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Despite their ability to mitigate climate change by efficiently absorbing atmospheric carbon dioxide (CO2) and acting as natural long-term carbon sinks, mangrove ecosystems have faced several anthropogenic threats over the past century, resulting in a decline in the global mangrove cover. By using standardized methods and the most recent Bayesian tracer mixing models MixSIAR, this study aimed to quantify source contributions, burial rates, and stocks of organic carbon (Corg) and explore their temporal changes (∼100 years) in seven lead-210 dated sediment cores collected from three contrasting Mexican mangrove areas. The spatial variation in Corg burial rates and stocks in these blue carbon ecosystems primarily depended on the influence of local rivers, which controlled Corg sources and fluxes within the mangrove areas. The Corg burial rates in the cores ranged from 66 ± 16 to 400 ± 40 g m-2 yr-1. The Corg stocks ranged from 84.9 ± 0.7 to 255 ± 2 Mg ha-1 at 50 cm depth and from 137 ± 2 to 241 ± 4 Mg ha-1 at 1 m depth. The highest Corg burial rates and stocks were observed in cores from the carbonate platform of Yucatan and in cores with reduced river influence and high mangrove detritus inputs, in contrast to patterns identified from global databases. Over the past century, the rising trends in Corg burial rates and stocks in the study sites were primarily driven by enhanced inputs of fluvial-derived Corg and, in some cores, mangrove-derived Corg. Despite their decreasing extension, mangrove areas remained highly effective producers and sinks of Corg. Ongoing efforts to enhance the global database should continue, including mangrove area characteristics and reliable timescales to facilitate cross-comparison among studies.

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INTRODUCTION AND IMPORTANCE: By 2030 it is predicted that 1 in 5 women and 1 in 7 men will be living with obesity. The only long-term effective strategy for achieving significant weight loss over time is surgical treatment. One Anastomosis Gastric Bypass (OAGB) has been proposed as an effective therapeutic option. Stenosis of Gastro-Jejunal Anastomosis (GJA) is one of the most common long-term complications and its cause recognized as multifactorial. CASE PRESENTATION: We present the case of a patient with a history of progressive postoperative oral intolerance after OAGB with 60 kg weight loss (BMI 20.7 kg/m2). Severe stenosis of the GJA and massive dilation of the gastric remnant was documented, treated multiple times with endoscopic balloon dilation. He was referred to our unit due to persistent symptoms. Revision surgery to a Gastric Bypass was programmed, ultimately performed via an open approach with resection of 80 % of the gastric remnant. CLINICAL DISCUSSION: Endoscopic dilatation and surgical revision are the two primary treatment options for GJA stricture. In refractory cases to pneumatic dilation, laparoscopic revision surgery is indicated, however an open approach is frequently required, as surgeries are technically demanding due to distorted anatomy in this population. CONCLUSION: Operations to correct chronic complications are tailored to the patient's anatomy as well as the symptoms or pathologies they are intended to correct. Whilst revision surgeries are associated with an increased risk of conversion, complications and longer hospital stay, they can be performed safely in experienced centers.

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Several challenges exist for referral and transport of critically ill children in resource-limited regions such as Latin America; however, little is known about factors associated with clinical outcomes. Thus, we aimed to describe the characteristics of critically ill children in Latin America transferred to pediatric intensive care units for acute respiratory failure to identify risk factors for mortality. We analyzed data from 2,692 patients admitted to 28 centers in the Pediatric Collaborative Network of Latin America Acute Respiratory Failure Registry. Among patients referred from another facility (773, 28%), nonurban transports were independently associated with mortality (adjusted odds ratio = 9.4; 95% confidence interval: 2.4-36.3).

