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Aim Our study aims to investigate the safety and effectiveness of sentinel lymph node biopsy using indocyanine green (ICG) for the surgical staging of early-stage endometrial cancer in comparison to technetium-99 m use. Methods We conducted an observational retrospective study with patients diagnosed of endometrial cancer and FIGO stages I-II. All participants were injected technetium-99m the day prior to the surgery and underwent lymphoscintigraphy along with single-photon emission computed tomography. In addition, all patients were administered intraoperatively ICG injection to detect sentinel lymph node biopsy. The surgical staging was then completed according to the European Society for Medical Oncology preoperative risk category. Data obtained from the analysis of technetium-99m detection was compared to ICG detection. Results A total of 53 women with endometrial cancer were included in the study, 49 (92.5%) of them showed drainage preoperatively in the single-photon emission computed tomography and/or lymphoscintigraphy. The intraoperative bilateral detection rate for technetium-99 m was 26 (49.1%) patients compared to 40 (75.5%) patients with ICG (p = 0.013). We observed a 42.5% increase in the mean number of lymph nodes retrieved by ICG compared to technetium-99m (2.85 vs 2,0 nodes; p = 0.002). We intraoperatively identified 164 lymph nodes, 104 (63.4%) located in both obturator areas and external iliac vessels. Conclusion The use of ICG for the performance of sentinel node biopsy in patients with endometrial cancer seems safe and could be superior to technetium-99 m, since it offers a higher bilateral detection rate and nodal retrieval, resulting in the possibility to perform safely less full staging lymphadenectomies.

BACKGROUND The retroperitoneal hematoma is a very rare entity in obstetrics. A type of obstetric hematoma that extends into the retroperitoneal space, this hematoma usually occurs after laceration of the uterine artery, after uterine rupture, or by extension of a vaginal hematoma. Although the hematoma usually manifests as intense abdominal pain, sometimes the clinical signs can go unnoticed. This is the main reason it is important to report the cases in which retroperitoneal hematomas occur. In addition to clinical suspicion, experience in management can also help improve maternal morbidity and mortality from this cause. CASE REPORT We present a series of 3 clinical cases in which retroperitoneal hematomas occurred after instrumental deliveries. The 3 clinical cases described took place before the COVID-19 pandemic. In the first 2 deliveries, a vacuum was used, while in the third delivery, spatulas were used. CONCLUSIONS Our findings showed that suspicion is essential in patients with symptoms of nonspecific pain, as well as in patients with anemia that causes hemodynamic instability in the immediate postpartum period. The use of early computed tomography angiography in hemodynamically stable patients is essential to reach a diagnosis and to determine if the patient can be treated by embolization of the bleeding vessel.

Objective: The aim of this research was to assess university students’ health-related quality of life whether they use some contraceptive method or not. Methods: This research is a cross-sectional study. Female participants who studied a degree in health at the University of Seville (Spain) were recruited. Respondents completed a demographic questionnaire and health-related quality of life was measured with validated instrument SEC-QoL (Sociedad Española de Contracepción- Quality of Life) in Spanish that measured five dimensions: sexual, social, breast, menstrual and psychosocial. Results: A total of 992 women aged 21.37 (3.6) years old participated in this study. Women who used a contraceptive method reached higher scores at the SEC-QoL questionnaire 47.09 (17.04) and 46.91 (18.73) than those that didn’t. Likewise, women who chose a hormonal method showed a better overall health-related quality of life, compared to those who used a non-hormonal method. Participants who used hormonal contraceptives obtained higher scores in all health-related quality of life domains (social, menstrual, breast and sexual), except psychological domain when compared to those who used a non hormonal method or none. Furthermore, a moderated mediation model showed that the effect of the current contraceptive method on health-related quality of life was partially explained by the moderated mediation of the time using this method, the reason for using it and the existence of a partner. Conclusion: The usage of hormonal contraceptives increases health-related quality of life in young women. Several variables regarding the experience with contraceptive methods should be considered in order to examine the effect on health-related quality of life in undergraduate women.

