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Resumen OBJETIVO: Determinar las mutaciones genéticas en el cáncer de mama de patrón hereditario y demostrar si existe alguna asociación significativa entre las más comunes en población mexicana y el riesgo de padecerlo. MATERIALES Y MÉTODOS: Estudio transversal y observacional efectuado en el Hospital Ángeles México en coordinación con el Instituto Nacional de Medicina Genómica. Criterios de inclusión: pacientes con cáncer de mama y uno o más familiares de primer grado afectados por esta enfermedad y pacientes con cáncer de ovario. Criterios de exclusión: pacientes sin antecedentes de cáncer de mama ni ovario, o con algún familiar en el protocolo. Se empleó la técnica de rearreglos en placas RT2 Profiler para Master-Mix Quantinova probe PCR kit. Para el análisis estadístico se utilizó el programa SPSS versión 22 y Epi Info versión 7. RESULTADOS: Se estudiaron 39 pacientes con edad promedio de 53.2 ± 12.1 años. Los receptores de progesterona y estrógeno no mostraron diferencia entre grupos. Hubo mayor tendencia para BRCA1. Al estudiar las mutaciones con significación estadística, en las que sobresalieron los casos de BRCA2 versus sin significación y los casos negativos, no hubo diferencia estadística significativa, pero con una tendencia a mayor frecuencia de BCRA1. Al evaluar las estirpes de cáncer de mama y los grados nucleares comparados por edad, los tres grupos de grado nuclear comparados por edad mostraron diferencias. CONCLUSIÓN: Los datos obtenidos muestran que en la población mexicana el gen BRCA2 es el de mayor incidencia de cáncer hereditario, en edad de aparición más temprana y mayor grado nuclear al momento del diagnóstico.

Abstract OBJECTIVE: To determine the genetic mutations in hereditary pattern breast cancer and demonstrate whether there is a significant association between the most common in the Mexican population and the risk of suffering it. MATERIALS AND METHODS: Cross-sectional and observational study conducted at the Hospital Angeles México in coordination with the National Institute of Genomic Medicine. Inclusion criteria: patients with breast cancer and one or more first-degree relatives affected by this disease and patients with ovarian cancer. Exclusion criteria: patients without a history of breast or ovarian cancer, or with a family member in the protocol. The RT2 Profiler plate rearrangement technique was used for Master-Mix Quantinova probe PCR kit. The SPSS version 22 program and Epi Info version 7 were used for the statistical analysis. RESULTS: 39 patients with an average age of 53.2 ± 12.1 years were studied. Progesterone and estrogen receptors showed no difference between groups. There was a greater trend for BRCA1. When studying the mutations with statistical significance, in which the cases of BRCA2 versus without significance and the negative cases stood out, there was no significant statistical difference, but with a tendency to higher frequency of BCRA1. When evaluating breast cancer lines and nuclear grades compared by age, the three nuclear grade groups compared by age showed differences. CONCLUSION: The data obtained show that in the Mexican population the BRCA2 gene has a higher incidence in hereditary cancer, at an age of earlier onset and greater nuclear grade at the time of diagnosis.

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Venezuelan equine encephalitis (VEE) has been assessed according to the criteria of the Animal Health Law (AHL), in particular criteria of Article 7 on disease profile and impacts, Article 5 on the eligibility of VEE to be listed, Article 9 for the categorisation of VEE according to disease prevention and control rules as in Annex IV and Article 8 on the list of animal species related to VEE. The assessment has been performed following a methodology composed of information collection and compilation, expert judgement on each criterion at individual and, if no consensus was reached before, also at collective level. The output is composed of the categorical answer, and for the questions where no consensus was reached, the different supporting views are reported. Details on the methodology used for this assessment are explained in a separate opinion. According to the assessment performed, it is inconclusive whether VEE is eligible to be listed for Union intervention as laid down in Article 5(3) of the AHL because there was no full consensus on the criterion 5 A(v). Consequently, since it is inconclusive whether VEE can be considered eligible to be listed for Union intervention as laid down in Article 5(3) of the AHL, the assessment on compliance of VEE with the criteria as in Sections 4 and 5 of Annex IV to the AHL, for the application of the disease prevention and control rules referred to in points (d) and (e) of Article 9(1), and which animal species can be considered to be listed for VEE according to Article 8(3) of the AHL is also inconclusive.