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Resumen: Introducción: la fascitis o fasciosis plantar es una causa de dolor en el pie, en la cual frecuentemente se encuentran casos resistentes al tratamiento conservador. La cirugía queda reservada para los pacientes que no han respondido a tratamientos conservadores, ondas de choque o infiltraciones con corticosteroides. El objetivo de este trabajo es realizar una revisión sistemática de la literatura disponible y describir una técnica para el tratamiento de la fascitis o fasciosis plantar consistente en el rasgado longitudinal de la aponeurosis plantar asistido con ecografía. Material y métodos: se realizó una búsqueda sistemática de publicaciones previas sobre la tenotomía longitudinal en el tratamiento de la fascitis plantar. Se incluyeron los encabezados de temas médicos o MeSH (Medical subjects headings por sus siglas en inglés), en inglés: Curettage, Tenotomy y Plantar Fasciitis. La búsqueda electrónica incluyó las bases de datos de PubMed, Embase, Cochrane central register of controlled trials, Trip database y National Institute for Health and Care Excellence (NICE por sus siglas en inglés). Se realizó una descripción detallada de la técnica con la intención de que pueda ser reproducida. Conclusión: la tenotomía longitudinal representa una alternativa para el tratamiento de la fascitis plantar. Se basa en la extrapolación del conocimiento en el territorio Aquíleo con una base fisiopatológica de respaldo. Se trata de una técnica no invasiva que se puede realizar de forma ambulatoria y que permitiría la rápida incorporación del paciente a sus actividades. La tenotomía longitudinal podría evitar al paciente someterse a cirugías de mayor envergadura.

Abstract: Introduction: plantar fasciitis or fasciosis is a cause of foot pain with cases resistant to conservative treatment. Surgery is reserved for patients who have not responded to conservative treatment, shock waves, or corticosteroid injections. The aim of this publications is to carry out a systematic review of the available literature and to describe a specific technique for the treatment of plantar fasciosis consisting of the longitudinal tearing of the plantar aponeurosis assisted with ultrasound. Material and methods: a systematic search was carried out for previous publications on longitudinal tenotomy in the treatment of plantar fasciitis. The Medical Subject Headings (MeSH) terms «Curettage¼, «Tenotomy¼ and «Plantar Fasciitis¼ were included. The electronic search included PubMed, Embase, Cochrane central register of controlled trials, Trip database, and National Institute for Health and Care Excellence (NICE) databases. A detailed description of the technique was included with the intention that it can be reproduced. Conclusion: longitudinal tenotomy represents an alternative for the treatment of plantar fasciitis. It is based on the extrapolation of knowledge in the Achilles tendon territory with a supporting pathophysiological basis. It is a non-invasive technique that can be performed on an outpatient basis and that would allow the rapid incorporation of the patient to their activities. Longitudinal tenotomy would prevent the patient from undergoing major surgeries.

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Since the beginning of 2020, worldwide attention has been being focussed on SARS-CoV-2, the second strain of the severe acute respiratory syndrome virus. Although advances in vaccine technology have been made, particularly considering the advent of mRNA vaccines, up to date, no single antigen design can ensure optimal immune response. Therefore, new technologies must be tested as to their ability to further improve vaccines. Nanosecond Pulsed Electric Field (nsPEF) is one such method showing great promise in different biomedical and industrial fields, including the fight against COVID-19. Of note, available research shows that nsPEF directly damages the cell's DNA, so it is critical to determine if this technology could be able to fragment either viral DNA or RNA so as to be used as a novel technology to produce inactivated pathogenic agents that may, in turn, be used for the production of vaccines. Considering the available evidence, we propose that nsPEF may be used to produce inactivated SARS-CoV-2 viruses that may in turn be used to produce novel vaccines, as another tool to address 20 the current COVID-19 pandemic.Key MessagesViral inactivation by using pulsed electric fields in the nanosecond frequency.DNA fragmentation by a Nanosecond Pulsed Electric Field (nsPEF).Opportunity to apply new technologies in vaccine development.

