Quality of life in patients undergoing minimally invasive surgery.

OBJECTIVE: Current evidence has shown how laparoscopic surgery results in shorter hospital stay, faster recovery, and better aesthetic results. However, we do not have information on populations in Latin America and the impact that the social environment has on quality of life in patients with gynecological cancer undergoing minimally invasive surgery. To assess quality of life of patients undergoing minimally invasive surgery in a gynecologic oncology department over time and to establish the relationship with patient and treatment variables. METHODS: This cross-sectional study evaluated the quality of life of women undergoing minimally invasive surgery from August 2019 to July 2021. The FACT-G (Functional Assessment of Cancer Therapy-General) scale encompasses global quality of life and four domains of physical, social, emotional, and functional components. This scale was applied to measure quality of life in the preoperative, early operative, and late postoperative periods. Additionally, mixed models were used to compare quality of life based on demographic and clinical factors after minimally invasive surgery. RESULTS: A total of 158 patients were analyzed. Belonging to a higher socioeconomic stratum (3 vs 1) had a positive impact on the global quality of life in patients undergoing surgery with an increase of 7.6 points (p=0.011). Also, a lower Charlson Index had a positive impact of 0.393 points for the physical component of quality of life (p=0.031). For the social component of quality of life, having a partner and being part of a higher socioeconomic stratum (3 and 2 vs 1) resulted in an increase of 2.11 (p=0.005), 4.06 (p<0.05), and 2.55 (p=0.004) points, respectively. Belonging to a higher socioeconomic stratum (3 vs 1) resulted in an increase of 2.03 points (p=0.031) for the functional component of quality of life. Finally, the complexity of the procedure, or whether the procedure was ambulatory or not did not impact quality of life. CONCLUSIONS: Lower Charlson Index, having a partner, or having higher socioeconomic status are all associated with higher quality of life of patients undergoing minimally invasive surgery.

Melanoma primario de cuello uterino: Reporte de caso / Primary malignant melanoma of the cervix: Case report

Resumen El melanoma primario de mucosas representa el 1% de todos los cánceres. Su localización en cuello uterino es rara y existen menos de 100 casos reportados en la literatura hasta la fecha. Los datos son limitados en cuanto su estadificación y tratamiento y su pronóstico es malo con tasas de supervivencia del 10% a 5 años. Se presenta el caso clínico de una paciente de 82 años con sangrado vaginal, con evidencia de una lesión melanótica en cuello uterino, la biopsia de la lesión reportó compromiso por tumor maligno pobremente diferenciado, con inmuno perfil que confirma melanoma maligno. Los estudios de extensión no mostraron enfermedad metastásica a distancia, se presentó el caso en junta multidisciplinaria de ginecología oncológica por lo que se indicó tratamiento con radioterapia pélvica externa exclusiva con intención paliativa para control de síntomas, teniendo en cuenta: la edad, las comorbilidades y el estado funcional ECOG (Eastern Cooperative Oncology Group) 3; luego de 10 meses de seguimiento la paciente falleció.

Abstract Primary mucosal melanoma represents 1% of all cancers, the location in the cervix is rare, there are less than 100 cases reported in the literature to date, the data is limited in terms of staging and treatment, its prognosis is poor with survival rates of 10% at 5 years. We present a clinical case of a primary melanoma of the cervix in an 82-year-old patient with vaginal bleeding with evidence of a melanotic lesion in the cervix. The biopsy of the lesion reported poorly differentiated malignant tumor involvement, with an immuno-profile that favors melanoma. Extension studies were performed that did not show distant metastatic disease, the case was presented in a multidisciplinary oncological gynecology meeting, indicating treatment with exclusive external pelvic radiotherapy with palliative intention for symptom control taking into account patient comorbidities and ECOG functional status. (Eastern Cooperative Oncology Group) 3, after 10 months of follow-up the patient died.

Cardiac catheterization in children with pulmonary hypertensive vascular disease: consensus statement from the Pulmonary Vascular Research Institute, Pediatric and Congenital Heart Disease Task Forces.

Cardiac catheterization is important in the diagnosis and risk stratification of pulmonary hypertensive vascular disease (PHVD) in children. Acute vasoreactivity testing provides key information about management, prognosis, therapeutic strategies, and efficacy. Data obtained at cardiac catheterization continue to play an important role in determining the surgical options for children with congenital heart disease and clinical evidence of increased pulmonary vascular resistance. The Pediatric and Congenital Heart Disease Task Forces of the Pulmonary Vascular Research Institute met to develop a consensus statement regarding indications for, conduct of, acute vasoreactivity testing with, and pitfalls and risks of cardiac catheterization in children with PHVD. This document contains the essentials of those discussions to provide a rationale for the hemodynamic assessment by cardiac catheterization of children with PHVD.

