necrosis showed a statistically significant difference between the control group and the group of women with GDM (p=0.03). Monocytes did not show a statistically significant difference between the groups regarding live cells in early and late apoptosis. The diabetic participants whose blood was analyzed were between the 12th and 38th gestational week and apoptosis was present in all of them. Final considerations: In general, there was a greater quantity of live cells in the control population when compared to the groups of pregnant women with diabetes in the lymphocyte and granulocyte population. In addition, the difference in the expression of apoptosis between the groups of women with GDM only and the group of women with type 1 and 2 diabetes was minimal. Therefore, regardless of the type of diabetes, the pregnant woman suffered cell loss throughout the pregnancy.

The immune response of pregnant women with COVID-19, as well as the histopathological changes in the placenta caused by the infection, have not yet been elucidated. The characterization of lymphocyte subpopulations and natural killer (NK) cells, via flow cytometry, in the peripheral blood of pregnant and postpartum women infected or not by SARS-CoV-2, together with placental histopathological analysis, can contribute with more evidence on the effects caused by COVID-19 during the puerperal pregnancy period. In this cross-sectional study, the peripheral levels of total T lymphocytes, TCD4+ lymphocytes (ThL), TCD8+ lymphocytes (TcL), B lymphocytes and NK cells, in pregnant and postpartum women with positive and negative PCR for SARS-CoV-2 were compared. In addition, a comparison of placental histopathological findings was performed, using the Hematoxylin/Eosin staining method, of part of the parturients included in the study. The collection of peripheral blood and placental tissue samples took place between May 2021 and March 2022, in a teaching hospital in the northeast region of Brazil. Immunophenotyping was performed in 99 women, of which 78 (78.8%) had a confirmed diagnosis of COVID-19. Pregnant women and postpartum women infected with SARS-CoV-2 had higher levels of cytotoxic T cells, median (ME) = 574.2; interquartile range (IIQ) = 382.4, when compared with uninfected patients, ME = 404.7; IIQ = 363.5); p = 0.032. Histopathological analysis was performed on 30 placentas, of which 10 parturients had a diagnosis of COVID-19 confirmed by PCR (33.3%). Results revealed higher levels of congestion, focal chronic villitis, and acute funisitis in placentas from COVID-19 positive parturients. Negative parturients had a higher percentage of intervillous hemorrhage with thrombus formation, dystrophic calcification, placental infarction except marginal and acute capsular deciduitis. However, there was no statistically significant difference between the groups, nor a predominant histopathological pattern in pregnant women infected by the virus in the sample studied for comparison of placental findings. Pregnant women and postpartum women with COVID-19 had significantly higher levels of cytotoxic T cells in peripheral blood, but there was no difference in placental histopathological findings, although the group with confirmed infection had a higher percentage of congestion, focal chronic vilitis and acute funisitis.

Introduction: Skin aging in women is mainly correlated with exposure to solar radiation with menopausal events, such as hypoestrogenism. In parallel with the increase in life expectancy, both are associated with the induction of oxidative stress, motivating the signs and symptoms of senescence. The development of phytotherapics based on polyphenols can minimize the unwanted effects of skin wear, highlighting flavonoids. Despite its probable beneficial potential, there are limitations in the literature. Objective: To develop a systematic review of clinical trials, addressing the effectiveness of polyphenol compounds in delaying skin aging in women, comparing oral and topical routes. Methodology: A literature search was carried out in the electronic databases MEDLINE (via PubMed), Cochrane, Embase and Web of Science, published between the years 2012 and 2022. Eligible studies were randomized, double-blind, controlled trials, with the exception of one study that did not include a comparator group. Studies were selected that evaluated the effectiveness of an isolated or combined herbal medicine, which reported the following outcomes: elasticity (R2) and roughness or volume of wrinkles (visiometer or Primos). Results: After retrieving the articles, 13 studies were selected, with a total number of participants ranging from 20 to 120 individuals, composed of healthy women aged between 30 and 65 years, with the predominant inclusion criterion being the presence of wrinkles (usually the Wrinkles score ≥ 3) and with intervention protocol applied on the face. Four studies with low risk of bias and high heterogeneity regarding the plants used were identified. Favorable results were shown in elasticity and roughness, being attested after eight weeks of topical administration, and twelve orally. Conclusion: We emphasize that herbal medicines based on polyphenols have a positive impact on skin elasticity and roughness. In addition to the biomolecule, we emphasize the importance of time and route of administration to achieve the expected effect, since the topical route revealed brevity in the response compared to the oral route. Furthermore, we identified in the literature the diversity of tested compounds and methodological weaknesses, making more methodologically consolidated tests necessary.

