Use of pedicled flaps after oncologic resections in pediatric patients.

The aim of this study is to review the indications of pedicled flaps and analyze the results. A observational retrospective study of under 18-year-old oncology patients who required reconstructive surgery with pedicled flaps between 2011 and 2022 was performed. Demographic and clinical variables, indications, complications, and outcomes were collected. 236 patients were reviewed and 13 met inclusion criteria, eight girls and five boys (mean age: 10.6 years). Indications were Ewing's sarcoma (5), osteosarcoma (5), neuroblastoma, desmoid tumor, and neurofibroma. Preoperative PET-CT, MRI and bone scintigraphy were performed. The flaps were used on costal and extremity reconstruction: latissimus dorsi (5), pectoralis (2), medial gastrocnemius (2), combined latissimus dorsi, trapezius and serratus muscle, biceps femoris, fascio-neuro-cutaneous saphenous and cutaneous advancement-rotation. Two were performed on allograft and eight on prosthesis. All allowed immediate and complete closure. Six patients received intraoperative radiotherapy. One flap infection and two vascular complications were reported, a total necrosis, which required a new flap, and a partial necrosis, treated with a local plasty. Chemotherapy was resumed after 21 days (15-31). Mean follow-up time was 5.34 years. Flaps are an effective therapeutic option allowing reconstruction of large defects after pediatric oncologic surgeries. The most frequent complication was vascular.

Prevalence, incidence, clinical manifestations and factors associated with pediculosis capitis in nursery school children of a lowincome area from Colombia / Prevalencia, incidencia, manifestaciones clínicas y factores asociados con pediculosis capitis en niños de guardería de un área de bajos ingresos en Colombia

Objectives: epidemiology of pediculosis capitis was determined. The worldwide distributed ectoparasite, Pediculus humanus capitis, causes pediculosis capitis. Although risk factors for children are known, studies about its clinical description are rare. Materials and methods: cross-sectional descriptive study based on a sample (356 children) aged 1 to 5 of a low-income area from Popayán, Colombia. Two observations were practiced: at the beginning and at the end of the year 2017. Hair, scalp, lymphatic nodules and frontotemporal, parietal, occipital, nuchal and retroauricular cutaneous regions were examined. Insects were mechanically removed by wetting the hair and using lice combs. Nits, nymphs and adult lice were gathered and stored for future studies. Results: prevalence and incidence of pediculosis capitis were 5.1 % and 20.2 %, respectively. The associated variables were mainly infestation antecedent, long hair, female sex and eliminating with shampoo (95 % CI: 15-20). Clinical variables: presence of adenopathies, hair scalp inflammation and nuchal adenopathies (25-35 %); nits and lice localized in occipital region, hair scalp itching and retroauricular itching (20-25 %). Conclusions: pediculosis capitis affects those nursery children studied. It is important to know the variables associated for prevention, control and eradication of head lice infestation..(AU)

Objetivo: se determinó la epidemiólogía de la pediculosis capitis. El ectoparásito mundialmente distribuido, Pediculus humanus capitis, causa pediculosis capitis. Aunque los factores de riesgo son conocidos, investigaciones sobre su descripción clínica son pocas. Materiales y métodos: estudio descriptivo de corte transversal con una muestra (356 niños) entre 1 y 5 años de un área de bajos ingresos (Popayán, Colombia). Se realizaron dos observaciones: al inicio y al final del año 2017. Se examinaron el pelo, cuero cabelludo, nódulos linfáticos y las regiones cutáneas frontotemporales, parietales, occipital, nuca y retroauriculares. Los insectos fueron removidos mecánicamente por medio de peines liendrera y humedeciendo el pelo. Las liendres, ninfas y piojos adultos se almacenaron para futuros estudios. Resultados: la prevalencia e incidencia de pediculosis capitis fueron 5,1 % y 20,2 %, respectivamente. Las variables asociadas fueron principalmente antecedentes de infestación, pelo largo, sexo femenino y eliminación con champú (95 % CI: 15-20). Variables clínicas: presencia de adenopatías, inflamación del cuero cabelludo y adenopatías nucales (25-35 %); liendres y piojos localizados en la región occipital, prurito del cuero cabelludo y prurito retroauricular (20-25 %). Conclusiones: la pediculosis capitis está presente y afecta a los niños de guardería. Es importante conocer las variables asociadas a la pediculosis capitis para prevenir, controlar y erradicar la infestación por piojos de la cabeza..(AU)

Virus de Epstein-Barr y su relación con el desarrollo del cáncer / Relationship between Epstein-Barr virus and cancer development / O Vírus de Epstein-Barr e sua relação com o desenvolvimento do cáncer

RESUMEN El virus de Epstein-Barr (VEB) es un agente infeccioso que tiene tropismo por células linfoides y ocasionalmente por células epiteliales. La Agencia Internacional para la Investigación sobre Cáncer (IARC, por su sigla en inglés) lo clasificó hace 20 años como carcinógeno de tipo I, porque durante la infección latente expresa diferentes proteínas o micro-ARN con capacidad oncogénica, por lo que las células infectadas tendrían el potencial de desarrollar cáncer. Esto se ha demostrado en algunos tipos de cáncer como linfomas, carcinoma nasofaríngeo y cáncer gástrico, mientras que la asociación no es completamente clara en los cánceres de mama y pulmón. La presente revisión describe, profundiza y analiza la relación del VEB con dichos tipos de cáncer, así como los métodos diagnósticos empleados para su detección. Finalmente, se plantean preguntas cuyas respuestas podrían contribuir al conocimiento de los mecanismos moleculares involucrados en la relación VEB-cáncer.

SUMMARY Relationship between Epstein-Barr virus and cancer development Epstein-Barr virus (EBV) is an infectious agent with tropism for lymphoid cells and occasionally for epithelial cells. Twenty years ago it was classified by the International Agency for Research on Cancer (IARC) as type I carcinogen, because during latent infection it expresses different proteins or microRNAs with oncogenic ability, so that infected cells could potentially develop cancer. This association has been shown in some cancers such as lymphoma, nasopharyngeal carcinoma and gastric cancer, while the association has not been completely clear in breast and lung cancer. This review describes, deepens and analyzes the relationship between EVB and the aforementioned types of cancer, as well as diagnostic methods for its detection. Finally, this paper poses different questions whose answers could contribute to understand the molecular mechanisms involved in the EVB-cancer relationship.

RESUMO O vírus de Epstein-Barr (VEB) é um agente infeccioso que tem tropismo pelas células linfóides e, ocasionalmente, por células epiteliais. A Agência Internacional de Investigação do Câncer (IARC, por sua sigla do Inglês) classificou-o há 20 anos como substância cancerígena tipo I, devido a que durante a infecção latente expressa diferentes proteínas ou micro-ARN com capacidade oncogênica, de modo que as células infectadas têm o potencial de desenvolver câncer. Isto tem sido demonstrado em alguns tipos de câncer tais como linfomas, carcinoma da nasofaringe e câncer gástrico, enquanto que a associação não é inteiramente claro nos câncer da mama e do pulmão. Esta revisão descreve, analisa os aprofunda a relação do VEB com os mencionados tipos de câncer, bem como os métodos de diagnóstico para a sua detecção. Finalmente, planteiam se questões cujas respostas poderiam contribuir na compreensão dos mecanismos moleculares envolvidos na relação VEB-câncer.