Tumor maligno de la vaina nerviosa periférica: reporte de un caso / Malignant peripheral nerve sheath tumor, a case report

Resumen El tumor maligno de la vaina nerviosa periférica (TMVNP) es un sarcoma de alto grado de malignidad. Es poco frecuente, agresivo y generalmente se localiza en tronco y miembros inferiores. Se presenta mayormente en pacientes con neurofibormatosis tipo 1, aunque no siempre se encuentra esta asociación. Este tumorcomparte características histológicas e inmunohistoquímicas con el melanoma, lo que puede dificultar el diagnóstico. Presentamos el caso de un paciente con TMVNP, en el cual los hallazgos histológicos iniciales condujeron a un diagnósticoerróneode melanoma.

Abstract Malignant peripheral nerve sheath tumor (MPNST) is a high-grade sarcoma. It is rare, aggressive and generally located on the trunk and lower limbs. It occurs in a high percentage of patients with neurofibormatosis type 1, although this association is not always found. This tumor shares histological and immunohistochemical characteristics with melanoma, which can make diagnosis difficult. We present the case of a patient with MPNST, in whom the initial histological findings led to an erroneous diagnosis of melanoma.

Risk factors for severe postoperative complications after oncologic right colectomy

This study aims to examine the possible risk factors for severe postoperative sequelae following oncologic right colectomy. This retrospective analysis included all consecutive patients with right colon cancer who had right colectomy in our department from 1st Jan 2022 to 31st Dec 2023. The Clavien-Dindo grading system was employed to assess postoperative problems. Univariate and multivariate logistic regression analysis were done to look into risk variables for serious postoperative complications. Of the 21 patients, there were 10 males and 11 females, with a median age of 68 (IQR 60­78). Postoperative morbidity and mortality rates were 42.85% (9 patients) and 9.52% (2 patients), respectively. The anastomotic leak rate was 4.76% (1 patient). Severe postoperative complications (Clavien­ Dindo grades III­V) were present in 3 patients (14.28%). Univariate analysis showed the following as risk factors for postoperative severe complications: Charlson score, lack of mechanical bowel preparation, level of preoperative proteins, blood transfusions, and degree of urgency (elective/emergency right colectomy). In the logistic binary regression, the Charlson score (OR = 1.932, 95% CI = 1.077­ 3.463, p = 0.025) and preoperative protein level (OR = 0.048, 95% CI = 0.006­0.433, p = 0.007) were found to be independent risk factors for postoperative severe complications. Severe consequences after oncologic right colectomy are linked to a low preoperative protein level and a higher Charlson comorbidity index

Outcomes of radical prostatectomy in a 20-year localized prostate cancer single institution series in China / 亚洲男科学杂志(英文版)

The long-term survival outcomes of radical prostatectomy (RP) in Chinese prostate cancer (PCa) patients are poorly understood. We conducted a single-center, retrospective analysis of patients undergoing RP to study the prognostic value of pathological and surgical information. From April 1998 to February 2022, 782 patients undergoing RP at Queen Mary Hospital of The University of Hong Kong (Hong Kong, China) were included in our study. Multivariable Cox regression analysis and Kaplan-Meier analysis with stratification were performed. The 5-year, 10-year, and 15-year overall survival (OS) rates were 96.6%, 86.8%, and 70.6%, respectively, while the 5-year, 10-year, and 15-year PCa-specific survival (PSS) rates were 99.7%, 98.6%, and 97.8%, respectively. Surgical International Society of Urological Pathology PCa grades (ISUP Grade Group) ≥4 was significantly associated with poorer PSS (hazard ratio [HR] = 8.52, 95% confidence interval [CI]: 1.42-51.25, P = 0.02). Pathological T3 stage was not significantly associated with PSS or OS in our cohort. Lymph node invasion and extracapsular extension might be associated with worse PSS (HR = 20.30, 95% CI: 1.22-336.38, P = 0.04; and HR = 7.29, 95% CI: 1.22-43.64, P = 0.03, respectively). Different surgical approaches (open, laparoscopic, or robotic-assisted) had similar outcomes in terms of PSS and OS. In conclusion, we report the longest timespan follow-up of Chinese PCa patients after RP with different approaches.

Bloqueio do Quadrado Lombar Tipo II para Tratamento de Dor Oncológica de Difícil Controle ­ Relato de Caso / Type II Quadratus Lumborum Block for Treatment of Difficult-to-Control Cancer Pain - Case Report

A dor oncológica é um fator impactante para a qualidade de vida dos pacientes, cujo manejo é desafiador, pois pode ser refratária à terapia sistêmica multimodal otimizada. Descrito pela primeira vez em 2007, o bloqueio do quadrado lombar tem sido amplamente utilizado para promover analgesia em região abdominal.

Cancer pain is a factor that impacts the quality of life of patients, whose management is challenging because it can be refractory to optimized multimodal systemic therapy. First described in 2007, quadratus lumborum block has been widely used to promote analgesia in the abdominal region.