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Se describe una experiencia clínico-formativa en el ámbito hospitalario, donde destacan los aportes de la neuropsicología en la atención multidisciplinaria a pacientes con tumores cerebrales. Se ejemplifican cuatro casos atendidos en el Servicio de Neurocirugía del Hospital México en Costa Rica, a quienes se les realizó una valoración neuropsicológica como parte del protocolo de atención en cirugía de resección tumoral. Se documenta una leve pero consistente tendencia a la mejoría en los rendimientos tras la intervención neuroquirúrgica de los casos reportados, evidenciando, también, las secuelas neurocognitivas y emocionales que permanecen e impactan directamente la calidad de vida. Se discute sobre los retos asociados a la expectativa sanitaria de prolongación de la vida pero preservando su calidad y funcionalidad.

The systematization of a clinical and educational experience in a hospital setting shows evidence of the neuropsychological contributions to the multidisciplinary care for patients with brain tumors. Four cases of people diagnosed with brain tumors are exemplified. The patients were treated at the Neurosurgical Unit at the Hospital Mexico, Costa Rica. Each patient underwent neuropsychological evaluations as part of the established protocol for neurosurgical interventions. Results showed a slight yet consistent trend of cognitive performance improvement after each surgery, and identified residual neurocognitive consequences that would have a direct impact on the patients quality of life. This paper discusses the challenges associated with health expectancy of prolonging life while preserving its quality and functionality.

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Los adenomas de hipófisis se encuentran entre las neoplasias intracraneales más frecuentes después de los gliomas y meningiomas. Estos tumores, los cuales en la mayoría de los casos son benignos, pueden ser no funcionantes o funcionantes en cuyo caso se manifiestarán como síndromes clínicos endocrinológicos específicos dependiendo de la hormona secretada. Incluso algunos tumores hipofisiarios asocian efectos de masa con alteraciones neurológicas secundarias. Se caracterizan por presentar una pseudocápsula histológica constituida por reticulina, que sirve como límite anatómico entre el tejido glandular normal y el tumor. Es más frecuenteencontrada en tumores productores de prolactina y se encuentra íntegra principalmente en microadenomas de hipófisis puesto que conforme crece el tumor tiende a tornase discontinua. La pseudocápsula ha cobrado importancia principalmente en el manejo quirúrgico, puesto que al tomar como referencia la pseudocápsula en resecciones extracapsulares, se obtienen mejores quirurgicos en cuanto a menores índices de recidiva y de resecciones incompletas, al mismo tiempo que se logra conservar la función pituitaria.

Pituitary adenomas are within the most frequent intracranial tumors after gliomas and meningiomas. These tumors that often are benign can be nonfunctioning or functioning. In the latter will manifest as specific clinical endocrine syndromes depending on the produced hormone. Other may associate a mass effect with secondary neurologic alterations. These adenomas are characterized by the presence of a histologic pseudocapsule made of reticulin and serves as an anatomic limit between the normal pituitary gland and the tumor. It's more frequently found in prolactin secreting adenomas and conserves its integrity more in microadenomas because as the tumor grows is more likely to be discontinued. The pseudocapsule is of great importance especially in the surgical manage of the tumor since its recognition during the surgical procedure in extracapsular resections has proven to result in better patient outcome, seen on lower incomplete resection rates and recurrence, as well as managing to preserve pituitary function.

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Dengue is an important public health problem in the Amazon area of Peru, resulting in significant morbidity each year. As in other areas of the world, ultra-low volume (ULV) application of insecticides is the main strategy to reduce adult populations of the dengue vector Aedes aegypti, despite growing evidence of its limitations as a single control method. This study investigated the efficacy of deltamethrin S.C. applied through indoor residual spraying (IRS) of dwellings in reducing A. aegypti populations. The residual effect of the insecticide was tested by monthly bioassays on the three most common indoor surfaces found in the Amazon area: painted wood, unpainted wood and brick. The results showed that in an area with moderate levels of A. aegypti infestation, IRS dramatically reduced all immature indices the first week after deltamethrin IRS application and the adult index from 18.5 to 3.1, four weeks after intervention (p<0.05). Even though housing conditions facilitated reinfestation with A. aegypti (100% of the houses have open roof eaves, 31.5% lack sewage systems, and 60.4% collected rain in open containers), indices remained low compared to baseline 16 weeks after insecticide application. Bioassays showed that deltamethrin S.C. caused mortalities >80% 8 weeks after application on all types of surfaces. The residual effect of the insecticide was greater on brick than on wooden walls (p<0.05). Our results demonstrate that IRS can have both an immediate and sustained effect on reducing adult and immature A. aegypti populations and should be considered as an adult mosquito control strategy by dengue vector control programs.

