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2.
Rev. cir. (Impr.) ; 73(1): 103-106, feb. 2021. ilus
Artigo em Espanhol | LILACS | ID: biblio-1388776

RESUMO

Resumen Objetivo: Comunicar el caso de una paciente de 77 años tratada de un angiosarcoma de cuero cabelludo, que evoluciona con neumotórax bilateral, cuyo estudio histopatológico informa enfermedad metastásica. Materiales y Método: Revisión de ficha clínica electrónica, registro informático de imagenología e informes de biopsias. Seguimiento ambulatorio en policlínico de cirugía. Resultados: Se realiza manejo por videotoracoscopía bilateral, con bulectomía más pleurodesis. Discusión: El neumotórax secundario por enfermedad metastásica es poco frecuente, aproximadamente 1% a 2% de los casos. De los tumores que más frecuentemente metastizan al pulmón se encuentran los sarcomas. Conclusión: El neumotórax metastásico es poco frecuente y requiere un alto índice de sospecha. Su manejo va a depender del pronóstico y de las condiciones generales del paciente.


Aim: To report the case of a 77-year-old patient treated for angiosarcoma of the scalp, who evolves with bilateral pneumothorax, whose histopathological study reports metastatic disease. Materials and Method: Review of electronic clinical record, computerized imaging record and biopsy reports. Outpatient follow-up at the polyclinic of surgery. Results: Management was performed by bilateral videothoracoscopy, with bulectomy plus pleurodesis. Discussion: Secondary pneumothorax due to metastatic disease is rare, approximately 1 to 2% of cases. Sarcomas are among the tumors that most frequently metastasize to the lung. Conclusion: Metastatic pneumothorax is infrequent and requires a high index of suspicion. Its management will depend on the prognosis and the general conditions of the patient.


Assuntos
Humanos , Feminino , Idoso , Pneumotórax/diagnóstico por imagem , Couro Cabeludo/patologia , Metástase Neoplásica/terapia , Pneumotórax/terapia , Hemangiossarcoma/complicações , Neoplasias Pulmonares/diagnóstico por imagem
3.
MEDICC Rev ; 22(4): 87-88, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33295327

RESUMO

At fi rst, COVID-19 was thought to be primarily a respiratory disease, progressing in some patients to serious respiratory symptoms, pneumonia, severe respiratory distress syndrome and even death. Later analysis revealed entire systems were compromised, affecting other vital organs, including the kidneys, and a correlation was observed between chronic kidney disease (CKD) and COVID-19 severity COVID-19 severity.


Assuntos
COVID-19/complicações , Nefropatias/virologia , COVID-19/epidemiologia , Cuba , Progressão da Doença , Humanos , Pandemias , Fatores de Risco , SARS-CoV-2
4.
Artigo em Espanhol | LILACS | ID: biblio-1382261

RESUMO

Los Trastornos del Neurodesarrollo, en particular, los Trastornos del Espectro Autista (TEA) afectan la comunicación e interacción social, además de caracterizarse por conductas estereotipadas que en muchos casos se desajustan de la norma social. Dichas características nucleares de TEA pueden afectar el desarrollo afectivo-sexual y esto se puede ver exacerbado según el nivel de funcionamiento del niño o Adolescente. En este artículo revisaremos aspectos en conflicto en la sexualidad de Adolescentes con TEA de alto funcionamiento. Métodos: Se efectuó una revisión sistematizada de la evidencia reciente publicada y anexada a bases de datos en relación a conflictos en el área afectivo-sexual vivenciados por adolescentes con diagnóstico de Trastorno del Espectro Autista de alto funcionamiento. Se incluyeron estudios específicos respecto al tema, principalmente auto-reportes, denotando la escasez de revisiones sistemáticas. Se compara con literatura clásica de autismo. En la revisión se excluyó la población infantil con TEA, o sea, menores a 12 años al igual que jóvenes con TEA de bajo funcionamiento debido a las dificultades implícitas que la discapacidad intelectual y/o alteraciones del lenguaje generan en la interacción social y desarrollo afectivo-sexual. Resultados: En la revisión del tema se pesquisaron estudios enfocados en la comprensión de las dimensiones afectivo-sexuales afectadas en adolescentes con TEA de alto funcionamiento, comparaciones del desarrollo normativo en adolescentes sin TEA considerados casos controles y sus contrapartes con TEA, así mismo, se hizo énfasis en conflictos en común v/s conflictos específicos en TEA. Se evaluaron además, factores de riesgo en el ámbito sexual de jóvenes con TEA y las problemáticas en torno a educación sexual. Al respecto los estudios coincidieron en mayores porcentajes de conductas hipersexualizadas y parafílicas (principalmente fantasías sádicas y conductas voyeuristas y masoquistas) en adolescentes con TEA de alto funcionamiento. Además reportaron tasas más altas de orientación sexual "no heterosexual", disforia de género e identidad de género Trans. Discusión y Conclusiones: Del análisis de estudios en población específica de Adolescentes con diagnóstico de TEA catalogados como de alto funcionamiento, y en comparación con individuos controles sin TEA, la evidencia muestra un amplio espectro de dificultades relacionadas al desarrollo afectivo-sexual y su enfrentamiento en esta etapa del ciclo vital, así como la relación de los síntomas nucleares de TEA con conductas no normativas en torno a sexualidad del tipo "Hipersexualización" y "Parafilias". Se discuten además conflictos en orientación sexual e identidad de género. Se logró establecer una asociación entre las variables, lo que afecta su desempeño social global. Se evidenció además, la escasa educación sexual que reciben éstos adolescentes a nivel familiar y académico, lo que perpetúa tales conflictivas y establece un escenario de riesgo en su desarrollo. Se requiere mayor evaluación y utilización de escalas específicas adaptadas a TEA para mejorar y suplir tales falencias y así mejorar la calidad de vida de dichos jóvenes.