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PURPOSE: The aim of this study was to identify the risk factors associated with house infestation by Triatoma dimidiata as well as with Trypanosoma cruzi infection in humans and owned dogs in two rural communities from the municipality of Catemaco, Veracruz, Mexico. METHODS: One hundred and 16 human blood samples and 34 dog blood samples were collected. The presence of anti-T. cruzi antibodies was determined using four different ELISA assays. Moreover, reactive ELISA sera from humans and dogs were processed by indirect immunofluorescence (IFI) to confirm the presence of anti-T. cruzi antibodies. RESULTS: Serologic tests for T. cruzi infection showed a prevalence of 5.1% (6/116) in humans and of 50% (17/34) in owned dogs. CONCLUSION: The presence of animals (dogs, chickens and wild animals), as well as some characteristics of house construction were identified as risk factors for infestation and infection. Complementary studies must be carried out to allow a better understanding of the transmission dynamics in the state of Veracruz, Mexico, and the implementation of adequate control programs.

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Resumen Introducción: La rinoplastia de preservación dorsal es una técnica innovadora en rinoplastias de reducción primaria, logrando una adecuada ventilación nasal y resultados estéticos naturales. Objetivo: Describir los resultados estéticos y funcionales en pacientes sometidos a rinoplastias de preservación dorsal. Material y Método: Se realiza un estudio de intervención no aleatorio "antes-después", donde se evaluaron las variables estética y funcional previo a la cirugía y luego a los seis meses. La variable estética se evaluó mediante el cuestionario de Utrecht (CU), escala visual análoga de apariencia nasal (EVA) y set de fotos clínicas. La variable funcional mediante el cuestionario de NOSE (Nasal Obstruction Symptoms Evaluation). Resultados: Un total de 15 pacientes fueron sometidos a rinoplastia de preservación dorsal. No hubo complicaciones tanto intra como posoperatorias. Ningún paciente intervenido presentó irregularidades dorsales, asimetrías, ni deformidades en "V" invertidas. Se observó una mejoría estadísticamente significativa (p < 0,01) en los resultados del CU, EVA y NOSE. Conclusión: La rinoplastia de preservación dorsal ofrece como resultado una nariz funcional, con líneas dorsales posoperatorias naturales. Esta técnica no presenta estigmas quirúrgicos, por lo que no es necesario la utilización de injertos para reparación del dorso nasal. Es rápida y fácil de realizar por cualquier cirujano especialista en rinoplastias.

Abstract Introduction: Dorsal preservation rhinoplasty is an innovative technique in primary reduction rhinoplasty, achieving adequate nasal ventilation and natural aesthetic results. Aim: To describe the aesthetic and functional results in patients undergoing dorsal preservation rhinoplasties. Material and Method: A non-randomized "before-after" intervention study was carried out, where the aesthetic and functional variables were evaluated before surgery and then at six months. The aesthetic variable was evaluated using the Utrecht questionnaire (CU), the visual analog scale of nasal appearance (VAS), and a set of clinical photos. The functional variable using the Nasal Obstruction Symptoms Evaluation (NOSE) questionnaire. Results: A total of 15 patients underwent dorsal preservation rhinoplasty. There were no intraoperative and postoperative complications. No patient who underwent surgery presented dorsal irregularities, asymmetries, or inverted "V" deformities. A statistically significant improvement (p < 0.01) was observed in the UC, VAS, and NOSE results. Conclusion: Dorsal preservation rhinoplasty results in a functional nose, with natural postoperative dorsal lines. This technique does not present surgical stigmata, so it is not necessary to use grafts to repair the nasal dorsum. It is quick and easy to perform by any rhinoplasty surgeon.