Resumen La traquelectomia radical es una intervencion que permite preservar la fertilidad en mujeres jovenes con cancer de cervix en estadio precoz. Su seguridad ha sido sobradamente demostrada en el tratamiento de la estirpe escamosa, pero existen dudas sobre la conveniencia de usarla en histologias vinculadas tradicionalmente a un peor pronostico. Presentamos aqui 2 casos atipicos de cancer de cervix (adenocarcinoma de celulas claras y carcinoma escamoso con adenocarcinoma coexistente) intervenidos mediante traquelectomia radical previa biopsia de ganglio centinela pelvico.

Sertoli-Leydig cell tumors are a rare type of non-epithelial ovarian cancer; these tumors belong to the group of sex cord-stromal tumors and account for approximately 2-5% of all malignant ovarian tumors. We report the case of a 42-year-old woman who underwent surgery for a Sertoli tumor with sarcomatoid foci. Diagnosis of these tumors is difficult before surgery and, due to the scarcity of publications on the topic, there is controversy about the appropriate surgical staging and the role of adjuvant therapy in the management of this entity.

The coexistence of a complete mole and live term fetus is a rare entity seldom reported in the literature. Primary non-invasive diagnosis is usually achieved through ultrasound examination and definitive diagnosis can be achieved when molar tissue samples are available for histopathological examination. Patients with a complete mole have a 12-20% risk of developing persistent gestational trophoblastic disease, hence the importance of close follow-up. We report the early diagnosis of a complete mole coexisting with a normal fetus and also provide a review of the literature on the topic.

The aim of this study was to understand the potential complications of the Essure® device as well as the factors influencing its onset and patient satisfaction. We present a 9-year descriptive pros...

Resumen Las metastasis mamarias bilaterales de melanoma son infrecuentes y generalmente en el momento del diagnostico este tumor posee otros sitios de diseminacion. El pronostico clinico es malo, con una supervivencia habitualmente menor a un ano a pesar de efectuar un tratamiento agresivo. La afectacion ovarica por un melanoma metastasico tampoco es habitual y puede confundirse con un tumor primario, representando un reto diagnostico tanto clinico como anatomopatologico. Presentamos un caso atipico de melanoma de localizacion primaria desconocida que comenzo clinicamente con metastasis mamarias y ovaricas bilaterales.

Focused microwave irradiation of equimolecular mixtures of 9-chloroacridines, 4-chloroquinolines and 4-chloroquinazolines with amines in the presence of 2 equiv of phenol allows the general, fast and high-yielding synthesis of aminated heterocycles, with a very broad scope in terms of amine structure (aromatic, linear primary aliphatic, α-branched primary aliphatic, secondary aliphatic and diamines). Workup consisted of a simple washing with water and purification could be achieved by crystallization, avoiding the use of organic solvents in extraction and chromatographic purification steps. This protocol provides a solution to the long-standing synthetic problem of achieving a practical and efficient method for the amination of pi-deficient nitrogen heterocycles for medicinal chemistry applications.

Resumen La evisceracion transvaginal es una situacion poco frecuente, con pocos casos publicados en la literatura internacional. Cuando se presenta lo hace habitualmente en mujeres posmenopausicas y esta relacionada con la cirugia vaginal previa, especialmente con la histerectomia. Requiere una intervencion quirurgica de urgencia para reparar el defecto en el fondo vaginal, e incluso, si es preciso, resecar el tramo de intestino afectado. Presentamos un caso de evisceracion transvaginal del intestino delgado transcurridos 14 anos desde la realizacion de una histerectomia radical por un cancer de endometrio y con un prolapso de la cupula vaginal.

Resumen La atresia ileal aislada es una situacion poco frecuente que cuenta con limitados casos publicados en la literatura internacional. Su diagnostico es complejo y se realiza siempre en el tercer trimestre de gestacion. Puede complicarse en un 5% de los casos con peritonitis meconial, la cual empeora el pronostico. Presentamos un caso de comienzo tardio de atresia ileal con perforacion intestinal y peritonitis meconial en una mujer con buen control gestacional.

Resumen La torsion aislada de la trompa de Falopio es un motivo infrecuente de consulta en ginecologia. La clinica que produce es sumamente inespecifica, dificultando mucho la realizacion de un diagnostico de sospecha y de un tratamiento precoz.

Reinvestigation of the title natural product's structure (1) has shown the easy racemization of the Trp-stereocenter in some derivatives of cyclo-L-Trp-Gly. The here described synthesis of compound 2, a regioisomer of 1 with the N-methyl group on the nitrogen adjacent to the ethylidene side-chain, permits us to conclude that structure 1 was correct.