Complicaciones en cirugía ortopédica oncológica: una nueva propuesta de clasificación / Complications in orthopaedic oncology surgery: A new proposal for classification

Se presenta un análisis de las clasificaciones previamente publicadas para las complicaciones que ocurren después de una cirugía realizada para extirpar un tumor que afecta a los huesos. En cuanto a la importancia de ofrecer una propuesta sencilla, fácil de entender, completa, y orientada a las posibilidades de manejo de esas complicaciones, se presenta una nueva propuesta de clasificación(AU)

An analysis of previously published classifications for complications happening after a surgery performed to remove a tumor affecting bones, is presented, and commented. Regarding the importance of offering a simple, easy to understand, complete, and aimed at the possibilities of management of those complications, a new proposal for classification is presented(AU)

Prevalencia de serotipos del virus de papiloma humano en mujeres de Ecuador

Resumen El Virus del Papiloma Humano constituye un problema de salud pública al presentar una prevalencia muy alta debido a que es una de las infecciones de transmisión sexual más frecuente a nivel mundial, está asociado a distintos tipos de cánceres sobre todo al cáncer cérvico uterino. Este cáncer es la segunda causa de muerte por enfermedades oncológicas en mujeres del Ecuador. Objetivo . Caracterizar la infección de Virus del Papiloma Humano a partir de la prevalencia de sus serotipos asociados a lesiones cervicales en mujeres del Ecuador durante el periodo enero 2010 hasta diciembre 2020. Metodología . Se realizó una revisión sistemática de tipo documental de acuerdo a la declaración PRISMA. Para lo cual se incluyeron artículos de investigación relacionados con la problemática. La búsqueda se realizó en bases de datos de gran impacto como PubMed, Scopus, ScieLO, Redalyc, Google Académico, Web of Science, Springer, Taylor & Francis, Elsevier, MedLine; se encontraron 38 artículos de los cuales 10 fueron válidos para la investigación. Resultados . Los serotipos de Virus del Papiloma Humano más prevalentes del grupo de alto riesgo oncológico fueron el 16, 58, y 31; mientras que para los de bajo riesgo oncológico fueron los serotipos 61, 81 y 6. Conclusiones . No todas las regiones presentaron estudios de prevalencia de serotipos de VPH. Sin embargo, las regiones que si presentaron datos evidenciaron que el serotipo de alto riesgo oncológico más frecuente es el 16, mientras que el de bajo riesgo oncológico es el 61.

Abstract The Human Papilloma Virus constitutes a public health problem by presenting a very high prevalence due to the fact that it is one of the most frequent sexually transmitted infections worldwide, it is associated with different types of cancers especially cervical uterine cancer. This cancer is the second cause of death due to oncological diseases in women in Ecuador. Objective . The objective of this research was to characterize the infection of Human Papillomavirus from the prevalence of its serotypes associated with cervical lesions in women in Ecuador during the period January 2010 to December 2020. Methodology . A systematic documentary review was carried out according to the PRISMA statement. For this purpose, research articles related to the problem were included. The search was carried out in high impact databases such as PubMed, Scopus, ScieLO, Redalyc, Google Scholar, Web of Science, Springer, Taylor & Francis, Elsevier, MedLine; thirty-eight articles were found of which 10 were valid for the research. Results . The most prevalent serotypes of Human Papillomavirus in the high oncologic risk group were 16, 58 and 31; while for the low oncologic risk group they were serotypes 61, 81 and 6. Conclusions . Not all regions presented studies of HPV serotype prevalence. However, the regions that did present data showed that the most frequent high oncologic risk serotype is 16, while the low oncologic risk serotype is 61.

Resumo O Vírus do Papiloma Humano constitui um problema de saúde pública ao apresentar uma prevalência muito elevada porque é uma das infecções sexualmente transmissíveis mais frequentes em todo o mundo, está associado a diferentes tipos de cancros, especialmente o cancro do útero cervical. Este cancro é a segunda principal causa de morte por doenças oncológicas nas mulheres do Equador. Objectivo . O objectivo desta investigação era caracterizar a infecção pelo Papilomavírus Humano a partir da prevalência dos seus serótipos associados a lesões cervicais em mulheres no Equador durante o período de Janeiro de 2010 a Dezembro de 2020. Metodologia . Foi realizada uma revisão documental sistemática de acordo com a declaração do PRISMA. Foram incluídos artigos de investigação relacionados com o problema. A pesquisa foi realizada em bases de dados de alto impacto tais como PubMed, Scopus, ScieLO, Redalyc, Google Scholar, Web of Science, Springer, Taylor & Francis, Elsevier, MedLine; foram encontrados 38 artigos dos quais 10 eram válidos para a pesquisa. Resultados : Os serotipos mais prevalentes do Papilomavírus Humano no grupo de alto risco oncológico foram 16, 58, e 31; enquanto para os de baixo risco oncológico foram os serotipos 61, 81, e 6. Conclusões . Nem todas as regiões apresentaram estudos de prevalência do serotipo HPV. Contudo, as regiões que apresentaram dados mostraram que o serótipo de alto risco mais frequente é o 16, enquanto que o serótipo de baixo risco mais frequente é o 61.

La superación de la enfermera en la atención integral a la familia con enfermo oncológico / The upgrade of the nurse in the comprehensive care to the family with oncological patients

RESUMEN Introducción: la enfermera que se desempeña en los consultorios de la Atención Primaria de Salud, asume la responsabilidad de propiciar una atención integral al familiar encargado del cuidado del enfermo oncológico. Objetivo: diseñar una propuesta de superación para el perfeccionamiento de la actuación de la enfermera en la atención integral a la familia con enfermo oncológico. Materiales y métodos: se efectuó una investigación de desarrollo en la Facultad de Ciencias Médicas de Matanzas Dr. Juan Guiteras Gener, durante el curso 2018-2019. Se utilizó una muestra de 23 enfermeras de los consultorios de la atención primaria del municipio de Matanzas. Se analizaron los documentos que avalan su desempeño profesional. Se diseñó una encuesta dirigida a la identificación de las necesidades de aprendizaje y una guía de observación para caracterizar el modo de actuación del profesional de Enfermería. Se aplicaron entrevistas a supervisoras y directivos. Resultados: el análisis de las encuestas aplicadas a la muestra seleccionada y las observaciones realizadas a las actividades en el hogar, permitieron detectar las necesidades de aprendizaje para el perfeccionamiento de la atención integral a la familia con enfermo oncológico. Las entrevistas realizadas a supervisoras y directivos corroboraron la necesidad de la propuesta. Conclusiones: se diseñó un curso de posgrado para el perfeccionamiento de la actuación de los profesionales de la Enfermería, relacionado con el cuidado integral a la familia con enfermos oncológicos en la Atención Primaria de Salud (AU).