Preeclampsia (PE) for a long time was diagnosed based on the triad of edema, proteinuria and hypertension; with the advance of studies, edema and proteinuria became criteria related to severity and not necessarily to diagnosis, thus the presence of hypertension together with isolated proteinuria are not decisive criteria for the diagnosis of PE. In this sense, this study aimed at identifying the correlation between worsening of the clinical picture of pregnant women diagnosed with preeclampsia and neonates, considering that proteinuria is nowadays an unnecessary diagnostic criterion for the disease.

This is a longitudinal, prospective, observational study carried out from January to October 2022 at the Januário Cicco Maternity School. The study population consisted of 32 pregnant women and their newborns (NB), classified according to the assessment of qualitative proteinuria in the strip, being Proteinuria negative or traces (n=13) and Proteinuria ≥ 1+ (n=19). Blood samples were collected from fasting pregnant women in a tube without anticoagulant for biochemical evaluation (10ml), analyzed using the Dimension RxL equipment (Siemens, São Paulo, SP, Brazil) and collected (4ml) in a tube with anticoagulant ethylenediaminetetraacetic acid (EDTA) in order to assess hematological parameters, analyzed by Advia 2120i equipment (Siemens, São Paulo, SP, Brazil). Proteinuria was measured at admission by qualitative evaluation in isolated urine sample (Uri-Color Check reactive strip from WAMA Diagnóstica, São Carlos, SP, Brazil).

Data were collected from the electronic medical records of pregnant women and their respective neonates in the University Hospitals Management Application (AGHU). The distribution of continuous variables was assessed by the Shapiro-Wilk test, and all variables were considered nonparametric. Non-parametric data were 

analyzed by the Mann-Whitney test and correlated by Spearman. Regarding differences between categorical variables, these were tested by chi-square analysis.  The evaluations were performed using SPSS Statistics version 20.0 (IBM, New York, USA). P values lower than 0.05 were considered statistically significant.

 Among the results obtained we can highlight that 28 (87.5%) of the pregnant women were admitted to the high-risk sector, 12 (92.3%) from the negative or trace proteinuria group and 16 (84.2%) from the proteinuria ≥1+ group, the predominant route of delivery was cesarean section, most of the NB presented prematurity, low birth weight, and most of them required hospitalization (p=0.007). In addition, 15 (78.9%) RNs in the proteinuria ≥ 1+ group required ventilatory support (p=0.020). Differences were observed between groups regarding diastolic blood pressure at the time of delivery (p<0.018), uric acid (p<0.012), urea (p<0.030), AST (p<0.001), ALT (p<0.033), LDH (p<0.005), total protein (p<0.004), albumin (p<0.001). The main positive correlations observed were between maternal age and total proteins (r=0.404; p<0.024), birth weight and total protein (r=0.511; p<0.009) and LDH and AST (r=0.727;p=0.001), the negative correlations observed were blood pressure at delivery and total proteins (r=0.670; p=0.001), total proteins and AST (r=0.719;p=0.001), albumin and AST (r=0.728;p=0.001), Albumin and total proteins (r=0.882;p=0.001), urea and GI at birth (r=0.721;p=0.001), Urea and birth weight (r=0.667;p<0.001).Thus, proteinúria was associated to poorer mother and neonatal outcomes.