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The photophysics and photochemistry of the ß-lapachone derived diphenyldihydrodioxin 3 were investigated using steady-state and time resolved techniques. Laser excitation of 3 leads to the formation of its cation radical 4 (absorption maxima at 410 and 450 nm and a lifetime of 10 µs), which was confirmed by its thermal generation employing tris(2,4-dibromophenyl)-aminium hexachloroantimonate (BAHA) as the electron acceptor. The cation radical 4 was also formed via the triplet excited state of 3 through a triplet sensitized process using benzophenone (ET = 69 kcal mol(-1)) as the sensitizer.

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BACKGROUND: Gluteal enhancement surgery includes buttock implants, gluteal flaps, lipografting, and gluteal lifts. However, no information is available on the outcomes achievable using the gluteal lift combined with subfascial gluteal implants. METHODS: A retrospective study was performed to analyze the outcomes of gluteal lift combined with subfascial gluteal implants performed during a 7-year period by a single surgeon at a single institution. RESULTS: During the study period, 114 patients (228 implants) ages 27-68 years (mean 47 years) were found. The follow-up period was 1-7 years (mean 4.5 years). The findings showed seroma in 11.4 % of the patients, hematoma in 5.26 %, minor wound dehiscence in 19.29 %, major wound dehiscence in 1.75 %, minor infection in 1.75 %, implant exposure in 0 %, capsular contracture Becker 3 and 4 in 3.5 %, implant rupture in 0 %, implant malposition in 5.25 %, long-term numbness of the buttock in 0 %, palpability of the implant in 0 %, implant rippling in 0 %, implant rupture in 0 %, wide scars in 41.2 %, need for secondary surgery in 26.31 %, and dissatisfaction with the final volume in 10.52 %. A patient satisfaction rate of 9.6 in 10 was found. CONCLUSIONS: The study showed that the gluteal lift combined with gluteal implants placed in the subfascial pocket provided good long-lasting results with an acceptable rate of complications, very high patient satisfaction, and easily concealed scars. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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BACKGROUND: The face-lift procedure is one of the most skillful interventions performed by plastic surgeons. Ultrasonic energy is used to elevate the facial skin flap, which allows for preservation of vascular, lymphatic, and nervous structures, thereby decreasing the morbidity associated with this procedure. METHODS: A retrospective study to compare the outcomes of ultrasound and non-ultrasound-assisted face-lifts is reported. All the procedures were performed at the Institute for Plastic Surgery. Each group consisted of 104 patients. Statistical analysis was performed to determine differences between the groups. RESULTS: The mean operating time was 4 h in the treatment group versus 4.2 h in the control group (p>0.05). The incidence of hematoma formation was 0.96% in the treatment group versus 2.4% in the control group (p<0.05). The incidence of flap necrosis was 0% in both groups. The duration of ecchymosis was 13 days in the experimental group versus 17.2 days in the control group (p<0.05). The duration of postoperative swelling was 17.4 days in the treatment group versus 20.4 days in the control group (p<0.05). As reported, 85% of patients in the treatment group were very satisfied, 14.42% were satisfied, 0% were mildly satisfied, and 0% were not satisfied. In the control group, 80.7% were very satisfied, 18.26% were satisfied, 0.96% were mildly satisfied, and 0% were not satisfied. According to Fisher's exact test, the p value for patient satisfaction exceeded 0.05%. CONCLUSIONS: The preservation of the blood and lymphatic vessels diminishes postoperative swelling and shortens the duration of ecchymosis considerably. The incidence of hematoma formation is lower than with a non-ultrasonic face-lift. This study failed to prove any statistically significant difference in operating time or patient satisfaction between the two groups.