ABSTRACT Introduction: the nurse who works in the primary health care consultations assumes the responsibility of providing comprehensive care to the relative who takes care of oncological patients. Objective: to design a proposal of upgrading to improve the performance of the nurse in the comprehensive care to the family with an oncological patient. Materials and methods: a development research was conducted in the Faculty of Medical Sciences Dr. Juan Guiteras Gener, of Matanzas, during the school year 2018-2019. The sample was 23 nurses from the primary health care offices of the municipality of Matanzas. The documents that support their professional performance were analyzed. A survey was designed to identify learning needs and also an observation guide to characterize the performance of the nursing professional. Interviews were conducted with supervisors and managers. Results: the analysis of the surveys applied to the chosen sample and the observations made to the activities carried out at home, made it possible to determine the learning needs for the improvement of the comprehensive care to the families with oncological patients. Interviews with supervisors and managers confirmed the necessity of the proposal. Conclusions: a postgraduate course was designed for the improvement of nursing professionals' performance, aimed to the comprehensive care to families with oncological patients in the primary health care (AU).

Resultados tempranos en pacientes con cáncer gástrico sometidos a gastrectomía laparoscópica con intención curativa / Early results in gastric cancer patients undergoing laparoscopic gastrectomy with curative intent

Introducción. El manejo de pacientes con cáncer gástrico está determinado por el estadio preoperatorio y requiere de una estrategia multidisciplinaria. La cirugía radical, especialmente en pacientes con estadios tempranos, es potencialmente curativa. El abordaje por vía laparoscópica ofrece ventajas sobre la vía abierta, sin embargo, en nuestro medio no hay información en cuanto a resultados oncológicos y posoperatorios tempranos. Métodos. Estudio retrospectivo, descriptivo, de tipo transversal, en pacientes con cáncer gástrico llevados a gastrectomía laparoscópica con intención curativa, entre el 2014 y el 2019, en tres instituciones de la ciudad de Medellín. Se analizaron los datos demográficos, los resultados posoperatorios y oncológicos a corto plazo. Resultados. Se incluyeron 75 pacientes sometidos a gastrectomía laparoscópica. La mediana de edad fue de 64 años y el estadio más frecuente fue el III. La gastrectomía fue subtotal en 50 pacientes (66,7 %) y total en 25 pacientes (33,3 %). Se hizo disección linfática D2 en 73 pacientes (97,3 %) con una mediana en el recuento ganglionar de 27. La tasa de resección R0 fue de 97,3 %. La mediana de estancia hospitalaria fue de seis días. La tasa de complicaciones mayores fue del 20 % y la mortalidad a 90 días fue del 4 %. Discusión. La calidad oncológica de la gastrectomía laparoscópica fue adecuada y cumple con las recomendaciones de las guías internacionales. Si bien la morbilidad sigue siendo alta, tiene una tasa de sobrevida del 96 % a 90 días.

Introduction. The management of patients with gastric cancer is determined by the preoperative stage and requires a multidisciplinary strategy. Radical surgery, especially in patients with early stages, is potentially curative. The laparoscopic approach offers advantages over the open approach, however, in our setting there is no information regarding oncological and early postoperative results.Methods. Retrospective, descriptive, cross-sectional study in patients with gastric cancer who underwent laparoscopic gastrectomy with curative intent, between 2014 and 2019, in three institutions in the city of Medellín. Demographic data, postoperative and short-term oncological results were analyzed.Results. Seventy-five patients undergoing laparoscopic gastrectomy were included. The median age was 64 years and the most frequent stage was III. Gastrectomy was subtotal in 50 patients (66.7%) and total in 25 patients (33.3%). D2 lymphatic dissection was performed in 73 patients (97.3%) with a median lymph node count of 27. The R0 resection rate was 97.3%. The median hospital stay was six days. The major complication rate was 20% and the 90-day mortality was 4%.Discussion. The oncological quality of the laparoscopic gastrectomy was adequate and complies with the recommendations of international guidelines. Although morbidity remains high, it has a 96% survival rate at 90 days

Osteonecrosis asociada a pacientes con consumo de antirresortivos bajo tratamiento oncológico / Osteonecrosis associated to patients who take anti-resorptive drugs, undergoing oncologic treatment

La Asociación Americana de Cirugía Oral y Maxilofacial (American Association of Oral and Maxillofacial Surgeons [AAOMS]): define el concepto de osteonecrosis maxilar asociada a drogas antirresortivas (MRONJ) como: «área ósea necrótica expuesta al medio bucal con más de ocho semanas de permanencia, en presencia de tratamiento crónico con bifosfonatos en ausencia de radioterapia en cabeza y cuello¼. El objetivo de este artículo es asociar la enfermedad oncológica en relación con las drogas antirresortivas consumidas por pacientes, la prescripción de dichas drogas y el depósito de ellas en el organismo. Al mismo tiempo, la interacción médico-odontológico debe implementarse en favor de la salud de nuestros pacientes (AU)