Neurodevelopmental Disorders, in particular Autism Spectrum Disorders (ASDs), affect social communication and interaction, as well as being characterized by stereotypical behaviors that in many cases are mismatched from the social norm. Such nuclear characteristics of ASD can have an impact on affective-sexual development and this may be exacerbated by the function level of the child or adolescent. In this article we will review conflicting aspects in the sexuality of adolescents with high-functioning ASD. Methods: A systematized review of recent evidence published and annexed to databases related to conflicts in the affective-sexual area lived by adolescents diagnosed with high-functioning Autism Spectrum Disorder was conducted. Specific studies were included on the subject, mainly self-reports, denoting the scarcity of systematic reviews. It was compared to classical autism literature. The review excluded the child population with ASD, i.e., under 12 years of age, as well as young people with low-functioning ASD due to the implicit difficulties that intellectual disability and/or language alterations generate in social interaction and affective-sexual development. Results: The review looked at studies focused on understanding the affective-sexual dimensions affected in adolescents with high-functioning ASD, comparisons of normative development in adolescents without ASD, considered control cases and their counterparts with ASD, as well as emphasizing common conflicts v/s specific conflicts in ASD. Risk factors in the sexual field of young people with ASD and sexual education issues were also assessed. In this regard, studies coincided with higher percentages of hypersexualized and paraphilic behaviors (mainly sadistic fantasies and voyeuristic and masochistic behaviors) in adolescents with high-functioning ASD. They also reported higher rates of "non-heterosexual" sexual orientation, gender dysphoria and transgender identity. Discussion and Conclusions: From the analysis of studies in the specific population of adolescents diagnosed with ASD listed as high functioning, and compared to individuals controls without ASD, the evidence shows a wide affective-sexual development and its confrontation at this stage of the life cycle, as well as the relationship of nuclear symptoms of ASD with non-normative behaviors around sexuality of the type "Hypersexualization" and "Paraphilias". Conflicts in sexual orientation and gender identity are also discussed. It was possible to establish a partnership between variables, which affects their overall social performance. It was also evident that these adolescents receive poor sex education within their families and at the academic levels, perpetuating such conflicts and establishing a scenario of developmental risk. Further evaluation and use of specific scales adapted to ASD are required to improve and supplement such false conditions and thus improve the quality of life of such young people.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Comportamento Sexual/psicologia , Sexualidade/psicologia , Transtorno do Espectro Autista/psicologia , Disfunções Sexuais Fisiológicas/psicologia
5.
Rev. cir. (Impr.) ; 72(3): 195-202, jun. 2020. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1115542

