Conservative Management of Spondylodiscitis after Laparoscopic Sacral Colpopexy: A Case Report and Review of Literature / Manejo conservador da espondilodiscite após colpopexia sacral laparoscópica: Relato de caso e revisão da literatura

Abstract Sacral colpopexy is one of the standard procedures to treat apical pelvic organ prolapse. In most cases, a synthetic mesh is used to facilitate the colposuspension. Spondylodiscitis is a rare but potentially serious complication that must be promptly diagnosed and treated, despite the lack of consensus in the management of this complication.We report one case of spondylodiscitis after a laparoscopic supracervical hysterectomy and sacral colpopexy treated conservatively. We also present a literature review regarding this rare complication. A conservative approach without mesh removal may be possible in selected patients (stable, with no vaginal lesions, mesh exposure or severe neurologic compromise). Hemocultures and culture of imageguided biopsies should be performed to direct antibiotic therapy. Conservative versus surgical treatment should be regularly weighted depending on clinical and analytical progression. A multidisciplinary team is of paramount importance in the follow-up of these patients.

Resumo A colpopexia sacral é um dos procedimentos padrão para tratar o prolapso de órgãos pélvicos apical. Na maioria dos casos, uma tela sintética é usada para facilitar a colposuspensão. A espondilodiscite é uma complicação rara, mas potencialmente grave, que deve ser prontamente diagnosticada e tratada, apesar da falta de consenso no manejo dessa complicação. Relatamos um caso de espondilodiscite após histerectomia supracervical laparoscópica e colpopexia sacral tratada conservadoramente. Também apresentamos uma revisão da literatura sobre essa complicação rara. Uma abordagem conservadora sem remoção da tela pode ser possível em pacientes selecionadas (estáveis, sem lesões vaginais, exposição da tela ou comprometimento neurológico grave). Hemoculturas e cultura de biópsias guiadas por imagem devemser realizadas para direcionar a antibioticoterapia. O tratamento conservador versus o cirúrgico deve ser avaliado regularmente, dependendo da progressão clínica e analítica. Uma equipe multidisciplinar é de suma importância no acompanhamento desses pacientes.

Prevalencia de la enfermedad periodontal autopercibida en escolares de 12 años de edad / Prevalence of selected periodontal disease in schools 12 years old

Resumen Introducción: La auto percepción periodontal tiene como objetivo permitir al paciente auto valorar su estado de salud bucal, así como tomar conciencia del riesgo que provoca padecer esta patología, motivando a mejorar el estilo de vida, disminuyendo los riesgos mediante la planificación de propuestas de intervención preventiva. Objetivo: Calcular la prevalencia de la enfermedad periodontal auto percibida en escolares de 12 años de edad, en la parroquia Monay del cantón Cuenca 2016. Materiales y Métodos: La metodología aplicada fue de tipo cualitativa, de diseño descriptivo, técnica observacional transversal retrospectivo. La muestra constituida por 252 fichas epidemiológicas de escolares de 12 años. Los datos se obtuvieron de la base de datos de la Universidad Católica de Cuenca, a través del programa EpiInfo, las cuales fueron analizadas por operadores quienes recibieron una previa calibración. Resultados: Los resultados de la prevalencia de auto percepción obtenidos en la parroquia de estudio, indicaron que el 63% perciben la enfermedad periodontal y el 37% no la perciben, de acuerdo al sexo se obtuvo una mayor prevalencia de auto percepción en las mujeres con 73% y en hombres un 52%; según el tipo de sostenimiento educacional no se obtuvieron diferencias significativas entre los porcentajes de escolares que acudieron a escuelas privadas o públicas, se obtuvo un 56% de auto percepción periodontal en escuelas privadas y el 54% de autopercepción periodontal en escuelas públicas. Conclusiones: Se reporta un resultado del 63%, constituyendo una alta prevalencia de escolares que si autoperciben la enfermedad periodontal.