American Association of Oral and Maxillofacial Surgeons AAOMS defined Medication Related of the Jaw (MRONJ) as «necrotic bone area exposed to the oral environment with more than eight weeks of permanence, in the presence of chronic treatment with BPs, in the absence of radiation therapy to the head and neck¼. The objective of this article is associate oncology antiresorptives treatments prescribed by physicians, their prescription and body accumulation in patients whose are treated with them. Interdisciplinary dental and physician clinical treatments must be implemented in patient favours (AU)

Experiences, dietary behavior and cultural characteristics of people with colorectal neoplasms / Experiencias, conducta alimentaria y características culturales de personas con neoplasias colorrectales / Experiências, comportamento alimentar e características culturais de pessoas com neoplasias colorretais

ABSTRACT Objectives: to interpret the socio-cultural, religious, and spiritual aspects of the experience of people who have colorectal cancer and were submitted to surgical treatment with ostomy. Methods: ethnographic study under the perspective of the Sociology of Health, in the comprehensive aspect, in a surgical unit of an oncologic hospital of the state of Pará, Brazil. Eighteen deponents participated, eleven patients, and seven caregivers, between December 2018 and March 2019. Data were obtained with non-participant observation, field diary records, and semi-structured interviews with subsequent inductive content analysis. Results: religious attachment and socio-cultural aspects of the illness were interpreted, emphasizing the social fact of the Immediate Dream, emotional shock, modern totemism, toxic food as taboo, and medicalization in the sphere of common sense and biomedical system. Final Considerations: microsocial and macrosocial factors of the participants' experiences contribute to the qualification of oncologic assistance in the public system, assuming the need for specialized interprofessional assistance.

RESUMEN Objetivos: interpretar aspectos socioculturales, religiosos y espirituales de experiencia de enfermedad de personas por cáncer colorrectal sometidas al tratamiento quirúrgico con estomatización. Métodos: estudio etnográfico bajo la perspectiva de la Sociología de Salud, en la vertiente comprensiva, en unidad quirúrgica de un hospital oncológico de Pará, Brasil. Participaron 18 deponentes, siendo 11 enfermos y 7 cuidadores, entre diciembre de 2018 y marzo de 2019. Los datos obtenidos con observación no participante/participante, registro en diario de campo y entrevista semiestructurada con posterior análisis de contenido inductivo. Resultados: interpretaron el apego religioso y aspectos socioculturales del enfermo, enfatizando el hecho social del Sueño Inmediato, choque emocional, totemismo moderno, la reimosidad alimentaria como tabú y la medicalización en la esfera del sentido común y sistema biomédico. Consideraciones Finales: factores microsociales y macrosociales de las experiencias de los participantes contribuyen en cualificación de asistencia oncológica en el sistema público, presuponiendo la necesidad de una asistencia interprofesional especializada.

RESUMO Objetivos: interpretar os aspectos socioculturais, religiosos e espirituais da experiência de adoecimento de pessoas por câncer colorretal submetidas ao tratamento cirúrgico com estomização. Métodos: estudo etnográfico sob a perspectiva da Sociologia da Saúde, na vertente compreensiva, em unidade cirúrgica de um hospital oncológico do estado do Pará, Brasil. Participaram 18 depoentes, sendo 11 adoecidos e 7 cuidadores, entre dezembro de 2018 e março de 2019. Os dados foram obtidos com observação não participante/participante, registro em diário de campo e entrevista semiestruturada com posterior análise de conteúdo indutiva. Resultados: interpretaramse o apego religioso e aspectos socioculturais do adoecimento, enfatizando o fato social do Sonho Imediato, choque emocional, totemismo moderno, reimosidade alimentar como tabu e a medicalização na esfera do senso comum e sistema biomédico. Considerações Finais: fatores microssociais e macrossociais das experiências dos participantes contribuem na qualificação da assistência oncológica no sistema público, pressupondo a necessidade de uma assistência interprofissional especializada.

Bilateral renal cell carcinoma operated as right radical nephrectomy and left partial nephrectomy with histopathologically confirmed R0 resection

Bilateral renal tumors remain relatively uncommon, accounting for 1-5% of patients with renal cell carcinoma. Most sporadic renal cell carcinomas are unilateral and unifocal. Bilateral involvement can be synchronous or asynchronous and is found in 2-4% of sporadic renal cell carcinomas. We report a case of 70 years old male who was incidentally found to have bilateral renal masses. Right sided radical nephrectomy and left partial nephrectomy was performed. Histopathological examination of the specimen revealed clear cell carcinoma and confirmed R0 resection. The patient was discharged on 7th postoperative day.

Perfil sociodemográfico e qualidade de vida em mulheres acometidas por câncer de mama / Sociodemographic profile and quality of life in women with breast cancer

Objetivo: Identificar o Estado Geral de Saúde/Qualidade de vida e comparar as médias entre o perfil sociodemográfico e a qualidade de vida de mulheres com câncer de mama. Metodologia: Estudo quantitativo, descritivo, exploratório, realizado com 29 mulheres em tratamento para câncer de mama. Para avaliação do Estado Geral de Saúde/Qualidade de Vida, foi utilizado o instrumento European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-30. Resultados: O Estado Geral de Saúde/Qualidade de vida atingiu uma média de 73,1, sendo este um indicativo de satisfação. Os principais domínios afetados foram as funções física e social, insônia, constipação, fadiga, dor e perda de apetite. A função física e o desempenho de papel se mostraram significativos em relação à renda familiar per capita. Sobre a escala de sintomas, os resultados foram significativos entre a dor, a faixa etária e a renda familiar per capita; dispneia e renda familiar per capita; náuseas e vômitos e a faixa etária e o estado civil e, diarreia e escolaridade, renda familiar per capita e estado civil. Conclusão: As participantes apresentaram satisfação com o seu Estado Geral de Saúde/Qualidade de vida, problemas relacionados às funções física e social e a insônia.