Introduction - Congenital heart defects are the most common congenital anomalies and account for 8% of infant mortality, causing a great impact on morbidity and mortality in the pediatric age group. However, in Brazil, underreporting of cardiac malformations suggests that the diagnosis is made late, which prevents early surgical treatment. In Rio Grande do Norte (RN) the dimension of this situation is unknown, requiring greater detail, so that public policies to reduce morbidity and mortality due to cardiac malformations can be implemented at the state level. Given this scenario, the objective of this study was to describe the prevalence of surgical congenital heart defects in children from the cases observed at Hospital Rio Grande, the only reference center in pediatric cardiac surgery in the state. Methodology - After approval by the Research Ethics Committee, a cross-sectional study was started with analysis of electronic medical records of patients with surgical congenital heart disease admitted to the state's pediatric cardiology ICU, which operates at Hospital Rio Grande, from October 2018 to December 2022. The collected data were analyzed, firstly, through descriptive statistics using the JAMOVI 2.3.21 software. The frequency of cases by municipality and Health Region (HR) was represented by maps, using the Qgis 3.22.6 software. A generalized linear model using binomial distribution was also performed. Results –There were 594 admissions of children, with a mean age at admission of 2 years and 1 month, with 86% of the procedures performed by the SUS. It was observed that 41.7% of the patients resided in the VII HR, which includes the state capital and adjacent municipalities. There was a higher prevalence of surgical congenital heart diseases in the Health Regions located in the territorial strip to the south of the state. There was a predominance of procedures classified as severity score RACHS-1 categories 2 (38.6%) and 3 (33.7%). There were 59 deaths, 77.9% of which were patients with cyanotic defects, with a mean age of 6.9 months. Higher mortality was observed in category 6 RACHS-1 procedures. Risk factors for postoperative death were length of stay in the ICU (p<0.001), level of surgical complexity (p<0.01), need for reoperation (p<0.005) and diagnosis of cyanotic heart disease (p<0.05). On the other hand, municipal HDI and distance to the service were not associated with risk of death. The total length of hospital stay was a protective factor for death. Evaluation of DATASUS data from 2019 to 2022 indicated a scenario of underreporting and deficit of surgical procedures in RN. Conclusion – The results found serve as potential support for the development and implementation of public policies that allow improving care for children with heart defect, from prenatal care to clinical and surgical treatment, in the state of RN and in other locations in Brazil. Furthermore, the finding of a specific territorial area with a higher prevalence of surgical congenital heart disease calls for further investigation into the genetic and environmental factors involved in the etiology of congenital heart defect in this region and in adjacent territorial areas of the semi-arid region in other states.

Background: Vulvodynia is described as pain in the vulvar region that impacts dramatically women's lives leading to sexual dysfunction, reduction in self-esteem and decrease in the quality of life. Neurologic (central and peripheral) mechanisms may be associated to this condition, thus systematic reviews focusing the efficacy and benefits of physiotherapy on this population are necessary for consolidated evidence to aid clinical practice. Objectives: To assess the efficacy of physiotherapy for vulvodynia. Methods: The present systematic review was designed and reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). PubMed, Embase, Scopus, Web of Science, SciELO, PEDro, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched on February 2023. Two authors selected and extracted the data independently. The risk of bias was assessed using the Cochrane Risk of Bias tool (Rob 2). Due to the high heterogeneity presented between the studies, it was not possible to carry out the qualitative analysis. The results were presented in narratively. PROSPERO registration: CRD42023394207. Results: A total of 2.274 articles were retrieved from the databases. Seven studies met the criteria and were included in a systematic review, a total of 477 patients. The interventions included were electromyography biofeedback (n= 2), Transcutaneous electrical nerve stimulation TENS (n= 1), Transcranial direct current stimulation (TDSC) (n= 1), LowIntensity Shockwave (LISWT) (n= 1), physiotherapy treatment (n= 1), and pelvic floor exercise more behavioral modifications (n= 1). Of the seven studies present in the article, all evaluated pain reduction, five evaluated sexual function, and two evaluated qualities of life. All interventions were effective for the main outcomes; only the TDSC intervention had no significant difference when compared to the placebo group (Sham). Three studies presented a high risk of bias due to the lack of studies blinding. Conclusions: The studied interventions (electromyography biofeedback, TENS, Shockwave, physiotherapy, and pelvic floor exercise) seem to improve pain, sexual function, and quality of life. However, the heterogeneity of the studies prevented the metaanalysis. Additionally, well-designed trials are needed to improve the certainty of the evidence.