Abstract Introduction: Periodontal self perception allows the patient to assess his own oral health, as well as he becomes aware of the risks that it may trigger, motivating him to improve his life style, diminishing those risks with the planning of a preventive intervention. Objective: To calculate the prevalence of self-perceived periodontal disease in 12-year-old schoolchildren in the Monay parish of the 2016 Cuenca canton. Materials and Methods: The methodology applied was of qualitative type, descriptive design, retrospective cross-sectional observational technique. The sample consists of 252 epidemiological records of 12-year-old schoolchildren. The data were obtained from the database of the Catholic University of Cuenca, through the Epi Info program, which were analyzed by operators who received a previous calibration. Results: The results of the prevalence of automatic perception in the study parish, indicate that 63% perceive periodontal disease and 37% do not perceive it, according to sex, a higher prevalence of perception was obtained in women with 73% and in men 52%; According to the type of educational support, no significant differences were obtained between the percentages of schools that went to private or public schools, 56% of periodontal self-perception in private schools and 54% of periodontal self-perception in public schools were obtained. Conclusions: A result of 63% is reported, constituting a high prevalence of schoolchildren who perceive periodontal disease.

Prevalencia de la enfermedad periodontal autopercibida en escolares de 12 años de edad

Introducción: La auto percepción periodontal tiene como objetivo permitir al paciente auto valorar su estado de salud bucal, así como tomar conciencia del riesgo que provoca padecer esta patología, motivando a mejorar el estilo de vida, disminuyendo los riesgos mediante la planificación de propuestas de intervención preventiva. Objetivo: Calcular la prevalencia de la enfermedad periodontal auto percibida en escolares de 12 años de edad, en la parroquia Monay del cantón Cuenca 2016. Materiales y Métodos: La metodología aplicada fue de tipo cualitativa, de diseño descriptivo, técnica observacional transversal retrospectivo. La muestra constituida por 252 fichas epidemiológicas de escolares de 12 años. Los datos se obtuvieron de la base de datos de la Universidad Católica de Cuenca, a través del programa EpiInfo, las cuales fueron analizadas por operadores quienes recibieron una previa calibración. Resultados: Los resultados de la prevalencia de auto percepción obtenidos en la parroquia de estudio, indicaron que el 63% perciben la enfermedad periodontal y el 37% no la perciben, de acuerdo al sexo se obtuvo una mayor prevalencia de auto percepción en las mujeres con 73% y en hombres un 52%; según el tipo de sostenimiento educacional no se obtuvieron diferencias significativas entre los porcentajes de escolares que acudieron a escuelas privadas o públicas, se obtuvo un 56% de auto percepción periodontal en escuelas privadas y el 54% de autopercepción periodontal en escuelas públicas. Conclusiones: Se reporta un resultado del 63%, constituyendo una alta prevalencia de escolares que si autoperciben la enfermedad periodontal.

Introduction: Periodontal self perception allows the patient to assess his own oral health, as well as he becomes aware of the risks that it may trigger, motivating him to improve his life style, diminishing those risks with the planning of a preventive intervention. Objective: To calculate the prevalence of self-perceived periodontal disease in 12-year-old schoolchildren in the Monay parish of the 2016 Cuenca canton. Materials and Methods: The methodology applied was of qualitative type, descriptive design, retrospective cross-sectional observational technique. The sample consists of 252 epidemiological records of 12-year-old schoolchildren. The data were obtained from the database of the Catholic University of Cuenca, through the Epi Info program, which were analyzed by operators who received a previous calibration. Results: The results of the prevalence of automatic perception in the study parish, indicate that 63% perceive periodontal disease and 37% do not perceive it, according to sex, a higher prevalence of perception was obtained in women with 73% and in men 52%; According to the type of educational support, no significant differences were obtained between the percentages of schools that went to private or public schools, 56% of periodontal self-perception in private schools and 54% of periodontal self-perception in public schools were obtained. Conclusions: A result of 63% is reported, constituting a high prevalence of schoolchildren who perceive periodontal disease.