A pandemia do COVID-19, deflagrada no início de 2020, foi acompanhada por rápida disseminação, taxas de mortalidade sem barreiras sociais e uma corrida científica sem precedentes.Neste cenário mundial o Brasil tem lugar de destaque, pois é o 11º país que mais produziu artigos sobre o assunto. Este e-book tenho o objetivo de expor as pesquisas epidemiológicas, revisões científicas, estudos experimentais pré-clínicos, observacionais e clínicos sobre o assunto COVID-19 -O VÍRUS QUE MOVIMENTOU A CIÊNCIA.Esperamos que tenha uma leitura agradável e possa desfrutar ao máximo o conhecimento transmitido por nossos autores.
Objective To understand the impact of the coronavirus disease 2019 pandemic on in vitro fertilization (IVF) clinical pregnancy rates and analyze factors that may have influenced their outcome.
Methods This was a retrospective observational study conducted at a tertiary-care Brazilian fertility center. All fresh IVF and embryo warming cycles performed from March 11 to December 31, 2018–2021 were analyzed, and their data were used to calculate fertilization, embryo cleavage, cycle cancellation, embryo transfer (ET), and clinical pregnancy rates. Statistical tests were used to evaluate the alterations found. Logistic regression models were used to explore the association of the categorical variables with the observed clinical pregnancy rates. Data from 2018 and 2019 (prepandemic) and 2020 and 2021 (pandemic) were grouped.
Results A total of 756 cycles were analyzed (n = 360 prepandemic and n = 396 pandemic). The age group of the patients, fertilization rates, and cleavage rates did not have significant differences (p > 0.05). There was a reduction in the percentage of fresh IVF and an increase in embryo warming cycles (p = 0.005) during the pandemic. There was also an increase in fresh cycle cancellations (p < 0.001) and a reduction in ET rates (p < 0.001). The pandemic had a negative impact on clinical pregnancy rates (p < 0.001) especially due to the increase in fresh cycle cancellations (p < 0.001).
Conclusion Embryo warming cycles with subsequent frozen-thawed ET were presented as a viable alternative to continue assisted reproductive treatments against pandemic restrictions on fresh cycles, ensuring clinical pregnancy, albeit at a lower rate than that of the prepandemic period.
OBJECTIVE: To understand if COVID-19 pandemic impacts on delays in non-metastatic HER2-negative breast cancer diagnosis and in the beginning/development of neoadjuvant chemotherapy, as well as on changes in treatment plan to Paclitaxel intensification doses, impaired patients’ quality of life and mental health. METHODS: This is a cross-sectional study of 67 women diagnosed with non-metastatic HER2-negative breast cancer during the first sixteen months of COVID-19 pandemic and receiving neoadjuvant treatment due to pandemic impossibility of immediate definitive cancer surgery following the neoplasm diagnosis. Sociodemographic, Functional Assessment of Cancer Therapy Scale - General, Beck Anxiety and Depression Inventory were used for outcomes assessment. Inferential analysis was performed by Mann-Whitney, Pearson's chi-squared, and Fisher's exact tests. The adopted significance was 5%. RESULTS: The study revealed that the oncological diagnosis delays caused a worsening of the patients' physical (8 x 21; p = 0.001), functional (13 x 21; p = 0.03) and general (61 x 83; p = 0.004) well-being; retardment in the beginning of neoadjuvant chemotherapy decreased physical well-being (13 x 21; p = 0.01). Changes in treatment plan, to Paclitaxel doses intensification, had a negative effect on functional well-being (20 x 25.5; p = 0.04). COVID-19 pandemic impacts on neoplasm diagnosis and neoadjuvant treatment delays were also associated with psychosocial manifestations, including higher levels of severe anxiety (60% x 14.5%; p = 0.03 and 40% x 14%; p = 0.04) and depression (40% x 3.2%; p = 0.004 and 60% x 5.3%; p = 0.03) respectively. CONCLUSION: The present study shows that COVID-19 pandemic impacts on non-metastatic HER2-negative breast cancer patients’ diagnosis and neoadjuvant chemotherapy impaired patients' quality of life and mental health.
Introduction: Oncological surgery is one of the main pillars in the cancer treatment. Despite the significant advances of immunotherapies, target therapies, chemotherapies, and radiotherapies, surgery continues as an essential therapy. Objective: to present an updated overview of the oncological surgery’s role, highlighting its evolution throughout history and the current approaches and techniques in cancer treatment. Methods: Narrative and exploratory bibliographic study. The research was carried out in the Medline and Embase databases, using the terms (((surgical oncology)) OR ((surgery) AND (cancer) OR (tumors))). Results: Oncological surgery has made significant advances over its history. Currently, what prevails is the minimally invasive mentality with the techniques of video laparoscopy and robotic surgery. Although access is not uniform throughout the world, the expectation is that more popularization of these techniques will occur in the coming years. The oncological surgery is indicated to prevent, diagnose, evaluate the disease’s spread, curative treatment, sequelae and complications management, as well as palliation. Conclusion: Surgery is a procedure that improves the quality of life and increases cancer patients’ survival. The knowledge of its applicability, different techniques, and future expectations is essential for the correct orientation, referral to specialists, and patient’s follow-up.
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