Objective: To identify the General State of Health / Quality of Life and compare the averages of the sociodemographic profile and the quality of life of women with breast cancer. Methodology: Quantitative, descriptive, exploratory study conducted with 29 women undergoing treatment for breast cancer. In order to evaluate the General Health Status / Quality of Life, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire-30 was used. Results: The General State of Health / Quality of Life reached an average of 73.1, which is an indication of satisfaction. The main domains affected were the physical and social functions, insomnia, constipation, fatigue, pain and loss of appetite. Physical function and role performance were significant in relation to per capita household income. Regarding the symptom scale, the results were significant between pain, age and per capita household income; dyspnea and per capita household income; nausea and vomiting and age and marital status, and diarrhea and education, per capita household income and marital status. Conclusion: The participants were satisfied with their General State of Health / Quality of life, problems related to physical and social function and insomnia.

My role and responsibility: mothers' perspectives on overload in caring for children with cancer* / Meu papel e responsabilidade: as perspectivas das mães sobrecarregadas com o cuidado dos filhos com câncer / Mi rol y responsabilidad: las perspectivas de las madres sobrecargadas con el cuidado a los hijos con cáncer

Abstract Objective: To understand the experience of maternal overload in caring for children with cancer from the mother's perspective. Method: Symbolic Interactionism was adopted as a theoretical framework and the Grounded Theory as methodological framework. The study was conducted in a public hospital, which is reference in pediatric oncology. Data was collected from six mothers through semi-structured interviews in the second semester of 2017. Results: Mothers of children with cancer attributed meaning to the care experience when trying to cope with the emotional, social, physical, financial, family-related, information and moral overload. Maternal overload arises as a dynamic inter-relation process between the many types of overload. Conclusion: The maternal figure is the main person involved in care and experiences overload in caring for their sick child, facing limitations and responsibilities. The research acted as a key element to broaden the analysis and intervention of the family nurse, not only contributing to the theoretical construct related to maternal overload, but also and mainly to the scope of practice in patient care.

Resumo Objetivo: Compreender a experiência da sobrecarga materna no cuidado dos filhos com câncer do ponto de vista da mãe. Método: O Interacionismo Simbólico foi adotado como um marco teórico e a Teoria Fundamentada nos Dados, como marco metodológico. O estudo foi conduzido em um hospital público, que é referência em oncologia pediátrica. Os dados foram coletados de seis mães por meio de entrevistas semiestruturadas no segundo semestre de 2017. Resultados: As mães das crianças com câncer atribuíram significado à experiência do cuidado quando tentaram lidar com a informação emocional, social, física, financeira, relacionada à família e a sobrecarga moral. A sobrecarga materna emerge como um processo inter-relacional dinâmico entre os vários tipos de sobrecarga. Conclusão: A figura materna é a pessoa principal envolvida no cuidado e experimenta sobrecarga no cuidado com seus filhos doentes, enfrentando limitações e responsabilidades. A pesquisa agiu como um elemento-chave para ampliar a análise e intervenção do enfermeiro familiar, não apenas contribuindo para o construto teórico relacionado à sobrecarga materna, mas também e principalmente para o escopo da prática no cuidado com o paciente.

Resumen Objetivo: Comprender la experiencia de la sobrecarga materna en el cuidado a los hijos con cáncer desde el punto de vista de la madre. Método: El Interaccionismo Simbólico fue adoptado como un marco teórico y la Teoría Fundamentada en los Datos, como marco metodológico. Se llevó a cabo el estudio en un hospital público, que es referencia en oncología pediátrica. Se recogieron los datos de seis madres mediante entrevistas semiestructuradas en el segundo semestre de 2017. Resultados: Las madres de los niños con cáncer atribuyeron significado a la experiencia del cuidado cuando intentaron manejar la información emotiva, social, física, financiera, relacionada con la familia y la sobrecarga moral. La sobrecarga materna surge como un proceso interrelacional dinámico entre los distintos tipos de sobrecarga. Conclusión: La figura materna es la persona principal involucrada en el cuidado y experimenta sobrecarga en el cuidado a sus hijos enfermos, enfrentando limitaciones y responsabilidades. La encuesta actuó como un elemento clave para ampliar el análisis y la intervención del enfermero familiar, no solo contribuyendo al constructo teórico relacionado con la sobrecarga materna, sino también y especialmente al marco de la práctica en el cuidado con el paciente.

Versatilidad del colgajo miofascial de temporal para la reconstrucción tras cirugía oncológica / Versatility of the temporal myofascial flap for reconstruction after oncological surgery

RESUMEN Introducción: La magnitud de las resecciones de tumores de cabeza y cuello, depende del tamaño tumoral, la adecuación de los márgenes y factores inherentes al paciente. El músculo temporal, constituye una excelente opción para reconstruir defectos de zonas aledañas a su sitio de implantación. Objetivo: Demostrar la versatilidad del colgajo miofascial de temporal para la reconstrucción tras, cirugía oncológica de cabeza y cuello, en el Hospital Provincial Universitario "Camilo Cienfuegos Gorriarán" desde enero de 2017 a diciembre de 2018. Métodos: Se realizó una revisión retrospectiva de los informes operatorios de los casos intervenidos con cirugía oncológica de cabeza y cuello, en el servicio de cirugía maxilofacial; se tomó de muestra a pacientes a los que, se les realizó reconstrucción del defecto quirúrgico, utilizándose colgajo miofascial de temporal. Resultados: Fueron sometidos a reconstrucción, 12 pacientes de forma inmediata, en un solo tiempo quirúrgico. El defecto se presentó mayormente en lesiones de piel. La edad promedio de los pacientes fue 66,2 años. Se observó una distribución equitativa en cuanto a sexo, con 6 pacientes para cada grupo. El seguimiento osciló entre 2 y 20 meses, con una media de 11,25 meses, de los cuales todos los pacientes se encontraban vivos y controlados. Conclusiones: El colgajo temporal continúa siendo una opción válida para la reconstrucción en cirugía oncológica de cabeza y cuello. En la serie revisada no ocurrió necrosis, lo que, lo hace un colgajo muy seguro, con buenos resultados estéticos y funcionales y con buena tolerancia ante los tratamientos oncoespecíficos adyuvantes(AU)