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INTRODUCTION: plantar fasciitis or fasciosis is a cause of foot pain with cases resistant to conservative treatment. Surgery is reserved for patients who have not responded to conservative treatment, shock waves, or corticosteroid injections. The aim of this publications is to carry out a systematic review of the available literature and to describe a specific technique for the treatment of plantar fasciosis consisting of the longitudinal tearing of the plantar aponeurosis assisted with ultrasound. MATERIAL AND METHODS: a systematic search was carried out for previous publications on longitudinal tenotomy in the treatment of plantar fasciitis. The Medical Subject Headings (MeSH) terms "Curettage", "Tenotomy" and "Plantar Fasciitis" were included. The electronic search included PubMed, Embase, Cochrane central register of controlled trials, Trip database, and National Institute for Health and Care Excellence (NICE) databases. A detailed description of the technique was included with the intention that it can be reproduced. CONCLUSION: longitudinal tenotomy represents an alternative for the treatment of plantar fasciitis. It is based on the extrapolation of knowledge in the Achilles tendon territory with a supporting pathophysiological basis. It is a non-invasive technique that can be performed on an outpatient basis and that would allow the rapid incorporation of the patient to their activities. Longitudinal tenotomy would prevent the patient from undergoing major surgeries.

INTRODUCCIÓN: la fascitis o fasciosis plantar es una causa de dolor en el pie, en la cual frecuentemente se encuentran casos resistentes al tratamiento conservador. La cirugía queda reservada para los pacientes que no han respondido a tratamientos conservadores, ondas de choque o infiltraciones con corticosteroides. El objetivo de este trabajo es realizar una revisión sistemática de la literatura disponible y describir una técnica para el tratamiento de la fascitis o fasciosis plantar consistente en el rasgado longitudinal de la aponeurosis plantar asistido con ecografía. MATERIAL Y MÉTODOS: se realizó una búsqueda sistemática de publicaciones previas sobre la tenotomía longitudinal en el tratamiento de la fascitis plantar. Se incluyeron los encabezados de temas médicos o MeSH (Medical subjects headings por sus siglas en inglés), en inglés: Curettage, Tenotomy y Plantar Fasciitis. La búsqueda electrónica incluyó las bases de datos de PubMed, Embase, Cochrane central register of controlled trials, Trip database y National Institute for Health and Care Excellence (NICE por sus siglas en inglés). Se realizó una descripción detallada de la técnica con la intención de que pueda ser reproducida. CONCLUSIÓN: la tenotomía longitudinal representa una alternativa para el tratamiento de la fascitis plantar. Se basa en la extrapolación del conocimiento en el territorio Aquíleo con una base fisiopatológica de respaldo. Se trata de una técnica no invasiva que se puede realizar de forma ambulatoria y que permitiría la rápida incorporación del paciente a sus actividades. La tenotomía longitudinal podría evitar al paciente someterse a cirugías de mayor envergadura.

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PURPOSE: We retrospectively analysed overall survival (OS) and potential predictive biomarkers of OS in patients with metastatic melanoma treated with ipilimumab plus nivolumab in a single institution. METHODS AND PATIENTS: Electronic medical records of patients with advanced melanoma receiving ≥ 1 dose of a combined ipilimumab plus nivolumab regimen between March 3, 2016 and March 7, 2020 in a single institution, were reviewed. OS was analysed using the Kaplan-Meier method. Sub-group analyses were conducted to examine several endpoints according to relevant clinical, molecular and pathological variables using logistic and Cox models. RESULTS: Forty-four cases were reviewed, 38 (86.4%), of whom had cutaneous melanoma, 21 (47.7%) were BRAF mutant, 21 (47.7%) presented high lactate dehydrogenase (LDH) values, 23 (52.3%) had ≥ 3 disease sites, and 10 (22.7%) patients had brain metastases. The median follow-up was 37.7 months, and the median OS was 21.1 months (95% CI 8.2-NR). In the multivariate analysis, the OS was significantly longer in patients with an Eastern Cooperative Oncology Group (ECOG) score of 0, LDH ≤ upper limit of normal, absence of liver metastases and neutrophil-to-lymphocyte ratio (NLR) < 5 (all p ≤ 0.05, log-rank test). These factors allowed the classification of patients into three prognostic risk groups (low/intermediate/high risk) for death. CONCLUSION: Overall survival of real-world patients from our cohort receiving ipilimumab plus nivolumab was lower than in previous studies. The ECOG score, LDH values, the presence of liver metastases and the NLR were independent prognostic factors for survival.