The high consumption of ultra-processed foods (UPF) has caused unfavorable effects on the health of the population and on the nutritional quality of the diet, however, there are still few studies that evaluate the impact of this consumption on metabolic outcomes of mother-child pairs in Gestational Diabetes Mellitus (DMG). Thus, the objective of the study was to evaluate the association between UPF consumption and the glycemic profile of women with GDM followed at a high-risk prenatal clinic and the occurrence of hypoglycemia in their newborns. The study was observational, longitudinal, prospective, cohort, with women diagnosed with GDM and their newborns. Data collection took place at least two times during prenatal care (during the 2nd and 3rd trimester of pregnancy) and immediately after birth. The assessment of food consumption was carried out according to the NOVA classification, with pairs grouped according to tertiles of energy contribution of UPF in the diet. The glycemic profile was assessed by fasting blood glucose, self-monitoring of capillary blood glucose (fasting, one hour after breakfast, one hour after lunch and one hour after dinner) in pregnant women, and according to capillary blood glucose levels in their newborns in the first 48 hours of life. Binary logistic regression analyzes were performed to evaluate the relationship between the increase in UPF participation, considering the highest tertile of UPF consumption as a reference category, in the control of glycemia in women with GDM at the time of the research and the occurrence of hypoglycemia in their neonates (&lt;50 mg/dL). 94 couples participated in the study, whose average caloric intake for women was 1,936 Kcal (1228 - 3124 Kcal), with 15% of the energy coming from UPF. Regarding the glycemic profile, 33.3% (n=30) and 52.3% (n=45) of them presented hyperglycemia in the second and third trimester of pregnancy, respectively. It was observed that UPF consumption had no significant association with maternal glycemic control, but showed a positive association with the occurrence of neonatal hypoglycemia (OR: 1.14; 95% CI: 1.037-1.262; p=0.007). Thus, the data suggest that the consumption of UPF can impact the occurrence of neonatal hypoglycemia in newborns of high-risk pregnant women, reinforcing the inclusion of guidelines for promoting healthy eating during pregnancy in nutritional assistance protocols for pregnant women with GDM.

Preeclampsia is a multifactorial and multisystem disease, specific to pregnancy, which manifests itself in previously normotensive pregnant women after the 20th week of pregnancy. Due to its systemic character, it is associated with maternal, perinatal and neonatal severity situations. Hypovitaminosis D is related to preeclampsia, increases the risk of premature birth, low birth weight, metabolic bone disease, bronchopulmonary dysplasia,  respiratory distress syndrome and neonatal sepsis, suggesting a protective role for this vitamin in the maternal-fetal interface. The aim of the study is to determine the association between 25-hydroxyvitamin D concentrations in pregnant women with preeclampsia and neonatal outcomes. So far, 7 pregnant women and their newborns have been included in the study, whose mothers, aged over 18 years, were previously diagnosed with preeclampsia and were followed up by the research group. Vitamin D was measured by chemiluminescence and data collected from electronic medical records. For statistical analysis, Spearman's aid was applied. For continuous variables, the median value was determined within the interquartile range referring to the 25th and 75th percentiles. P value < 0.05 was considered statistically significant. As the maternal profile data had a mean age of 28.4 years. The pregnant women's body mass index was classified as obese and the average time of sun exposure was 2.7 hours. The mean serum concentration vitamin D in pregnant women was 29.1 ng/mL. All newborns were born by cesarean delivery, 57.1% were female, gestational age and mean birth weight were 35.4 weeks and 2580g, respectively. All RNs were admitted to the MEJC. The mean length of stay in the NICU and in the other wards was 32.3 and 7.4 days, respectively. No deaths were recorded among maternal and neonatal participants. Due to insufficient sample size to date, it has not been possible to correlate maternal vitamin D levels with preeclampsia and neonatal deaths. Thus, the characterization of the sample was carried out.