ABSTRACT Introduction: The magnitude of the resections of head and neck tumors depends on the tumor size, the adequacy of the margins and factors inherent to the patient. The temporal muscle is an excellent option for reconstructing defects in areas surrounding its implantation site. Objective: To demonstrate the versatility of the temporal myofascial flap for reconstruction after oncological head and neck surgery, at the "Camilo Cienfuegos Gorriarán" Provincial University Hospital from January 2017 to December 2018. Methods: A retrospective review of the operative reports of the cases intervened with oncological head and neck surgery was performed in the maxillofacial surgery service; A sample was taken from patients who underwent reconstruction of the surgical defect, using a temporal myofascial flap. Results: 12 patients underwent reconstruction immediately, in a single surgical time. The defect occurred mainly in skin lesions. The average age of the patients was 66.2 years. An equitable distribution in terms of sex was observed, with 6 patients for each group. Follow-up ranged from 2 to 20 months, with a mean of 11.25 months, of which all the patients were alive and controlled. Conclusions: The temporary flap continues to be a valid option for reconstruction in head and neck cancer surgery. Necrosis did not occur in the revised series, which makes it a very safe flap, with good aesthetic and functional results and with good tolerance to adjuvant oncospecific treatments(AU)

Ovarian sertoli-leydig cell tumors: epidemiological, clinical and prognostic factors / Tumores de células de Sertoli-Leydig ovarianos: fatores epidemiológicos, clínicos e prognósticos

Abstract Objective To describe a series of cases of ovarian Sertoli-Leydig cell tumors (SLCTs). Methods Retrospective review of 12 cases of SLCT treated at the Hospital do Câncer de Barretos, Barretos, state of São Paulo, Brazil, between October 2009 and August 2017. Results The median age of the patients was 31 years old (15-71 years old). A total of 9 patients (75.0%) presented symptoms: 8 (66.7%) presented with abdominal pain, 5 (41.7%) presented with abdominal enlargement, 2 (16.7%) presentedwith virilizing signs, 2 (16.7%) presented with abnormal uterine bleeding, 1 (8.3%) presented with dyspareunia, and 1 (8.3%) presented with weight loss. The median preoperative lactate dehydrogenase (LDH) was 504.5 U/L (138-569 U/L), alpha-fetoprotein (AFP) was 2.0 ng/ml (1.1-11.3 ng/ml), human chorionic gonadotropin (β-hCG) was 0.6 mUI/ml (0.0-2.3 mUI/ml), carcinoembryonic antigen (CEA) was 0.9 ng/ml (0.7-3.4 ng/ml), and cancer antigen 125 (CA-125) was 26.0 U/ml (19.1-147.0 U/ml). All of the tumors were unilateral and surgically treated. Lymphadenectomy was performed in 3 (25.0%) patients, but none of the three patients submitted to lymphadenectomy presented lymph node involvement. In the anatomopathological exam, 1 (8.3%) tumor was well-differentiated, 8 (66.7%) were moderately differentiated, and 3 (25.0%) were poorly differentiated. A total of 5 (55.6%) tumors were solid-cystic, 2 (22.2%) were purely cystic, 1 (11.1%) was cystic with vegetations, and 1 (11.1%) was purely solid, but for 3 patients this information was not available. The median lesion size was 14.2 cm (3.2-23.5 cm). All of the tumors were at stage IA of the 2014 classification of the International Federation ofGynecology andObstetrics (FIGO). A total of 2 (16.7%) patients received adjuvant treatment; 1 of themunderwent 3 cycles of paclitaxel and carboplatin every 21days, and the other underwent 4 cycles of ifosfamide, cisplatin and etoposide every 21 days. None of all of the patients had recurrence, and one death related to complications after surgical staging occurred. Conclusion Abdominal pain was the most frequent presentation. There was no ultrasonographic pattern. All of the SLCTs were at stage IA, and most of them were moderately differentiated. Relapses did not occur, but one death related to the surgical staging occurred.