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Resumen En las últimas dos décadas, distintos tipos de abordajes extracervicales se han ido desarrollando en la cirugía endocrinológica, y principalmente en la tiroidectomía, con el fin de obtener mejores resultados cosméticos. Estos abordajes transfieren la incisión clásica descrita por Kocher, a puntos de acceso más discretos, sin embargo, requieren de disecciones extensas. Fue el desarrollo del abordaje vía vestibular el que cambió el paradigma terapéutico, ya que es el único potencialmente libre de cicatrices cutáneas, que ofrece la seguridad y resultados comparables con técnicas tradicionales. Además, la menor distancia entre el sitio de abordaje y la glándula tiroides, obvia la necesidad de extensas disecciones asociadas a otros tipos de abordajes remotos. La tiroidectomía endoscópica transoral por vía vestibular utiliza un instrumento laparoscópico convencional, vía vestíbulo oral, a través del espacio premandibular insuflado con CO2. Esta técnica se considera segura y reproducible. El presente artículo de revisión pretende describir la técnica quirúrgica, con la finalidad de aportar información que resulte relevante para la práctica clínica diaria.

Abstract In the last two decades, different types of extra-cervical approaches have been described in endocrine surgery, mainly for thyroidectomy, to achieve better cosmetic outcomes. These approaches transfer the classic incision described by Kocher, to inconspicuous locations, yet they necessitate of extensive surgical dissections. It was the development of the vestibular approach that changed the treatment paradigm, as it is the only approach free of visible scars, with a safety profile and overall outcomes comparable to traditional techniques. Furthermore, the shorter distance between the access point and the thyroid gland, obviates the need for extensive dissections, such as those used in other remote approaches. The vestibular transoral endoscopic thyroidectomy uses a conventional laparoscopic instrument via the oral vestibule, through the premandibular space, which is insufflated with CO2. This technique is considered safe and reproducible. This review article aims to describe the surgical technique, in order to provide information relevant to routine clinical practice.

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Resumen Introducción: La resección anterior baja protegida con una ileostomía en asa (IA) luego de neoadyuvancia es el tratamiento estándar del cáncer del recto bajo localmente avanzado. Objetivos: Investigar la incidencia, características clínicas de la disfunción ileostómica (DI) en estos pacientes y, eventualmente, definir un perfil de riesgo. Materiales y Método: Se analizan 103 pacientes consecutivos. La DI se define como la eliminación por la ileostomía de más de 1,5 litros por día durante 3 o más días consecutivos asociado a distensión y dolor abdominal con intolerancia a la alimentación oral en ausencia de una complicación intraabdominal Clavien-Dindo grado III o mayor. Se comparan el grupo con DI del resto (no DI). Resultados: La DI se presentó en el 14,5% de los casos, se resolvió entre 12 y 70 días (en el 50% superó los 30 días), la tasa de reingreso fue 27% y no hubo reoperaciones en este grupo. No hubo diferencias estadísticamente significativas entre ambos grupos salvo en el tiempo de hospitalizarán y la tasa de reingresos. Discusión: La DI corresponde a un tipo de íleo posoperatorio de gravedad y duración variable que paradojalmente se asocia con la eliminación de altos volúmenes de contenido intestinal por la IA, requiere aporte vigoroso de volumen y electrolitos y en los casos más graves apoyo con nutrición parenteral. El cuadro revierte en plazos variables con manejo conservador. En este estudio no se ha logrado definir un perfil del paciente en riesgo de sufrir esta complicación o factores predictivos de ella.