(E)-6-Methyl-4′-amino-2-styrylquinoline (3) is a small molecule with the proper features to potentially diagnose, deliver therapy and monitor response to therapy in protein misfolding diseases. These features include compound fluorescent emission in the NIR region and its ability to interact with both Aβ and prion fibrils, staining them with high selectivity. Styrylquinoline 3 also inhibits Aβ self-aggregation in vitro and prion replication in the submicromolar range in a cellular context. Furthermore, it is not toxic and is able to cross the blood brain barrier in vitro (PAMPA test).

The enzymatic activity of α-chymotrypsin chemically modified with monomethoxypolyethylene glycol (α-CT-PEG) is discussed using as test reactions the hydrolysis of esters different from the natural substrates of the enzyme, and the peptidic synthesis. These reactions allowed the analysis of the dimensions of “ar”, “h”, “n” and “am” subsites of α-CT-PEG. Using 2-aminoethanol esters and derivatives of glycine we have proved that the depth of the “n” subsite of the chemically modified α-CT (α-CT-PEG) must be lower than 14.455 A because the synthesis of peptides is not observed using 2-aminoethanol octanoate as nucleophile. α-CT-PEG is chemoselective towards the aromatic esters because unnatural aliphatic esters are not hydrolyzed in the presence of N-benzoyl-L-Tyrosine ethyl ester. Unnatural aliphatic acyl-donors with a distance H-C……C=O smaller than 8.8 A are recognized by the chemically modified enzyme as acyl-donors. From these results we can conclude that the presence of N-acyl group in the acyl-donor molecule is not necessary to be recognised by α-CT-PEG. The presence of bulky alkyl chain both in the acyl donor and in the nucleophile, reduces the enzymatic activity of the biocatalyst both in the hydrolysis of esters and in the synthesis of peptides.

The reaction generates a C—C double bond in a very efficient manner with only AcOH as the side product.

Focused microwave irradiation promoted the very effi- cient synthesis of 2-styrylquinolines by reaction between quinaldi- nes and benzaldehydes or cinnamaldehydes in the presence of acetic anhydride.

Condensation of N1-methyl-cyclo-Trp-Gly and aldehydes in basic media was studied to confirm the structure of the natural product TDD (N-methyl-Tryptophan Dehydrobutyrine Diketopiperazine, 1) and to prepare analogues with potential activity as GST (Glutathione-S-Transferase) inhibitors. This strategy was successful for 1,4-diacetyl-cyclo-Trp-Gly but it did not work for N4-acetyl, N1-methyl-cyclo-Trp-Gly derivatives. Pyrolytic cyclization of N- Boc- l -Thr -N- methyl- l -Trp methyl ester gave the Z-isomer of N-methyltryptophan dehydrobutyrine diketopiperazine, which was previously supposed to be the natural product. However, by comparison of melting points and pectroscopic data with those of 1, we conclude that the proposed structure for TDD must be corrected.

Prion diseases are fatal neurodegenerative and infectious disorders for which effective pharmacological tools are not yet available. This unmet challenge and the recently proposed interplay between prion diseases and Alzheimer's have led to a more urgent demand for new antiprion agents. Herein, we report the identification of a novel bifunctional diketopiperazine (DKP) derivative 1 d, which exhibits activity in the low micromolar range against prion replication in ScGT1 cells, while showing low cytotoxicity. Supported by properly addressed molecular modeling studies, we hypothesized that a planar conformation is the major determinant for activity in this class of compounds. Moreover, studies aimed at assessing the mechanism-of-action at the molecular level showed that 1 d might interact directly with recombinant prion protein (recPrP) to prevent its conversion to the pathogenic misfolded prion protein (PrP Sc )-like form. This investigation suggests that DKP based antiprion compounds can serve as a promising lead scaffold in developing new drugs to combat prion diseases.

An efficient and reproducible synthetic method is proposed for the preparation of 2-nitro-3,6-dimethoxybenzaldehyde.

An efficient method is proposed for the preparation of 3-substituted carbostyrilquinone derivatives, based on Friedlander synthesis of the 5,8-dialkoxyquinolines followed by cerium ammonium nitrate oxidative demethylation