Cervical cancer (CCU) is a public health problem that affects many women around the world and its etiology and pathogenesis are intrinsically linked to Human Papillomavirus (HPV), representing the fourth cause of death among women. Estimates report that about 80% of sexually active women will acquire an infection in their lifetime. It is known that the host's immune system, in most cases, is able to eliminate the HPV virus, but in some cases the patient will develop a persistent infection, which will culminate in the emergence of cervical cancer. Considering the importance of the immune system in this process, it is necessary to understand the cells and mechanisms involved. Therefore, evaluating the T helper cell pattern 1, 2 and 17 (Th1, Th2 and Th17) via cytokine quantification and associating the gene polymorphism of the IL-17-RA17 axis is the objective of the present study. This is a case-control observational study, with retrospective data and samples acquisition, having been collected from 2015 to 2019, and the study population consisted of 428 samples from a group of patients with indication of intraepithelial lesion and cervical cancer at the Cervical Pathology and Oncology outpatient clinic of the Januário Cicco Maternity School and the Hospital Luiz Antônio da Liga Contra o Câncer, they were stratified into 104 (24 %) with cervical cancer (CC), 125 (29 % ) with high-grade lesions, 86 (20%) with low-grade lesions, 104 (24%) were NILM, and 9 (3%) had indeterminate lesions, and the patients identified as NILM were classified as controls in this study. The execution of this work involves carrying out the gene polymorphism of IL17A and IL17RA in the following steps: DNA extraction and quantification; Polymerase Chain Reaction (PCR); and electrophoresis, while cytokine quantification was performed using the BD™ Cytometric Bead Array (CBA) Human Th1/Th2/Th17 cytokine kit. In our series, the data showed that there seems to be no association between the gene polymorphism of the IL-17-RA17 axis and the diagnosis of CC, in addition, in our study, the cytokines presented values below the detection limit, which can be justified by the action of HPV being a little cytopathic virus, imperceptible to the immune system.

Introduction: Newborns in critical condition hospitalized in Neonatal Intensive Care Units often need prolonged intravenous therapy for the recovery of their health and the peripherally inserted central catheter is the most indicated for the safe infusion of these solutions. However, the placement of this catheter in newborns can be difficult, becoming a challenge for the nursing team, predisposing the baby to multiple peripheral punctures, stress and pain. A particularly important aspect for this population is the lack of data on prediction equations for successful insertion of this device. Thus, this study aims to develop a prediction equation for success in peripherally inserted central catheter insertion in newborns. Methods: This is an observational, retrospective study carried out with the medical records of newborns admitted to the neonatal intensive care unit who used peripherally inserted central catheters between August 2018 and July 2021, whose sample was 359 newborns. Data on duplicated or incompletely and/or incorrectly completed newborns were excluded. Catheter insertion was considered successful when the tip of the catheter was inserted into the lower third of the superior vena cava from an upper extremity and into the upper third of the inferior vena cava from a lower extremity. Binary association tests and logistic regression were applied. Variables with p<0.05 remained in the final regression model. Results: 359 newborns were included between 23 and 41 weeks (median of 31 weeks and 4 days), 284 were on mechanical ventilation (invasive or non-invasive) and 70 progressed to successful PICC insertion. Being extremely premature, very premature and premature reduced the probability of PICC success by an average of 31.2% (95%CI: 25.5 to 38.1%), 21.4% (95%CI: 17.8 to 25. 7%) and 16.7% (95%CI: 14.0 to 19.8%) respectively. In addition, being on invasive and noninvasive ventilation reduced the probability of PICC success by an average of 82.4% (95%CI: 72.3 to 93.9%) and 85.3% (95%CI: 75.0 to 97.1%), respectively. The newborn's weight above 1500 grams and the access performed in the upper body region favored the success of the PICC in 2.5 and 2.93 times, respectively. Weight classification, gestational age, insertion site and being or not on mechanical ventilation were variables that were kept in the equation. The predictive equation for PICC success found was: OR PICC success = 0.178 x (IG classification) x (region) x (sup. vent.) x (weight classification). Conclusion: Gestational age classification and being on mechanical ventilation reduce the probability of successful introduction of PICC. While weight > 1500 grams and insertion of the catheter in the upper region increase the chance of success of the PICC. The predictive equation found is a practical and reproducible tool that can reduce the risk and complications related to unsuccessful catheter insertion.

