RESUMEN
Primary serous peritoneal carcinoma (PPC) is a rare malignancy often presenting with a significant disease burden and a poor prognosis. A 65-year-old female was seen in the surgical outpatient clinic with a two-month history of weight loss, altered bowel habits and a CT scan characterizing a heterogenous right paracolic gutter mass and suspicious liver lesions. At colonoscopy, a prominent appendiceal orifice was biopsied to be poorly differentiated carcinoma favouring gynaecological tract origin. The patient was admitted with an acute small bowel obstruction secondary to progression of metastases and underwent neoadjuvant chemotherapy with a near complete response on repeat staging. A debulking hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy and small bowel nodule excision were performed. The diagnosis of PPC was confirmed when no malignancy was found in the pelvic organs. The presence of intraluminal colonic metastasis with PPC is exceedingly rare with this being only the third such case in the literature.
RESUMEN
BACKGROUND: Mobile health (mHealth) technologies, such as wearable sensors, smart health devices, and mobile apps, that are capable of supporting pregnancy care are emerging. Although mHealth could be used to facilitate the tracking of health changes during pregnancy, challenges remain in data collection compliance and technology engagement among pregnant women. Understanding the interests, preferences, and requirements of pregnant women and those of clinicians is needed when designing and introducing mHealth solutions for supporting pregnant women's monitoring of health and risk factors throughout their pregnancy journey. OBJECTIVE: This study aims to understand clinicians' and pregnant women's perceptions on the potential use of mHealth, including factors that may influence their engagement with mHealth technologies and the implications for technology design and implementation. METHODS: A qualitative study using semistructured interviews was conducted with 4 pregnant women, 4 postnatal women, and 13 clinicians working in perinatal care. RESULTS: Clinicians perceived the potential benefit of mHealth in supporting different levels of health and well-being monitoring, risk assessment, and care provision in pregnancy care. Most pregnant and postnatal female participants were open to the use of wearables and health monitoring devices and were more likely to use these technologies if they knew that clinicians were monitoring their data. Although it was acknowledged that some pregnancy-related medical conditions are suitable for an mHealth model of remote monitoring, the clinical and technical challenges in the introduction of mHealth for pregnancy care were also identified. Incorporating appropriate health and well-being measures, intelligently detecting any abnormalities, and providing tailored information for pregnant women were the critical aspects, whereas usability and data privacy were among the main concerns of the participants. Moreover, this study highlighted the challenges of engaging pregnant women in longitudinal mHealth monitoring, the additional work required for clinicians to monitor the data, and the need for an evidence-based technical solution. CONCLUSIONS: Clinical, technical, and practical factors associated with the use of mHealth to monitor health and well-being in pregnant women need to be considered during the design and feasibility evaluation stages. Technical solutions and appropriate strategies for motivating pregnant women are critical to supporting their long-term data collection compliance and engagement with mHealth technology during pregnancy.