Background: Diverting loop ileostomy (LI) is commonly performed to protect a distal anastomosis after a low anterior resection. Aim: To investigate the frecuency and clinical features of ileostomic dysfunction (ID) and, eventually, to define a profile of patients at risk of this complicaction. Materials and Method: 103 consecutive patients operated on for rectal cancer were included. ID is defined when the maxime output was more than 1,5 lt/day for three or more consecutive days with biochemical disturbances, associated to abdominal distension and the inability to tolerate oral feeding without postoperative severe complication. Patients with ID were compared with noID group. Results: ID developed in 15 patients, lasting between 12 and 70 days (50% for more then 30 days), the readmission rate was 27% without reoperation in this group. Except for inhospital time and readmission rate, no other difference between both groups were founded. Discussion: ID is a kind of paralitic ileus of variable intensity with paradox high output ileostomy leading to depletion of water and electrolyte imbalance. ID requires reposition of high volumen of fluids and electrolytes and sometimes parenteral nutrition with full recovery in variable periods without invasive treatment. In this study it was not possible to define a patient profile at risk or predictive factores of this complication.

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The Atacama Desert represents the highest levels of mining exploitation in Chile, which inexorably results in high levels of pollution. Raptors, and particularly scavengers, have shown their usefulness to evaluate exposure to environmental contaminants in polluted scenarios. In this study, we used primary feathers from a local avian scavenger, turkey vulture Cathartes aura, to evaluate the exposure to cadmium (Cd), lead (Pb), copper (Cu) and zinc (Zn) in two locations from the southern Atacama Desert (coastal and inland) and a third location from the bordering semiarid region, in northern Chile. All metals were detected in all analyzed samples (n = 54). Mean concentrations in Coastal Atacama were 0.68 ± 0.84 ppm for Cd; 1.97 ± 2.01 ppm for Pb; 59.11 ± 80.69 ppm for Cu; and 107.96 ± 51.00 ppm for Zn, while mean concentrations in Inland Atacama were 0.55 ± 0.42 ppm for Cd; 3.37 ± 2.61 ppm for Pb; 91.66 ± 77.74 ppm for Cu; and 214.03 ± 99.08 ppm for Zn. Mean concentrations in Coastal Coquimbo were 0.63 ± 0.69 ppm for Cd; 1.57 ± 0.92 ppm for Pb; 18.09 ± 6.12 ppm for Cu; and 149.37 ± 105.56 ppm for Zn. These differences could be explained by differences on abundance of mining settlements among areas. According to the literature, these values are very high for all metals, exceeding in some cases those values referred as responsible of health disorders in birds. We strongly recommend further research looking at potential adverse effects caused by heavy metal pollution on the health of human and wildlife populations in the southern Atacama Desert.

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Resumen En el año 2020 las cirujanas chilenas se reunieron en torno a la necesidad de trabajar para solucionar varios problemas que aquejan a la labor quirúrgica de la mujer en nuestro país, desde la formación de pregrado en adelante. Algunos de estos problemas son la poca visibilidad de la mujer en cirugía y la falta de reconocimiento de las cirujanas líderes y referentes del pasado y actuales. El objetivo de esta investigación fue indagar quienes habían sido las primeras cirujanas de Chile. La búsqueda fue difícil, ya que la información en la internet es escasa, por lo que se recurrió a entrevistas a discípulos y a algunas de las primeras cirujanas tanto en su especialidad o región del país. La cronología muestra lo reciente que ha sido la llegada de cirujanas a algunas regiones o la escasa representatividad de cirujanas en algunas subespecialidades. Esto se puede entender por barreras legales y culturales que han tenido que enfrentar las mujeres desde el ingreso a la carrera de medicina hasta el poder desarrollar la especialidad en cirugía a lo largo de la historia de este país.

In 2020, Chilean women surgeons gathered to discuss different problems affecting the development of a career in surgery. Through the history of the medicine and surgery in Chile, there have been several legal and cultural barriers that have kept women out of this specialty. One of this problem is the lack of knowledge of who were the first female surgeons and the lack of awareness of that there are women that can be leaders as well as male surgeons. So, generations of medical students and residents continue thinking that surgery might be a man's job. The purpose of this investigation is to reveal who went and are the first women surgeon in this country, not only in their time but also in their specialty, so we all know that there were and there still are pioneers among us.