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BACKGROUND: Alloplastic malar augmentation is becoming an increasingly common procedure for enhancement of the midface and an adjunct method of improving the effects of other rejuvenation procedures. OBJECTIVES: The authors present a new surgical approach for placement of malar implants by means of an intranasal incision, which they believe has several advantages over traditional techniques. They also propose a new classification for regions of the midface to assist in augmentation planning. METHODS: Between 1990 and 2010, the authors treated 20 patients with an intranasal approach for alloplastic malar augmentation. Patients were preoperatively divided into three groups: Type 1 included those with adequate nostril opening, including good elasticity of the internal nasal mucosa, allowing a good exposure of the piriform aperture through the nasal speculum; Type 2a included those with inadequate nostril opening; and Type 2b included those who required an alar base correction. Implants were selected according to these classifications and placed with the authors' technique. RESULTS: Of the 20 patients treated, 18 were female and two were male. Ages ranged from 15 to 65 years. Average follow-up was 10 years, and all patients experienced favorable results. There were no major complications, no nerve or vascular supply compromise, and no cases of implant malposition. One patient requested removal of the implant at one year postoperatively despite her good postoperative outcome; overall patient satisfaction was 95%. CONCLUSIONS: The intranasal approach for alloplastic malar augmentation has shown good results for midface enhancement in the authors' hands. In this patient series, results showed excellent overall patient satisfaction and a very low (nearly 0%) complication rate.

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BACKGROUND: Implants with a polyurethane foam cover have been used by plastic surgeons since Ashley described them in 1970. Overwhelming evidence confirms the benefits of these implants, especially the extremely low incidence of capsular contracture (grades 3 and 4, Baker classification). On the other hand, except for a transient and self-limited rash, there is no evidence that polyurethane implants present more complications than texturized or smooth gel implants. Due to concerns of polyurethane-induced cancer, these implants were withdrawn in United States after approximately 110,000 American women had received them. This fact, together with the probability that these implants will be reintroduced in the United States, suggests that continued monitoring of their long-term safety and effectiveness is mandatory. METHODS: A retrospective study analyzed the outcomes of 996 implants inserted during a period of 15 years. The incidence of early and late complications was analyzed as well as the aesthetic outcome. RESULTS: The complications evaluated included hematoma (0.6%), infection (0.4%), seroma (0.8%), rash (4.3%), wound dehiscence (0%), capsular contracture (0.4%), implant malposition (0.8%), need for revisional surgery (1.2%), implant rupture (0.7%), rippling (1.8%), and polyurethane-related cancer (0%). Regarding the aesthetic outcome, 95% of the patients expressed satisfaction with their final result. CONCLUSION: The polyurethane foam-covered implants have been proven safe for use in breast surgery. They provide the lowest rate of capsular contracture (0.4% in the current study) and excellent aesthetic results.

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BACKGROUND: Body contouring in the calf region is becoming a more frequently requested procedure. There are several techniques for calf enhancement, including implants, liposuction, and free flaps. Alloplastic augmentation can be performed with several implant types and several layers of pocket dissection. We present our 25 years of experience using the subfascial technique for calf implantation along with an anatomical study to illustrate all the important steps and relevant anatomy of this augmentation technique. METHODS: The subfascial technique was performed in 25 cadavers, in which the important layers were dissected for high-resolution photos of the surgery to learn about the relevant anatomy of the region. Also, we did a retrospective study of our experience with calf implants, studying the aesthetic outcome, the presence of early complications, and the presence of late complications. RESULTS: We performed dissections in 25 cadavers and surgery in 63 patients (126 implants). In our series of patients the final aesthetic index was of 9.8. The early complications were severe postoperative pain (11.11%), infection (0.79%), seroma (21.42%), hematoma (0%), and wound dehiscence (7.14%). The late complications were capsular contracture (Baker grades III and IV) (3.17%), implant rupture (1.58%), implant leaking (0%), implant displacement (3.96%), numbness at the ankle (2.38%), and palpability of the implant (0%). CONCLUSION: The subfascial technique for calf augmentation has complication rates low enough and surgical outcomes good enough to recommend it as the gold standard for alloplastic calf augmentation.

