The goals of periorbital region reconstruction are to obtain both functional and esthetic results. Medial canthus is the second most common periorbital location for basal cell carcinoma. If left untreated, it is locally destructive but rarely metastasizes. Incompletely resected medial canthal tumors recur or penetrate along the lacrimal path and expand to wider lesions. A safety margin is necessary to ensure a complete lesion resection. Since it was introduced in 1941, Mohs surgery has been promoted as an efficient method of dealing with infiltrative periorbital skin tumors. It has been shown to have high rates of complete cancer removal during surgery, minimizing the amount of normal tissue loss and securing better functional and cosmetic outcomes. Due to its concave contour and convergence of skin units with variable thickness, texture and mobility, reconstruction of the medial canthal region (MCR) remains challenging. Reconstructive methods such as free full-thickness skin grafts and glabellar flaps have been used alone or in combination with other techniques. The concavity of the canthus must be achieved, but the maintenance of the normal contour and symmetry of the surrounding tissue is critical. The glabellar flap (GF) is a triangular advancement flap that adequately restores the volume in deeper defects, guaranteeing sufficient vascular support without complex or undesirable scars. We present two cases of basal cell carcinoma affecting the MCR that was successfully reconstructed using a GF alone in one case and together with a cheek advancement flap in the second one. In both cases, tumor excision was performed using Mohs surgery.
The role of Radiology in SARS-CoV-2 infection has been relevant but marginal. Even though it offers important information on pulmonary and vascular involvement in these patients, its contributions should not be considered diagnostic for COVID-19. Although there are characteristic patterns of involvement, these same radiological findings can be observed in other entities. Mainly it should be considered that Radiology contributes to the disease severity gradation, extension, complications, follow-up and in the prognostic evaluation of these patients. In this review, these contributions will be discussed together with the role of imaging in clinical trials and in the evaluation of new epidemic situations through the creation of Medical Imaging Biobanks capable of using the estimating potential of Artificial Intelligence.
Antecedentes : La epidemia por coronavirus 2019 (COVID-19) se ha extendido por todo el mundo desde principios de 2020, sometiendo a los profesionales sanitarios a una sobrecarga laboral y a un mayor nivel de estrés físico y emocional. Objetivos : El objetivo de este estudio es determinar la prevalencia de desgaste profesional y sus posibles factores asociados en los radiólogos españoles durante la COVID-19, y su comparación con la situación previa a la pandemia. Métodos : Estudio observacional realizado entre los meses de abril y agosto de 2020 (durante la pandemia) mediante una encuesta en línea. Se obtuvieron un total de 150 respuestas. Se recopiló y comparó la información demográfica y laboral de los encuestados. Se determinó la presencia del desgaste profesional con el cuestionario Maslach Burnout Inventory Human Services Survey (MBI-HSS) y se comparó su prevalencia y características con el estudio realizado de la misma manera en 2019. Se hizo un análisis estadístico para identificar los posibles factores de riesgo y protectores asociados con este síndrome, así como un análisis de homogeneidad entre las dos muestras. Resultados : La prevalencia del síndrome aumentó de forma significativa ( p = 0,002) durante la pandemia COVID-19 (49,3% frente a 33,6%). Ningún factor de riesgo o de protección se ha identificado como constante antes y después de la pandemia. No se he identificado ninguna correlación del desgaste con las características sociodemográficas o laborales. Conclusión : Este estudio demuestra un aumento importante del desgaste profesional durante la pandemia por la COVID-19 con afectación de casi la mitad de los radiólogos encuestados. Estos resultados destacan la necesidad de valorar el apoyo orientado al bienestar profesional de los radiólogos en España. No se ha identificado correlación entre el síndrome y género, edad, número de guardias, antigüedad, ingreso anual, docencia, estado civil, número de hijos o tipo de contrato laboral.
No abstract
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