RESUMO

Resumen Introducción: Uno de los mayores avances de las últimas décadas en la cirugía de tórax ha sido el desarrollo de la cirugía mínimamente invasiva. Objetivos: Describir la experiencia en videotoracoscopía (VATS) Uniportal de miembros del equipo de Cirugía de Tórax de la Universidad de Chile en 2 campos clínicos, (Clínica Las Condes y Hospital Clínico de la Universidad de Chile). Materiales y Método: Se estudiaron 105 pacientes sometidos a VATS uniportal entre enero de 2016 y enero de 2019. Los datos se analizaron de manera retrospectiva considerando variables demográficas (edad, sexo) y clínicas (diagnóstico, cirugía, estadía hospitalaria, días de pleurostomía, conversión y complicaciones). Resultados: De las 105 cirugías realizadas, 28 (26,6%) correspondieron a cirugías mayores complejas lobectomías y segmentectomías anatómicas. En 4 pacientes se agregó un 2° puerto, uno se convirtió a minitoracotomía y uno a toracotomía (5,7% conversión global). La estadía hospitalaria fue en promedio 3,07 ± 3,1 días y el promedio de mantención de pleurostomía de 2,67 ± 1,61 días. Siete pacientes (6,6%) presentaron complicaciones postoperatorias. Un paciente falleció por progresión de su enfermedad, no hubo mortalidad relacionada a la cirugía. Discusión: Las contraindicaciones de la VATS uniportal son las mismas que en la VATS multipuerto. En manos experimentadas, las complicaciones en cirugía por puerto único son bajas. Impresiona tener menos dolor postoperatorio, menor estadía hospitalaria y reintegración precoz a las actividades diarias comparado con la VATS tradicional. Conclusiones: Se presenta la primera serie de VATS uniportal publicada en Chile. Los resultados obtenidos son comparables a los observados en la literatura. Su implementación y desarrollo requiere de una curva de aprendizaje similar a cualquier nueva técnica quirúrgica.


Objective: To describe the initial results with uniportal Video-Thoracoscopic Surgery (VATS) performed in two campuses by members of the Section of Thoracic Surgery of the University of Chile ("Clínica Las Condes" and University of Chile Clinical Hospital). Materials and Method: Between January 2016 and January 2019, a total of 105 patients underwent uniportal VATS. Clinical data was collected retrospectively from digital records including demographic (age, sex) and clinical variables (diagnosis, surgery, duration of the chest tube, length of stay, conversion rate and postoperative complications). Results: Uniportal VATS was performed on 105 patients during the study period. Twenty-eight cases (26.6%) corresponded to lobectomy or anatomic segmentectomy. In 4 cases a 2nd port was required, 1 patient had to be converted to mini-thoracotomy and 1 to thoracotomy (5.8% global conversion). Overall, the median length of stay was 3.07 ± 3.1 days and the median duration of chest tube drainage was 2.67 ± 1.61 days. Seven patients (6.6%) presented complications. One patient died due to progression of his disease, there were no deaths related to the procedures. Discussion: Uniportal VATS has similar indications than multiportal VATS. On experienced hands, uniportal VATS has a low morbidity rate. Uniportal VATS appears to produce less post-operative pain, with shorter hospital stay and a faster return to normal life compared to standard VATS. Conclusion: We present the first uniportal VATS series in Chile. Results were similar to published series. Implementation and development of uniportal VATS requires a learning curve similar to any new surgical procedure.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Cirurgia Torácica Vídeoassistida/efeitos adversos , Cirurgia Torácica Vídeoassistida/métodos , Chile , Estudos Retrospectivos , Procedimentos Cirúrgicos Minimamente Invasivos , Procedimentos Cirúrgicos Torácicos/métodos , Cirurgia Torácica Vídeoassistida/instrumentação
6.
Rev. cir. (Impr.) ; 72(1): 17-21, feb. 2020. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1092885