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Resumen Los tumores malignos de la vaina nerviosa forman parte del 5% de los sarcomas de partes blandas. Si bien son infrecuentes, su incidencia aumenta en caso de neurofibromatosis tipo 1. Cuando estos tumores están ubicados en cabeza y cuello, suelen ser asintomáticos, por lo que su diagnóstico es tardío. El tratamiento es principalmente quirúrgico, con una tasa de recidiva importante y pobre sobrevida a los 5 años. Se presenta el reporte de un caso de una paciente de 52 años con antecedentes de neurofibromatosis tipo 1 y un tumor maligno de vaina nerviosa periférica del nervio vago, localizado en el espacio parafaríngeo.

Abstract Malignant peripheral nerve sheath tumors are part of 5% of soft tissue sarcomas. Although they are infrequent, their incidence increases in case of neurofibromatosis type 1. When these tumors are located in the head and neck, they are usually asymptomatic, so their diagnosis is delayed. Treatment is primarily surgical, with a significant recurrence rate and poor 5-year survival. We present a case report of a 52-year-old patient with a history of type 1 neurofibromatosis and a malignant peripheral nerve sheath tumor of the vagus, located in the parapharyngeal space.

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Resumen La invasión traqueal corresponde al tercer sitio más común de extensión extratiroidea del cáncer de tiroides. Se debe sospechar en caso de disnea, disfonía, estridor y hemoptisis, sin embargo, hasta un 30% de los pacientes se pueden presentar de forma asintomática, pesquisándose al momento de la cirugía. La nasofibroscopía de rutina, una alta sospecha y una planificación quirúrgica adecuada, serán fundamentales para lograr una resección tumoral completa y mejorar tanto el pronóstico como el control local. A continuación, presentamos dos casos clínicos manejados con resección cricotraqueal con anastomosis términoterminal en el Servicio de Otorrinolaringología del Hospital Carlos Van Buren.

Abstract Tracheal invasion is the third most common site of extrathyroideal invasión of thyroid cancer, recognized as a por prognostic indicator. It should be suspected in case of dyspnea, dysphonia, stridor, and hemoptysis. However, up to 30% of cases are asymptomatic, detected at the time of surgery. Routine nasofibroscopy, thorough examination and surgical planning are essential to ensure a complete tumoral resection, improvement in prognostic and local control of disease. We present two cases with cricotracheal resection and end-to-end anastomosis in Otholaringology Service from the Carlos Van Buren Hospital.

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Resumen El cáncer de lengua es una patología con una importante morbilidad e impacto en la calidad de vida del paciente, afectando la masticación, deglución, comunicación y gusto, por lo que requiere de un equipo multidisciplinario para establecer la rehabilitación adecuada. Se necesita realizar resecciones amplias para asegurar márgenes negativos, y si el cirujano considera que existe un volumen remanente insuficiente para obliterar la cavidad oral, la realización de un colgajo será necesario para mantener la función deglutoria. Se presenta el caso de un paciente de 76 años, masculino, con antecedentes de tabaquismo suspendido hace 23 años, que presenta una lesión ulcerada dolorosa en el borde derecho de la lengua móvil, la biopsia informa un carcinoma epidermoide, etapificado T2N0M0, por lo que se decide realizar hemiglosectomía derecha más disección cervical y reconstrucción con colgajo libre radial.