Resumo Objetivo Descrever uma série de casos de tumores de células de Sertoli-Leydig (TCSLs) ovarianos. Métodos Revisão retrospectiva de 12 casos de TCSL tratados no Hospital de Câncer de Barretos entre outubro de 2009 e agosto de 2017. Resultados A mediana de idade foi 31 anos (15-71 anos). Um total de 9 pacientes (75,0%) apresentaram sintomas: 8 (66,7%) apresentaram dor abdominal, 5 (41,7%) apresentaram aumento abdominal, 2 (16,7%) apresentaram virilização, 2 (16,7%) apresentaram sangramento uterino anormal, 1 (8,3%) apresentou dispareunia, e 1 (8,3%) apresentou emagrecimento. A mediana de desidrogenase láctica (DHL) foi 504,5 U/L (138-569 U/L), alfafetoproteína (AFP) foi 2,0 ng/ml (1,1-11,3 ng/ml), gonadotrofina coriônica humana (β-hCG) foi 0,6 mUI/ml (0,0-2,3 mUI/ml), antígeno carcinoembrionário (CEA) foi 0,9 ng/ml (0,7-3,4) ng/ml, e antígeno cancerígeno 125 (CA-125) foi 26,0 U/ml (19,1-147,0 U/ml), todos pré-operatórios. Todos os tumores foram unilaterais e tratados cirurgicamente. Realizou-se linfadenectomia em 3 (25,0%) pacientes, por em, nenhuma das tr^es apresentou acometimento linfonodal. No exame anatomopatológico, 1 tumor (8,3%) era bem diferenciado, 8 (66,7%) eram moderadamente diferenciados, e 3 (25,0%) eram pouco diferenciados. Um total de 5 (55,6%) tumores eram sólido-císticos, 2 (22,2%) eram puramente císticos, 1 (11,1%) era cístico com vegetações, e 1 (11,1%) era puramente sólido, mas para 3 pacientes estas informações não estavam disponíveis. A mediana da dimensão da lesão foi 14,2 cm (3,2-23,5 cm). Todos os tumores eram estádio IA de acordo com a classificação de 2014 da Federação Internacional de Ginecologia e Obstetrícia (FIGO, na sigla em inglês). Duas (16,7%) pacientes receberam adjuvância; uma realizou 3 ciclos de paclitaxel e carboplatina a cada 21 dias, e a outra 4 ciclos de ifosfamida, cisplatina e etoposide a cada 21 dias. Dentre todas as pacientes, nenhuma apresentou recidiva e houve um óbito relacionado a complicações após estadiamento cirúrgico. Conclusão Dor abdominal foi a apresentação mais frequente. Todos os TCSLs eram estádio IA e a maioria era moderadamente diferenciada. Não ocorreram recidivas, mas ocorreu um óbito relacionado ao estadiamento cirúrgico.

A Vivência do Luto da Equipe de Saúde na Oncologia Pediátrica / The experience of mourning in the pediatric oncology health team

A morte e a saúde são presentes na humanidade em todo tempo e espaço, contudo os modos de experiência diferem de acordo com cada cultura. Este trabalho, ancorado teoricamente na fenomenologia heideggeriana, buscou analisar a vivência do luto da equipe de saúde no contexto da oncologia pediátrica. Foi realizada uma revisão narrativa de periódicos em Psicologia e Saúde, os quais integraram o material qualitativo analisado e utilizado na construção das categorias temáticas "A equipe de saúde em seus processos de trabalho" e "O câncer infantil em seus processos de cuidado". A literatura indica o sofrimento dos profissionais de saúde em sua atuação e propõe estratégias de apoio para uma maior preparação desses sujeitos ao lidarem com os desafios e sentimentos despertados na prática. As dimensões éticas e emocionais da oncologia pediátrica são especialmente complexas; o extenso período de tratamento favorece maior envolvimento afetivo com o paciente, mobilizando intensamente os profissionais. Identificamos nos princípios norteadores dos cuidados paliativos possíveis contribuições para a capacitação e o cuidado da equipe de saúde referente à terminalidade, especialmente quanto à comunicação na relação terapêutica. O aprofundamento da temática pode favorecer o embasamento de práticas de apoio aos profissionais e uma assistência em saúde mais humanizada

Death and health are present in humanity in all time and space, yet their modes of experience differ according to each culture. This work, anchored theoretically in the Heideggerian Phenomenology, sought to analyze the experience of the health team's mourning in the context of pediatric oncology. A narrative review of journals in Psychology and Health was done, which integrated the qualitative material analyzed and used in the construction of the thematic categories "The health team in its work processes" and "Child cancer in its care processes". The literature indicates the suffering of health professionals in their work and proposes strategies of support for a greater preparation of these subjects in dealing with the challenges and feelings aroused in the professional practice. The ethical and emotional dimensions of pediatric oncology are especially complex; the long period of treatment favors a greater affective involvement with the patient, intensively mobilizing the professionals. We identified possible contributions to the training and care of the health team regarding terminality in the guiding principles of palliative care, especially regarding communication in the therapeutic relationship. The deepening of the thematic can favor the base of practices of support to the professionals and a more humanized health care

Development and psychometric test of oncology missed nursing care self-rating scale / 肿瘤研究与临床

Objective@#To develop a scientific oncology missed nursing care self-rating scale suitable for hospital culture background in China, and to test its validity and reliability.@*Methods@#The initial scale was formulated by literature review, qualitative interview and delphi expert consultation. A total of 388 clinical nurses from Shanxi Province were selected by convenience sampling. Item analysis was used to filtrate items. The validity was evaluated by using evaluation scale of construction and content validity, and the reliability was tested by using internal consistency, split-half reliability and retest reliability.@*Results@#Oncology missed nursing care self-rating scale consisted of 33 items and 4 dimensions including nursing assessment, nursing plan, basic nursing and nursing intervention. Exploratory factor analysis (EFA) revealed that 4 factors accounted for 63.664% of the accumulated variances. The scale-level content validity index (S-CVI) was 0.904. The Cronbach α coefficient was 0.948, the spilt-half reliability coefficient was 0.786, and the retest reliability coefficient was 0.833.@*Conclusion@#Oncology missed nursing care self-rating scale has good validity and reliability, which can be used as a measuring tool for oncology missed nursing care.

