National University of Itapua (Acronym: UNI) is a Paraguayan national university with a range of degree offerings. UNI's campus is located on the Itapúa Department in the city of Encarnacion.
Introducción: El tumor maligno de la vaina del nervio periférico (TMVNP) es un sarcoma de tejidos blandos de alta agresividad y diagnóstico infrecuente, especialmente en pacientes jóvenes sin neurofibromatosis tipo 1. Su presentación inicial como dolor cervical con irradiación puede confundirse fácilmente con patología músculo-esquelética benigna, retrasando el diagnóstico. Presentación del caso: Varón de 19 años que consultó por dolor cervical izquierdo persistente con irradiación al brazo. El seguimiento longitudinal en atención primaria permitió identificar la insuficiencia de las explicaciones habituales y motivar la derivación oportuna. La biopsia confirmó TMVNP de alto grado del plexo braquial izquierdo. Recibió resección quirúrgica y radioterapia adyuvante. A pesar de ello, la enfermedad progresó con crecimiento de la masa axilar, adenopatías supraclaviculares y metástasis pulmonares múltiples. El perfil genómico por NGS reveló 15 alteraciones (incluyendo CDKN2A, CDKN2B, MTAP, PTEN, ATM), sin terapias aprobadas disponibles para su tipo tumoral. El paciente falleció a los 20 años de edad. Conclusión: Este caso ilustra el rol fundamental de la atención primaria como eje del seguimiento longitudinal en pacientes jóvenes con dolor persistente. La insistencia clínica ante síntomas que no responden a tratamientos convencionales fue determinante para el diagnóstico. Pese a la fatal evolución de la enfermedad, el acompañamiento continuo representó un valor humano y clínico insustituible. Palabras claves: tumor maligno de la vaina del nervio periférico; sarcoma de tejidos blandos; plexo braquial; atención primaria; seguimiento longitudinal; diagnóstico tardío; dolor persistente; adolescente
Household water insecurity, defined as the inability of households to reliably access sufficient, safe water for health, livelihood, and well-being, remains a pressing global issue. However, its drivers are often poorly understood due to limited local data and the complex intersection of governance, infrastructure, and geography, particularly in rural and underserved regions. This study applied the Household Water Insecurity Experiences (HWISE) index to assess household water insecurity in Itapúa, Paraguay, identify water-insecure populations, and analyze spatial and demographic factors contributing to insecurity. Specifically, we assessed household water insecurity across rural distribution systems to evaluate how infrastructure, geography, and management shape vulnerability in this understudied region. Results revealed significant disparities in water insecurity both between and within communities, with an eight-point median difference in HWISE scores (out of 36) across the districts studied. Frequent water supply interruptions and psychological stress were major contributors to higher insecurity. Spatial analysis showed localized hotspots of medium- and high-insecurity households along water distribution networks, and statistical analysis indicated that infrastructural and geographic factors, particularly distance and elevation relative to key water infrastructure, more strongly influenced water insecurity than the demographic variables. Site-specific model deviations further highlighted the roles of governance and infrastructure quality, indicating that household water insecurity is not only a matter of access but also of system management. Communities with aging infrastructure, limited technical support, and sprawling distribution networks experienced greater insecurity, highlighting the need for improved maintenance support, management strategies, and targeted investment. These findings contribute to household water insecurity scholarship by integrating spatial analysis, multilevel modeling, and machine learning methods in a rural, data-scarce context and emphasize the value of cross-scalar, integrated assessments to support locally tailored water insecurity solutions.
Background: Nomophobia, understood as the irrational fear of being without a mobile phone, has become an increasingly relevant concern among university students, with potential negative implications for their digital well-being and academic performance. Objective: To synthesize recent evidence on the prevalence and levels of nomophobia, its associated factors, and its academic repercussions among university students. Methodology: A systematic review was conducted following the PRISMA protocol, with searches performed in PubMed, SciELO, ScienceDirect, and Google Scholar. Twenty-two studies published between 2020 and 2025 were included, addressing the prevalence and levels of nomophobia, associated factors, and academic repercussions in university populations. Results: The included studies reported the presence of nomophobia, with significant differences according to sociocultural context, gender, and technology-use habits. Associated factors included anxiety, insomnia, excessive social media use, and poor sleep quality. In the academic domain, difficulties with concentration, classroom distraction, and poorer academic adjustment were reported. Conclusion: The findings support addressing nomophobia as a multidimensional phenomenon. Further context-specific research in Latin America is needed, as well as the development of institutional strategies to promote healthy and responsible mobile phone use in university settings.