RESUMO

Resumen Objetivo Comunicar la experiencia en el tratamiento de pectus excavatum en el Instituto Nacional del Tórax. Material y Método: Estudio descriptivo con seguimiento. Se recolectaron datos de las variables de interés, mediante la revisión de fichas clínicas. Se incluyeron pacientes operados entre marzo de 2007 y abril de 2018. Resultados Se incluyeron 86 pacientes operados con técnica mínimamente invasiva en el período descrito. De ellos, 74 pacientes de sexo masculino. El promedio de edad al momento de la cirugía fue de 17,8 años. El principal motivo de consulta fue por desmedro estético que correspondió al 41,8% de los pacientes. Salvo en 1 paciente, en todo el resto se ocupó una sola barra. En nuestra serie hubo 12 pacientes que presentaron alguna complicación operatoria y 1 paciente fallecido. Hasta el cierre del seguimiento se retiraron 61 barras, 2 de ellas previo al período estipulado de tratamiento, por morbilidad. Hay 20 barras in situ y 4 pacientes de los cuales no se tiene registro por abandono de controles. Discusión El pectus excavatum es la más frecuente de las deformidades de la pared torácica, es 4 a 6 veces más frecuente en hombres que en mujeres. En general los pacientes son asintomáticos, aunque algunos pueden presentar síntomas cardiopulmonares. La reparación con cirugía mínimamente invasiva con técnica de Nuss aparece hoy en día como el gold standard de manejo. Conclusión El manejo de los pacientes con pectus excavatum en nuestra Institución se asemeja a lo reportado en la literatura internacional. Nuestros esfuerzos deben apuntar a disminuir la morbimortalidad asociada.


Aim To communicate the experience in the treatment of pectus excavatum in the National Institute of Thorax. Materials and Method: Descriptive study with follow-up. Data of variables of interest were collected through the review of clinical records. Patients operated between March 2007 and April 2018 were included. Results 86 patients operated with the Nuss technique were included in the period described. Of them, 74 male patients. The average age at the time of surgery was 17.8 years. The main reason for consultation was due to cosmetic detriment that corresponded to 41.8% of the patients. Except in 1 patient, in all the rest a single bar was occupied. In our series, there were 12 patients who presented some operative complication and 1 patient died. Up to the end of the follow-up, 61 bars were removed, 2 of them in non-scheduled surgery. There are 20 bars in situ and 4 patients of which there is no registration due to abandonment of controls. Discussion Pectus excavatum is the most frequent of the deformities of the chest wall, it is 4 to 6 times more frequent in men than in women. In general, patients are asymptomatic, although some may have cardiopulmonary symptoms. The repair with minimally invasive surgery with Nuss technique appears today as the goldstandard of management. Conclusion The management of patients with pectus excavatum in our Institution is similar to that reported in the international literature. Our efforts should aim to reduce the associated morbidity and mortality.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Próteses e Implantes , Implantação de Prótese/métodos , Tórax em Funil/cirurgia , Tórax em Funil/terapia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Ortopédicos/métodos , Implantação de Prótese/efeitos adversos , Tórax em Funil/diagnóstico por imagem
10.
Vitae (Medellín) ; 23(1): 65-77, 2016. Ilustraciones
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-988403

RESUMO

Antecedentes: El mango es una fruta climatérica que puede ver limitada su comercialización debido a la deficiencia en sistemas de procesamiento y conservación que ocasionan pérdidas poscosecha en la cadena agroindustrial. Los frutos mínimamente procesados y tratados con recubrimientos comestibles representan una alternativa para mitigar la perecibilidad del fruto, conservando sus atributos de calidad y ofreciendo al consumidor un producto de fácil consumo y almacenamiento. Objetivos: Conservar y prolongar la vida útil de mango Tommy Atkins mínimamente procesado con la aplicación de un recubrimiento comestible de Aloe vera, evaluando su efectividad mediante el análisis de parámetros físicos, fisicoquímicos, respiratorios, microbiológicos y sensoriales durante almacenamiento refrigerado. Métodos: El recubrimiento comestible fue preparado con gel mucilaginoso de aloe vera en una Concentración de 50 % P/P en dilución y homogenizado con cera carnauba y glicerol, para luego ser aplicado por inmersión en los frutos previamente cortados y secados en estufa. Se diseñaron cuatro tratamientos experimentales: C, R, PreREC y CA, almacenados en refrigeración durante un periodo de 12 de días, en los que se evaluó parámetros como firmeza, color, porcentaje de pérdida de peso, pH, Brix, acidez (%), tasas respiratorias, conteos microbiológicos y descriptores sensoriales por medio de un perfil de aproximación multidimensional. Los datos fueron procesados mediante ANOVA y por el método de comparaciones múltiples LSD. Resultados: Las muestras tratadas con el recubrimiento (R y PreREC) mostraron un retraso en la pérdida de la firmeza, menores cambios de color, una menor pérdida de peso, un aumento menos acelerado del pH y de °Brix y valores más elevados de acidez con respecto a los tratamientos control. Se lograron tasas bajas de consumo de O2 y una producción controlada de CO2 en comparación a las muestras sin tratar. A nivel microbiológico, el recubrimiento disminuyó el crecimiento de mesófilos, mohos y levaduras; mientras que sensorialmente, descriptores como la firmeza, calidad general, olor y sabor característico mostraron una mayor calificación por parte del panel sensorial. Conclusiones: El recubrimiento permitió conservar por 3 días más las muestras de mango mínimamente procesado respecto a los tratamientos control.