Respuesta electrodérmica y expresiones faciales de niños que entablan un juego de ficción relacionado con comportamientos de agresión / Electrodermal Response and Facial Expressions of Children who Engage in Pretense Play Related with Aggressive Behaviors

En Colombia existe un alto porcentaje de niños y jóvenes que despliegan o son víctimas de conductas agresivas en el contexto escolar. Existe evidencia que muestra que estas conductas están asociadas con dificultades en la regulación emocional y en los procesos de teoría de la mente. Se llevaron a cabo seis estudios de caso a niños entre los 4 y 8 años de edad. A los participantes del estudio se les presentó un cuestionario en donde se planteaban situaciones conflictivas y buscaba fomentar el juego de ficción. Se evaluó la respuesta electrodérmica y las expresiones faciales durante la entrevista. Se presentó una mayor frecuencia de expresiones faciales y cambios en la respuesta electrodérmica cuando la agresión, en las situaciones conflictivas, era intencional y dirigida a un sujeto. Las emociones más frecuentes, registradas en la expresión facial, fueron rabia, tristeza y desprecio. Los resultados de este estudio, sugieren que las expresiones faciales y la respuesta electrodérmica pueden ser medidas interesantes para estudiar la regulación emocional y las conductas agresivas.

Colombia displays a high percentage of children and teenagers that deploy or are victims of aggressive behaviour in the school. There is evidence that shows that these behaviours are associated with difficulties during emotion regulation and in theory of mind. Six case studies were developed in children between 4 and 8 years of age. A questionnaire that involved conflict situations and that sought to promote pretense play was presented to participants. Facial expressions and electrodermic responses were evaluated during the interview. A higher frequency of facial expressions and changes in electrodermic response were recorded when the aggression, in the conflict situations, was intentional and directed towards a person. The most frequent facial expressions of emotion were anger, sadness, and contempt. The results of the present study suggest that facial expressions and electrodermic response could be interesting measures to study emotion regulation and aggressive behaviour.

Arco aórtico derecho circunflejo retroesofágico con ligamento arterioso izquierdo: una variedad infrecuente de anillo vascular completo / Circumflex retroesophageal right aortic arch with left arterial ligament: an infrequent variety of complete vascular ring

Los anillos vasculares pertenecen a un grupo de anomalías congénitas de los arcos aórticos en los que la tráquea y el esófago, o ambos, están completamente rodeados por estructuras vasculares. Con frecuencia pueden causar obstrucción y, en consecuencia, alteración de la deglución y dificultad respiratoria, por lo cual deben incluirse en el diagnóstico diferencial de obstrucción de la vía aérea superior. El diagnóstico temprano y la liberación quirúrgica oportuna de la obstrucción de la vía aérea y del esófago, o ambos, pueden mejorar los síntomas en la mayoría de casos. Esta afección debe sospecharse y evaluarse en lactantes o niños pequeños con síntomas respiratorios recurrentes como tos crónica, estridor y sibilancias o, lo que es menos común, con síntomas relacionados con alteración de la deglución. A continuación se ilustra el caso de un niño de seis años con problemas de deglución crónicos y desnutrición a quién se le realizó un diagnóstico incidental del arco aórtico derecho circunflejo retroesofágico con ligamento arterioso izquierdo corregido mediante cirugía.

Vascular rings are a group of congenital anomalies of the aortic arches in which the trachea and esophagus, or both, are completely surrounded by vascular structures. Often, they can cause obstruction and consequently impaired swallowing and respiratory distress, so they must be included in the differential diagnosis of obstruction of the upper airway. Early diagnosis and timely surgical release of obstruction of the airway and esophagus, or both, may improve symptoms in the majority of cases. This condition must be suspected and evaluated in infants or young children with recurrent respiratory symptoms such as chronic cough, stridor, wheezing or, less commonly, with symptoms related to impaired swallowing. We illustrate the case of a six-year-old child with chronic swallowing problems and malnutrition who underwent an incidental diagnosis of circumflex retroesophageal right aortic arch with left ligamentum arteriosum corrected by surgery.