Sarcoma de Ewing extraóseo en cabeza y cuello: revisión de la literatura a propósito de un caso

ResumenIntroducciónEl sarcoma de Ewing extraesquelético (SEE) es un tumor maligno muy poco frecuente. La región de la cabeza y el cuello es una localización primaria inusual para este tipo de tumor.Material y métodosEl objetivo de esta revisión es identificar las principales localizaciones dentro de cabeza y cuello. Para ello se realizó una búsqueda en la base de datos MEDLINE. Se analizaron múltiples variables. Se realiza la revisión a propósito un caso clínico de un paciente con SEE en la mejilla.ResultadosDe un total de 31 pacientes, se reportan 18 casos en cabeza y 13 en cuello.ConclusionesEn nuestra revisión no pudimos determinar ninguna localización que sea de mayor frecuencia en esta región. Las pruebas de imagen son útiles para estadificar, y son necesarios estudios anatomopatológicos para confirmar el diagnóstico. El tratamiento intensivo es el de mayor eficacia.AbstractIntroductionExtraskeletal Ewing's sarcoma (EES) is a rare malignant neoplasm. It is a highly unusual finding in the head and neck region.Material and methodsThe aim of this review is to identify the main sites in the head and neck region, by searching in the MEDLINE database. A wide range of variables were analysed. This review was carried out due to a case report of a patient with EES of the cheek.ResultsOut of a total of 31 patients, there were 18 cases in the head and 13 in the neck.ConclusionsIn our review it was not possible to determine a more frequent head and neck location. The imaging studies are useful for staging, and the histology to confirm the diagnosis. An aggressive treatment has demonstrated to be more effective

The meridian incision : a technical modification in the conservative surgery of the impacted maxillary canine

We describe a technical modification of the apical repositioning flap in the conservative surgical treatment of the impacted canine in buccal position. This amendment improves the tooth?s eventual visualization, thus permitting a better evolutive follow-up of its eruption process and, most importantly, providing the tooth with buccal attached gingiva that will accompany it in its downward progression, procuring a cervical contour without retraction, a satisfactory esthetic outcome and a physiologically correct periodontal ridge. The traditional apical repositioning flap also bestows the canine with attached gingiva; however, since the flap is sutured apically and its width is significantly smaller than the remaining surgical defect, the wound?s closure is compromised at one of its edges and often requires healing by second intention at an undesired location next to the buccal sulcus. We believe the introduction of the meridian incision is a simple, expedient technical modification with efficient results

mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial

Background Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. Objectives The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. Method A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). Conclusions It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic

Functionalities of the Adhera MejoraCare solution.

Left: Symptom’s monitoring. Center: Patient empowerment categories in the educational section. Right: Educational units included in the ‘‘How to protect from coronavirus” category.</p

SPIRIT checklist.

(PDF)</p

Ethics committee protocol.

(PDF)</p

S3 File -

(DOCX)</p

Contents of the Adhera® MejoraCare Digital Program.

Contents of the Adhera® MejoraCare Digital Program.</p