Background: Mango is a climacteric fruit which can limit its marketing due to some deficiencies in processing and preservation systems that cause postharvest losses in the agribusiness and value chain. Minimally processed fruits and edible coatings represent an alternative to decrease the perishability of fruits, preserving its quality attributes and offering to consumers an easy product to use and storage. Objetives: The aim of this study was to conserve and extend the shelf life of minimally processed "Tommy Atkins" mango covered by an edible coating made of aloe vera mucilage, assessing its effectiveness by analyzing physical, physicochemical, respiratory, microbiological and sensory parameters during refrigerated storage. Methods: The edible coating was prepared with aloe vera, which is a mucilaginous gel, in a concentration of 50% w/w in dilution and homogenized with carnauba wax and glycerol. Then aloe vera was applied by immersion in the pre-cut fruits and dried in stove. Four experimental treatments were designed: C, R, PreREC and CA, stored under refrigeration for a period of 12 days, in which parameters such as strength, color, percentage weight loss, pH, Brix, acidity (%), respiratory rates, microbiological counts, and sensory descriptors were evaluated by a multidimensional approach profile. Data were analyzed using ANOVA and the LSD multiple comparison method. Results: Samples treated with the edible coating (R y PreREC) showed a delay in the loss of firmness, less color changes, less loss of weight, a less increase in pH and Brix values, and a higher acidity compared to the control treatments. Low rates of O2 consumption and controlled CO2 production compared to untreated samples were achieved. Coating decreased the growth of mesophilic, molds and yeasts; while sensory descriptors as firmness, overall quality, characteristic odor and taste showed a higher rating by the sensory panel. Conclusions: Edible coating made of aloe vera gel allowed to keep for 3 more days samples of minimally processed mango compared to control treatments.


Assuntos
Humanos , Mangifera , Aloe , Armazenamento de Alimentos
12.
Rev. chil. cir ; 66(3): 245-250, jun. 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-708782

RESUMO

Background: Parotid neoplasms correspond to 3 percent of head and neck tumors. Most are benign, treatment is parotidectomy. Aims: To analyze the results of treatment, histology, complications and recurrence. Patients and Methods: Retrospective analysis of patients with parotid tumors treated in our center among 2001-2010. Results: The series consisted of 82 patients, 52 (63 percent) women. Average age: 46 years (range, 17-77), 73 (89 percent) had benign tumors, 7 (8.5 percent) were malignant and 2 (2.4 percent) had chronic inflammatory disease. The most common benign tumors were pleomorphic adenoma (55 percent) and Warthin's tumor (20 percent). The most common malignant tumors were mucoepidermoid carcinoma (5 percent) and acinar cell carcinoma (4 percent). The technique was total parotidectomy in 10 patients (12 percent), total suprafacial 53 (64.6 percent) and partial in 19 (23 percent). The most common complication was transient facial nerve dysfunction in the immediate postoperative period in 38 cases (46.3 percent), 14 (17 percent) had surgical bed depression, 15 (18.3 percent), dysesthesia periauricular, 2 (2.4 percent) permanent paralysis of the facial nerve (tumor) and 6 (7.3 percent) Frey Syndrome. No patient had a disagreement with his scar and pain periauricular, there were no recurrences. There was lesser transient facial nerve paralysis with partial suprafacial parotidectomy than with total suprafacial parotidectomy (21 percent and 53 percent), RR 0.4 IC 95 percent (0.16-0.99). Discussion: The application of less invasive surgical techniques such as partial parotidectomy suprafacial allow comparable results in benign conditions, with low morbidity without increasing recurrence.


