Is Re-introducing Major Open and Minimally Invasive Surgery during COVID-19 Safe for Patients and Healthcare Workers? An International, Multi-centre Cohort Study in the Field of Oesophago-gastric Surgery.

INTRODUCTION: The COVID-19 pandemic has resulted in unparalleled changes to patient care, including the suspension of cancer surgery. Concerns regarding COVID-19-related risks to patients and healthcare workers with the re-introduction of major complex minimally invasive and open surgery have been raised. This study examines the COVID-19 related risks to patients and healthcare workers following the re-introduction of major oesophago-gastric (EG) surgery. PATIENTS AND METHODS: This was an international, multi-centre, observational study of consecutive patients treated by open and minimally invasive oesophagectomy and gastrectomy for malignant or benign disease. Patients were recruited from nine European centres serving regions with a high population incidence of COVID-19 between 1 May and 1 July 2020. The primary endpoint was 30-day COVID-19-related mortality. All staff involved in the operative care of patients were invited to complete a health-related survey to assess the incidence of COVID-19 in this group. RESULTS: In total, 158 patients were included in the study (71 oesophagectomy, 82 gastrectomy). Overall, 87 patients (57%) underwent MIS (59 oesophagectomy, 28 gastrectomy). A total of 403 staff were eligible for inclusion, of whom 313 (78%) completed the health survey. Approaches to mitigate against the risks of COVID-19 for patients and staff varied amongst centres. No patients developed COVID-19 in the post-operative period. Two healthcare workers developed self-limiting COVID-19. CONCLUSIONS: Precautions to minimise the risk of COVID-19 infection have enabled the safe re-introduction of minimally invasive and open EG surgery for both patients and staff. Further studies are necessary to determine the minimum requirements for mitigations against COVID-19.

Aspectos imaginológicos del sarcoma granulocítico en la cara y el cráneo de niños y jóvenes: informe de cinco casos y revisión de la literatura / Radiological findings of granulocytic sarcoma in the face and skull of children and young persons: report of five cases and literature review

Introducción: el sarcoma granulocítico (SG) es una neoplasia maligna cuya incidencia es de 2,9% a3,1% en pacientes con leucemia mieloide (LM) o enfermedades mieloproliferativas. Se presentahabitualmente en hombres y en población africana, asiática y suramericana. Objetivo: describir las características imaginológicas del SG en la cara y el cráneo de cinco niños y jóvenes. Pacientes y métodos: presentamos cinco pacientes con SG en la cara y la base del cráneo. A cuatro de ellos se les hizo tomografía computarizada (TC) y a tres, resonancia magnética (RM) cerebral. Cuatro presentaron una masa de tejido blando en la órbita, dos tenían afectación ósea y otro reveló lesión en el sistema nervioso central. En cuatro se diagnosticó leucemia mieloide aguda (LMA) .Conclusión: el SG puede manifestarse con invasión orbitaria y craneofacial en niños y adultos jóvenes. Usualmente los pacientes consultan por proptosis y edema orbitario. Con este cuadro clínico el SG es la primera probabilidad diagnóstica en el contexto de la LMA o las mielodisplasias. En otras situaciones clínicas se debe hacer diagnóstico diferencial con complicaciones de sinusitis, rabdomiosarcoma, linfoma de la órbita y otras neoplasias. La imaginología demuestra invasión de tejidos blandos e infiltración ósea. Es muy característico del SG afectar en un comienzo la pared lateral o la superior de la órbita. En algunos casos simula abscesos. El diagnóstico se confirma por histopatología.

Introduction: Granulocytic sarcoma (GS) is a rare malignant neoplasia, with an incidence rate of 2.9% to 3.1% in patients with myeloid leukemia or myeloproliferative diseases. Usually it affects males, of African, Asian and South American populations. Objetive: To describe the radiological characteristics of GS in the face and skull of children and young people. Patients and methods: We report five patients with GS in the face and skull. Computerized tomography (CT) was carried out in four and orbital and brain magnetic resonance (MRI) in three. Out of the five, four had soft tissue masses in the orbit, two had bone infiltration, and in one there was a central nervous system lesion. In four patients acute myeloid leukemia was demonstrated. Conclusion: GS may affect the orbit, the face and the skull of children and young adults; it manifests with exophthalmia and orbital edema. It must be considered as a diagnostic possibility in the context of myeloid leukemia and myelodysplasias. Otherwise, differential diagnosis should be made with complications of sinusitis, orbital rhabdomyosarcoma, orbital lymphoma and other tumors. Imaging studies may help in the diagnosis by revealing soft tissue masses and areas of bone infiltration. In some cases GS may resemble abscesses. Diagnosis must be confirmed by histopathology.

Tosferina en Vigia del Fuerte / Whooping cough in Vigia del Fuerte

Se comprobó la presencia de un brote de tosferina en el corregimiento de Vegáez, perteneciente al municipio de Vigía del Fuerte, el cual se inició posiblemente desde fines del año 1985 y/o comienzos de 1986 hasta el III período epidemiológico, encontrándose: 8 casos en fase paroxística, 9 casos en fase convalesciente y 17 casos con cuadro clínico catarral, a quienes se les realizó hisopado nasofaríngeo para determinar la presencia de B. pertussis, con resultado positivo de un 50% de las muestras analizadas. El factor causal se reduce a los esquemas de vacunación incompletos o ausentes, explicable por la inaccesibilidad de la región y las consabidas dificultades para la conservación de la cadena de frío para el biológico. Con la aplicación de las Normas de Vigilancia Epidemiológica, se busca interrumpir la cadena de transmisión y ofrecer la protección inmunológica de la vacunación, para modificar la situación encontrada