Successful stent implantation in a rural area on a patient with superior vena cava syndrome through specialist intervention: a case report / Journal of Rural Medicine

Superior vena cava syndrome (SVCS), which is characterized by facial edema and congestion of the head, upper extremities, and neck, is a life-threatening oncologic emergency. Although a combination of chemotherapy and radiation therapy has been considered as the standard treatment for SVCS, stent implantation to the superior vena cava (SVC) has been recently developed to alleviate edema or dyspnea caused by SVCS. On the other hand, stent implantation to the SVC requires skilled interventional cardiologists or radiologists. In general, those specialists reside in university hospitals or large hospitals in an urban area. In this case report, an 86-year-old man underwent stent implantation to a stenosed SVC in a rural area. Because the patient refused the transfer to the core, urban hospital, we invited a skilled interventional cardiologist from the core hospital and performed stent implantation to the SVC in a small, rural hospital. It is generally difficult to perform stent implantation for SVCS in a small hospital, because skilled operators in the field of interventional cardiology or radiology do not usually perform operations in smaller facilities. Our case indicates the importance of cooperation between rural generalists and urban specialists.

Research progress of compassion fatigue in oncologic nurses / 中国实用护理杂志

This paper reviews the occurrence, the influencing factors and the intervention strategies of compassion fatigue in the oncologic nurses at home and abroad. It provides information support for relieving the compassion fatigue of oncologic nurses in order to stabilize the professional group of oncologic nursing, improve the professional satisfaction and ensure the quality of nursing.

Acolhimento na Unidade de Cuidados Paliativos do INCA/MS: desafios da equipe multiprofissional sob a perspectiva da educação permanente em saúde / Reception at the Palliative Care Unit of INCA/MS: challenges for the multidisciplinary team from the perspective of permanent health education

O estudo teve como objetivo identificar e analisar desafios da equipe multiprofissional no acolhimento a pacientes encaminhados a unidade de Cuidados Paliativos Oncológicos (CPO ­ HC IV). Pesquisa exploratória de abordagem qualitativa, realizada com 25 profissionais que atuam em unidades do Instituto Nacional de Câncer (INCA), hospital público de referência para o tratamento oncológico, situado na cidade do Rio de Janeiro/Brasil. Foram realizadas entrevistas e observação participante durante os meses de julho de 2018 a maio de 2019. Os dados referentes à observação do campo da pesquisa foram registrados em um diário e os dados das entrevistas foram gravados, transcritos e processados, segundo a hermenêutica dialética de Minayo, sendo trabalhados na perspectiva da análise temática. Os desafios do acolhimento revelados foram: a entrada de pacientes com doença avançada e pouca perspectiva de intervenção paliativa, que pode ser relacionada as questões internas e externas ao INCA. Os internos são as que passam pela reorganização da rede de atenção oncológica do SUS, e os internos os que envolvem o investimento em ações capazes de aprimorar o acolhimento no HC IV; a ampliação da compreensão do conceito de CPO entre os trabalhadores das unidades de origem/tratamento, a promoção de uma maior integração entre trabalhadores das diferentes unidades de origem/tratamento, postos avançados e unidade CPO, de forma a enfrentar a quebra na cadeia de cuidado, a partir da transferência do paciente; a comunicação de notícias difíceis por trabalhadores das instituições de origem/tratamento, agravada pelo estigma da transferência para a unidade CPO, assim como a questão da sobrecarga de trabalho em função de dificuldades no dimensionamento que comprometem a capacidade de envolvimento com a complexidade do trabalho com CPO.A percepção da potência dos espaços de trocas, autoanálise e reflexão coletiva é incipiente e há incompreensão com relação aos conceitos de educação permanente em saúde e educação continuada (EPS e EC). A partir dos resultados da pesquisa foram realizados dois encontros formais para a discussão sobre o acolhimento na unidade HC IV, envolvendo trabalhadores da gestão e da assistência. a partir dos encontros se elaborou uma estruturação sistemática de acolhimento para novos pacientes e cuidadores/familiares e a definição de uma agenda de encontros para discussão de processos de EPS no HC IV.

The study aimed to analyze challenges of the multi-professional team in welcoming patients referred to the palliative oncologic care unit (POC ­ HC IV). Exploratory research with a qualitative approach, conducted with 25 professionals who work in units of the National Cancer Institute (INCA), public reference hospital for cancer treatment, located in the city of Rio de Janeiro / Brazil. Interviews and participant observation were conducted from July of 2018 to May 2019. Data from observation of the research field were recorded in a diary and interview data were recorded, transcribed and processed according to Minayo's dialectical hermeneutics. worked from the perspective of thematic analysis. One of the biggest challenges revealed is the entry of patients with advanced disease and little prospect of palliative intervention, which may be related to issues internal and external to INCA. External challenges include the reorganization of the Public Health System (SUS) cancer care network. Internal challenges involve investing in actions that qualify reception in HC IV; increase understanding of the concept of POC among workers in the origin / treatment units; and promote greater integration between workers from different units of origin / treatment, outposts and POC unit, in order to face the break in the chain of care, from the transfer of the patient. The difficulty related to the difficult news communication by workers from the origin / treatment institutions, aggravated by the transfer stigma to the POC unit, is one of the biggest difficulties for workers, as well as the issue of work overload due to difficulties in sizing that compromises the ability to engage with the complexity of working with POC. The perception of the power of spaces of exchange, self-analysis and collective reflection is incipient and there is misunderstanding regarding education and qualification of workers e concepts. Based on the results of the research, two formal meetings were held to discuss welcoming at the HC IV unit, involving management and care workers. The meetings provided the idea of the collective construction of a systematic welcoming structure for new patients and caregivers / family and the definition of meetings for discussion of workers education processes in HC IV.