Introducción: Las neoplasias parotídeas corresponden al 3 por ciento de los tumores de cabeza y cuello. La mayoría son benignas, el tratamiento es la parotidectomía. Objetivo: Analizar los resultados del tratamiento, histología, complicaciones y recurrencia. Pacientes y Métodos: Análisis retrospectivo de los pacientes con tumores parotídeas intervenidos en nuestro centro entre 2001-2010. Resultados: La serie estuvo compuesta por 82 pacientes, 52 (63 por ciento) mujeres. La edad promedio: 46 años (rango, 17-77); 73 (89 por ciento) tuvieron tumores benignos, 7 (8,5 por ciento) malignos y 2 (2,4 por ciento) presentaron enfermedad inflamatoria crónica. Los tumores benignos más frecuentes fueron el adenoma pleomorfo (55 por ciento) y el tumor de Warthin (20 por ciento). Los tumores malignos más frecuentes fueron el carcinoma mucoepidermoide (5 por ciento) y el carcinoma de células acinares (4 por ciento). La técnica fue parotidectomía total en 10 pacientes (12 por ciento), suprafacial total en 53 (64,6 por ciento) y parcial en 19 (23 por ciento). La complicación más frecuente fue la disfunción transitoria del nervio facial en el postoperatorio inmediato en 38 casos (46,3 por ciento); 14 (17 por ciento) presentaron depresión del lecho operatorio, 15 (18,3 por ciento) disestesia periauricular, 2 (2,4 por ciento) parálisis permanente del nervio facial (tumor maligno) y 6 (7,3 por ciento) Síndrome de Frey. Ningún paciente presentó disconformidad con su cicatriz ni dolor periauricular; no hubo recidivas. Se observó menos parálisis transitoria del nervio facial con la parotidectomía suprafacial parcial que con la parotidectomía suprafacial total (21 por ciento y 53 por ciento, respectivamente), RR 0,4 IC 95 por ciento (0,16-0,99). Discusión: La aplicación de técnicas quirúrgicas menos agresivas como la parotidectomía suprafacial parcial permite obtener resultados comparables en patologías benignas, con bajas tasas de morbilidad, sin aumentar la recurrencia.


Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Adulto Jovem , Pessoa de Meia-Idade , Neoplasias Parotídeas/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Complicações Pós-Operatórias , Estudos Retrospectivos
13.
Rev. chil. cir ; 66(1): 30-37, feb. 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-705549

RESUMO

Introducción: La reconstrucción de defectos mediofaciales representa un gran desafío. Los maxilares son los huesos más importantes del esqueleto facial, proveen soporte entre base del cráneo y arcos maxilares, separan cavidades, participan en la deglución, fonación, masticación, visión y apariencia. La maxilectomía conlleva diferentes grados de alteración funcional. La reconstrucción maxilar va desde el uso de prótesis obturadoras, colgajos locales hasta colgajos libres. Objetivo: Presentar las alternativas reconstructivas post maxilectomía por enfermedad neoplásica utilizadas en nuestro centro. Pacientes y Métodos: Análisis retrospectivo de todos los pacientes sometidos a maxilectomía por causa oncológica entre los años 2008 y 2011. Resultados: La serie estuvo compuesta por 12 pacientes, 8 mujeres, mediana de edad 57 años (rango 25-84). Se realizó maxilectomía Tipo IIA a cinco pacientes, Tipo IIB a dos pacientes, Tipo IIIA a cuatro pacientes y IIIB a un paciente. Se logró R0 en todos los casos. La reconstrucción se realizó con prótesis obturadora en cuatro pacientes, tres pacientes con colgajos pediculados y cinco pacientes con colgajos microquirúrgicos. En todos los pacientes se logró un resultado funcional adecuado. En un paciente hubo pérdida parcial del colgajo. Discusión: Es recomendable ajustar la alternativa reconstructiva según el pronóstico del paciente. Prótesis obturadoras son una opción para pacientes seleccionados. El colgajo de músculo temporal presenta un buen resultado funcional, recomendado en pacientes con enfermedad avanzada y mal pronóstico. La reconstrucción microquirúrgica es la alternativa de elección con los mejores resultados funcionales y estéticos en pacientes con maxilectomías Tipo II, III y IV.