Abstract Tongue cancer is a pathology with significant morbidity and impact on the quality of life of the patients. It affects chewing, swallowing, communication, and taste. Therefore, a multidisciplinary team is required to establish adequate rehabilitation. Extensive resections are needed to ensure negative margins. If the surgeon considers that there is insufficient remaining volume to obliterate the oral cavity, flap surgery will be carried out to maintain the swallowing function. We present a case report of a 76-year-old male patient with a history of smoking cessation of 23 years. He presents a painful ulcerated lesion on the right edge of the mobile tongue. The biopsy reports an epidermoid carcinoma, staged T2N0M0 which led to perform a right hemiglosectomy, cervical dissection, and reconstruction with free radial forearm flap.

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Resumen Durante las últimas décadas los avances en técnicas quirúrgicas, radioterapia y quimioterapia han logrado de forma significativa aumentar la sobrevida y disminuir la recidiva local en el cáncer de recto evitando una colostomía definitiva; sin embargo, este trascendental progreso médico no ha ido acompañado de una mejoría en los resultados funcionales de los pacientes sometidos a una cirugía conservadora de esfínter, siendo el conjunto de síntomas defecatorios posterior a la resección rectal, conocido como síndrome de resección anterior baja (LARS), una secuela prácticamente inevitable, que generalmente se asocia a disfunción sexual, urinaria, dolor crónico, altos costos en rehabilitación y control sintomático, además de una alteración importante en la calidad de vida. En este artículo presentamos una revisión completa y actualizada de las características clínicas y alternativas de tratamiento del LARS, finalizando con una propuesta de manejo integral multidisciplinario que destaca la importancia de la prehabilitación, evaluación objetiva de los síntomas, educación e información adecuada del paciente y su familia, además del trabajo en equipo en unidades especializadas de rehabilitación de piso pélvico, requisito fundamental a la hora de manejar adecuadamente esta patología.

During the last decades, advances in surgical techniques, radiotherapy and chemotherapy have significantly increased survival and reduced local recurrence in rectal cancer, avoiding a definitive colostomy. However, this transcendental medical progress has not been accompanied by an improvement in the functional results of patients after sphincter-preserving rectal resection, being the set of defecatory symptoms after rectal resection, known as low anterior resection syndrome (LARS), a practically inevitable sequel, which is usually associated with sexual or urinary dysfunction, chronic pain, high costs and an important alteration in the quality of life. In this article, we will present a complete and updated review of the clinical and alternative characteristics of LARS treatment, ending with a proposal for multidisciplinary and integral management that highlights the importance of prehabilitation, objective evaluation of symptoms, education and adequate information of the patient and his family, in addition to teamwork in units specialized in pelvic floor rehabilitation, a fundamental requirement when properly managing this pathology.

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OBJECTIVES: We aimed to determine the immunolocalization patterns of the interleukin (IL)-6 signaling complex in epithelialized and non-epithelialized apical lesions of endodontic origin (ALEOs). MATERIALS AND METHODS: Epithelialized (n = 8) and non-epithelialized (n = 7) ALEOs were obtained from teeth with indication of extraction in patients with clinical diagnosis of apical periodontitis. All tissues were subjected to routine processing for histopathologic examination and primary antibodies for IL-6, IL-6 receptor (R), and glycoprotein (gp)-130 were used for immunohistochemistry and double immunofluorescence co-localization. RESULTS: IL-6, IL-6R, and gp-130 were immunolocalized in endothelial cells and mononuclear leukocytes in a diffuse pattern within the connective tissue of epithelialized and non-epithelialized ALEOs. In the epithelialized lesions, two different patterns were identified: IL-6 signaling complex was localized within the proliferating epithelium in a diffuse intracellular pattern and in a cell membrane localization pattern within the mature epithelial lining, showing a decreased intensity towards the surface layers. CONCLUSIONS: IL-6, IL-6R, and gp-130 localized to mononuclear inflammatory cells, vascular endothelial cells, and immature proliferating epithelia in a diffuse pattern and in mature lining epithelia in a localized cell membrane pattern, supporting a role for epithelial proliferation during cyst formation. Additional cell membrane co-localization of IL-6 receptor complex suggests classic signaling involvement in addition to trans-signaling.

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