The covid-19 pandemic and the usability of telehealth in a midlife women's health integrated care program.

BACKGROUND: Telehealth has emerged as an alternative to conventional, face-to-face visits, and the COVID pandemic has hastened its introduction. Telephone appointments make use of an easy-to-use and accessible technology. AIM: To investigate the usability of telephone-based telehealth in a women's health outpatient clinic and whether this may be affected by the severity of the COVID pandemic. METHOD: A telephone survey was prepared to explore two usability domains: interaction quality (4 items) and satisfaction, preference and future use (6 items). Women were selected from two periods during the COVID pandemic when the infection rates were high and low. RESULTS: The survey was completed by 106 women (60 when the prevalence of COVID was high, mean age 53.58 years, and 46 when it was low, mean age 48.59 years) out of the 153 women who had a telephone appointment. The severity of the COVID pandemic showed an effect on responses. Women were less enthusiastic about using the telephone during the period of low COVID prevalence, as shown by lower scores on 3 of the 4 items of the first domain [I had enough time; I would have understood better in person; I would have expressed myself better in person (p < 0.001 for comparison between groups on each of the 3 items)], and on 4 of the 6 items in the second domain [satisfied with quality of care (p < 0.001), or with the information received (p = 0.018); use of telephone in future (p < 0.001); preference to try other technologies in future (p < 0.001)]. Overall, women expressed a preference for in-person visits regardless of COVID prevalence rates. CONCLUSION: Telephone calls were a feasible alternative to face-to-face visits in a women's health outpatient clinic, but the pandemic pressure modified usability parameters. Respondents preferred in-person visits at any pandemic stage.

The RANKL/RANK system in female reproductive organ tumors: A preclinical and clinical overview.

The receptor activator of nuclear factor-κB (RANK) and its ligand RANKL are members of the tumor necrosis factor (TNF) super-family of cytokines with a role in progestogen-associated malignancies in breast. Basic and clinical data support the participation of the cytokine pathway in metastatic disease and as poor prognosis markers. The value of RANK/RANKL as prognostic indicators in endometrial and ovarian tumors, as well as the data suggesting a potential role of RANK/RANKL in hormone dependent tumorigenesis in the endometrium, have been described. The D-CARE study could not confirm benefit in the modulation of RANKL in breast cancer.

Embarazo ectópico intersticial: tratamiento laparoscópico / Interstitial ectopic pregnancy: laparoscopic treatment

El embarazo ectópico intersticial es una entidad rara, que representa el 2-4% de los embarazos ectópicos. Es de difícil diagnóstico tanto por su ubicación como por su rareza. El tratamiento de elección es la laparoscopia.Presentamos un caso de embarazo ectópico intersticial en el que la laparoscópia nos sirvió tanto de diagnóstico como de tratamiento (AU)

The interstitial ectopic pregnancy is a rare condition, accounting for 2-4% of all ectopic pregnancies. It is difficult to diagnose both for its location and for its rarity. The treatment of choice is laparoscopic management. We present a case of interstitial ectopic pregnancy in which laparoscopy was useful in two ways, as a diagnostic tool and for its treatment (AU)

Neoplasia sincrónica de endometrio y ovario / Synchronous neoplasia of the endometrium and ovary

Éste es el caso de una paciente con neoplasia sincrónica de endometrio y ovario. Se presentó a una edad joven (45 años) y con signos clínicos de hipermenorrea. Posteriormente, mediante pruebas de imagen, hallamos la tumoración ovárica. Los tipos histológicos fueron endometrioides en ambas localizaciones y, como en la mayoría de este tipo de neoplasias sincrónicas, de bajo grado y estadio. Todos estos factores son de buen pronóstico. Dentro de las neoplasias sincrónicas, esta asociación de tumores es relativamente frecuente; se caracterizan por tener buen pronóstico y ser de bajo grado. Hay estudios en la actualidad cuyo objetivo es establecer criterios claros para diferenciar 2 neoplasias independientes de una sola neoplasia que afecta a 2 tejidos distintos, mediante sofisticadas técnicas de biología molecular

We report the case of a patient with synchronous neoplasms of the endometrium and ovary, which developed at a relatively young age (45 years). Clinical presentation consisted of hypermenorrhea. An ovarian tumor was subsequently detected through ultrasound and computed tomography. Pathological examination revealed endometrioid histology at both sites and, as in most synchronous tumors occurring in these locations, both the grade and the stage of the tumors were low. All these factors indicate a good prognosis. The association of these two tumors is relatively frequent in synchronous neoplasia in general. These neoplasms are low grade and have a good prognosis. Several current studies aim to establish clear criteria on how to differentiate two independent tumors from a single neoplasm affecting two distinct tissues by using sophisticated molecular biology techniques