The reconstruction of midfacial defects is a major challenge. The maxillary bones are the more important of the facial skeleton, provide support between skull base and maxillary arches, separate cavities and are involved in swallowing, phonation, mastication, vision and appearance. The maxillectomy involves varying degrees of functional impairment. The maxillary reconstruction ranges from the use of obturator prosthesis, local flaps to free flaps. Aim: To present the different reconstructive alternatives used after a maxillectomy for oncologic disease in our hospital. Patients and Methods: Retrospective analysis of all patients that was submitted to a maxillectomy for oncologic disease between 2008 and 2011 in our center. Results: The series consisted of 12 patients, 8 women and median age 57 years (range, 25-84). We realized Type IIA maxillectomy in five patients, IIB to two patients, IIIA to four patients and IIIB to one patient. We achieved R0 in all cases. The reconstruction was realized with obturator prosthesis in four patients, three patients with pedicled flaps and five patients were reconstructed with free flaps. All patients obtain an adequate functional status. One patient has partial flap loss. Discussion: Is recommended adjust the surgical choice to the patient prognosis. The obturator prosthesis is a good choice for selected group. The temporal muscle flap presents adequate functional results and is recommended in advanced disease and poor prognosis. The microsurgical reconstruction is the best choice with better functional and aesthetics outcomes in type II, III and IV maxillectomy.


Assuntos
Humanos , Masculino , Adulto , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Microcirurgia , Maxila/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos de Tecido Biológico , Neoplasias de Cabeça e Pescoço , Cuidados Pós-Operatórios , Estudos Retrospectivos , Resultado do Tratamento
14.
Vitae (Medellín) ; 20(3): 172-183, Sep.-Dic. 2013.
Artigo em Espanhol | LILACS | ID: lil-706257

RESUMO

Antecedentes: La mora de castilla es una fruta comercialmente importante, pero altamente perecedera.Los recubrimientos comestibles se han utilizado para mejorar la apariencia y la conservación de los alimentos,minimizan el deterioro de las frutas provocados por la senescencia, el crecimiento de microorganismosy las condiciones de manejo poscosecha. Entre los materiales utilizados en los recubrimientosesta el Aloe vera. Objetivo: Evaluar la aplicación de un recubrimiento comestible a base del mucílagode penca sábila sobre la mora, para aumentar la vida útil de acuerdo al comportamiento fisicoquímico,microbiológico y sensorial durante el almacenamiento refrigerado. Métodos: El recubrimiento comestiblese elaboró con gel mucilaginoso de penca sábila, el cual se aplicó por inmersión de la fruta con posteriorsecado, almacenados en refrigeración durante 10 días y evaluando el comportamiento fisicoquímico; lafirmeza fue determinada usando un texturómetro con sonda de 5 mm de diámetro llevada a una penetracióndel 50% del diámetro del fruto, mientras que el color se determinó en las coordenadas L*, a*, b*con un espectrocolorímetro. La diferencia de color (ΔE) se calculó tomando como base el control al díacero. La evaluación de mesófilos y de mohos y levaduras se realizó por recuento de colonias en placa a35°C y 25°C, respectivamente. Los atributos sensoriales fueron evaluados por aproximación multidimensionala través de una escala descriptiva. Resultados: La aplicación del recubrimiento sobre los frutosde mora pudo disminuir la pérdida de peso en 2,5%, mantuvo la firmeza en un 44% más, los valoresen las coordenadas de color descendieron en ambos cromas a* y b*, el recuento de mesófilos fue de un69% menos y en mohos y levaduras un 60% menos para el tratamiento. Los atributos sensoriales en losfrutos con recubrimiento mostraron una mejor calificación, la tasa de respiración fue menor en un 47%en los frutos con tratamiento...


Background:The blackberry is a commercially important fruit, but highly perishable. The edible coating has been used traditionally to improve food appearance and conservation, it is helpful to decreasedamage caused by fruit senescence, the growth of microorganisms and postharvest handling conditions. Among the materials used as coatings is the Aloe vera.Objective:To evaluate the application ofan edible coating made of aloe vera mucilage on blackberry, in order to increase shelf life according to the physicochemical, microbiological and sensory behavior.Methods: Edible coating was developedwith aloe vera mucilaginous gel, this was applied by dipping the fruit in it, to subsequently dry at roomtemperature and store under refrigeration conditions for 10 days, while evaluating the physicochemicalbehavior; firmness was determined using a texture analyzer with a flat stainless steel probe of 5 mmdiameter, applying a penetration of 50% diameter of fruit; L*, a*, b*color parameters were evaluated witha spectrum-colorimeter. Color difference (∆E) was calculated taking as based the value of control fruitat day zero. The evaluation of mesophiles and molds and yeasts was done by counting of colonies inplate at 35°C and 25°C, respectively. Sensorial attributes were evaluated by multidimensional approxi-mation with a descriptive scale. Results: The application of edible coating decreased the weight loss in 2.5%, maintained the firmness a 44% more, the values in the color coordinates a*and b* decreased, the mesophiles count was 69% less and yeasts and molds was 60% less for treatment. The sensory attributes in coated fruits showed a better grade. The respiration rate was 47% lower in comparison with controlfruits.