The puerperium is a period of vulnerability due to the emotional and physical changes that occur after childbirth and that can influence a woman's quality of life. In this context, the decrease in physical andmental capacity associated with a persistent lack of energy, deficiencies in concentration, decreased rest and sleep time can favor the installation of physical and mental fatigue. The prevalence and incidence of postpartum fatigue has not been studied extensively and is considered an inevitable, temporary and frequently experienced symptom. This study aims to assess the level of fatigue of women in the immediate and late postpartum period and to associate it with sociodemographic and clinical factors. Through a prospective cohort study, 469 women were recruited from a public maternity hospital in the city of Natal-RN, from May to December 2021. The evaluations took place in the immediate postpartum period (between 24-48 hours) and in the puerperium. late (in the 1st and 3rd month after delivery). An evaluation form containing information on sociodemographic, clinical, gynecological-obstetric and newborn data was applied in the first evaluation along with three questionnaires for fatigue assessment: Global Short Form of selfreported global health from the Information System of Measurement of Outcomes by patient (PROMIS-GSF); multidimensional fatigue inventory (MFI) and fatigue pictogram. These data, with the exception of sociodemographic information, were applied one month after the assessment (AV2) and three months after delivery (AV3). Descriptive analysis of variables was used with mean, standard deviation, median, 25th and 75th percentiles, absolute and relative frequencies. Repeated measures ANOVA was used to compare the results of the three fatigue assessments. The multivariate model was adjusted for independent variables with significance ≤ 0.20 in the bivariate analysis and considering the clinical relevance for the occurrence of the outcome. The most prevalent age group was 26 to 34 years old, 59.5% completed elementary school, 47.6% had a salary income of up to one minimum wage and 76.1% reported having a partner. In obstetric information, 70.6% were multiparous with a median gestational age of 38 weeks, 60.5% had normal delivery, 95.7% breastfed after delivery, and 80.2% breastfed in past pregnancies. in the three evaluations showed a significant difference in the PROMIS-GSF (p < 0.01), general fatigue domains, physical fatigue and reduced motivation of the MFI (p < 0.01) and the fatigue pictogram (p < 0.01). In AV3, the PROMIS-GSF showed an association between fatigue and premature births (RR = 1.18; 95%CI: 1.02–1.37), absence of a support network (RR = 1.14; 95%CI: 1, 02–1.27), poor breastfeeding performance (RR = 1.16; 95%CI: 1.03– 1.31) and higher body mass index (BMI), (RR = 1.01; 95%CI: 1.005 –1.018). From the analysis of the results of this study, one can observe the presence of fatigue in the immediate postpartum period and its increase over three months postpartum. Prematurity, lack of a support network, poor performance in breastfeeding and higher BMI were factors associated with the persistence of fatigue in the late postpartum period.