Assuntos
Aloe , Frutas
15.
Artigo em Inglês | VETINDEX | ID: vti-441468

RESUMO

The goal of this study was to assess the population structure of Pseudis bolbodactyla Lutz, 1925 using natural markings to identify individuals. Recruitment, survival, and population size estimations were obtained using the Jolly-Seber stochastic method. A total of 166 individuals were captured, and the striped, spotted, and dotted patterns that make their recognition possible were recorded. Of the specimens captured, 27 were recaptured, including some at pre and post-metamorphic stages. The estimate maximum population size was 52. The indices of survival and recruitment varied among samplings. Sexual dimorphism in size and in the operational sex ratio were detected. Despite the limited scope of our characterization of the P. bolbodactyla population, our data might be useful in the interpretation and elaboration of new hypotheses about ecological processes acting on anuran populations.

16.
Artigo em Inglês | VETINDEX | ID: vti-441456

RESUMO

The goal of this study was to assess the population structure of Pseudis bolbodactyla Lutz, 1925 using natural markings to identify individuals. Recruitment, survival, and population size estimations were obtained using the Jolly-Seber stochastic method. A total of 166 individuals were captured, and the striped, spotted, and dotted patterns that make their recognition possible were recorded. Of the specimens captured, 27 were recaptured, including some at pre and post-metamorphic stages. The estimate maximum population size was 52. The indices of survival and recruitment varied among samplings. Sexual dimorphism in size and in the operational sex ratio were detected. Despite the limited scope of our characterization of the P. bolbodactyla population, our data might be useful in the interpretation and elaboration of new hypotheses about ecological processes acting on anuran populations.

17.
Artigo em Inglês | VETINDEX | ID: vti-690508

RESUMO

The goal of this study was to assess the population structure of Pseudis bolbodactyla Lutz, 1925 using natural markings to identify individuals. Recruitment, survival, and population size estimations were obtained using the Jolly-Seber stochastic method. A total of 166 individuals were captured, and the striped, spotted, and dotted patterns that make their recognition possible were recorded. Of the specimens captured, 27 were recaptured, including some at pre and post-metamorphic stages. The estimate maximum population size was 52. The indices of survival and recruitment varied among samplings. Sexual dimorphism in size and in the operational sex ratio were detected. Despite the limited scope of our characterization of the P. bolbodactyla population, our data might be useful in the interpretation and elaboration of new hypotheses about ecological processes acting on anuran populations.

18.
Artigo em Inglês | VETINDEX | ID: vti-690496

RESUMO

The goal of this study was to assess the population structure of Pseudis bolbodactyla Lutz, 1925 using natural markings to identify individuals. Recruitment, survival, and population size estimations were obtained using the Jolly-Seber stochastic method. A total of 166 individuals were captured, and the striped, spotted, and dotted patterns that make their recognition possible were recorded. Of the specimens captured, 27 were recaptured, including some at pre and post-metamorphic stages. The estimate maximum population size was 52. The indices of survival and recruitment varied among samplings. Sexual dimorphism in size and in the operational sex ratio were detected. Despite the limited scope of our characterization of the P. bolbodactyla population, our data might be useful in the interpretation and elaboration of new hypotheses about ecological processes acting on anuran populations.

19.
Artigo em Inglês | LILACS-Express | VETINDEX | ID: biblio-1504209

RESUMO

The goal of this study was to assess the population structure of Pseudis bolbodactyla Lutz, 1925 using natural markings to identify individuals. Recruitment, survival, and population size estimations were obtained using the Jolly-Seber stochastic method. A total of 166 individuals were captured, and the striped, spotted, and dotted patterns that make their recognition possible were recorded. Of the specimens captured, 27 were recaptured, including some at pre and post-metamorphic stages. The estimate maximum population size was 52. The indices of survival and recruitment varied among samplings. Sexual dimorphism in size and in the operational sex ratio were detected. Despite the limited scope of our characterization of the P. bolbodactyla population, our data might be useful in the interpretation and elaboration of new hypotheses about ecological processes acting on anuran populations.

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