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BACKGROUND: Breast cancer is the second mortality-related cancer and the leading cause of general mortality in women aged 40-55. Prophylactic mastectomy has proved to be effective in several clinical scenarios but is still a somewhat controversial procedure. METHODS: We performed a retrospective study by reviewing the records of all patients who underwent prophylactic mastectomy in a 25-year period. We evaluated the aesthetic and long-term oncologic outcomes, complications, and patient satisfaction. RESULTS: We had 52 patients, 40 of them unilateral cases (contralateral prophylactic mastectomy) and 12 bilateral (bilateral prophylactic mastectomy) for a total of 64 mastectomized breasts. We had 1 (1.56%) case of unexpected breast cancer in the mastectomy specimens. Forty-two (65.62%) cases had a subcutaneous prophylactic mastectomy and 22 (34.37%) cases had a simple total prophylactic mastectomy. Fifty-eight (90.62%) cases underwent reconstruction with alloplastics and 6 (9.37) cases with autologous tissue of which 5 (7.81%) cases received latissimus dorsi flaps with alloplastic implants and 1 (1.56%) case had a TRAM flap. The complications included 4 (6.25%) breasts that developed capsular contracture, 2 (3.12%) cases of hematoma, and 1 (1.56%) infection. Concerning patient satisfaction, 39 (75%) patients reported being highly satisfied, 10 (19.23%) partially satisfied, and 3 (5.76%) unsatisfied. When we performed the aesthetic evaluation according to our scale, we got an overall aesthetic index of 8.8. CONCLUSION: Prophylactic mastectomy is becoming an increasingly frequent procedure. Plastic surgeons should consider the aesthetic outcome when planning mastectomy and reconstruction. Our ability to predict the high-risk population has improved and it is that population who can get the best benefit from this intervention. The recommendation against subcutaneous prophylactic mastectomy lacks scientific evidence. There is plenty of evidence that prophylactic mastectomy lowers the risk of breast cancer in the high-risk population in at least 95%. Our experience with prophylactic mastectomy is extremely satisfactory, with an overall patient satisfaction rate of 94%, no mortality, and an oncologic long-term outcome of 0% of ulterior development of breast cancer. Our series, although relatively small, should provide some insight into the power of this technique and we think all plastic surgeons should have it in their surgical armamentarium and should share their experiences so that this procedure may become more widely accepted. We also think that plastic surgeons should strive for perfecting the technique to reduce the complication rate and therefore help the procedure gain acceptance by the medical community.

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BACKGROUND: The aim of this study was to develop an operative sequence to guide plastic surgeons on how to handle the challenges of "Mestizo nose" during rhinoplasty. This type of nose has characteristics quite different from the Caucasian nose. Rhinoplasties on Mestizo nose represent a surgical challenge because of the anatomical characteristics of a weak frame and thick skin. The Hispanic population has grown, and nowadays a large number of patients requesting rhinoplasty within the US belong to this ethnic group. METHODS: We have developed an operative sequence for the treatment of Mestizo nose. This operative sequence has been tested in 879 rhinoplasties (92.37% females and 7.62% males, aged 15-63 years, mean age = 39 years). All were primary cases. An algorithm on how to approach the different types of Mestizo nose is presented. RESULTS: We had overall good results using our algorithm, with an improvement in the nasal aesthetics of about 54.75%. Complications were postoperative bleeding (1.37%), pain (0.57%), septal hematoma (0.23%), unaesthetic scars (0.34%), and cartilage extrusion (0.11%). Our revision rate was 5%. We present ten complete cases to show our surgical results. CONCLUSION: This operative sequence has allowed us to get predictable and reliable surgical outcomes when used in Mestizo rhinoplasty operations. We think it can be very useful for every plastic surgeon who performs Mestizo nose rhinoplasty, although not all steps need to be performed in every case.

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The photochemical reactivity of beta-lapachone (1), nor-beta-lapachone (2) and 1,2-naphthoquinone (3) towards amino acids and nucleobases or nucleosides has been examined employing the nanosecond laser flash photolysis technique. Excitation (lambda = 355 nm) of degassed solutions of 1-3, in acetonitrile, resulted in the formation of their corresponding triplet excited states. These transients were efficiently quenched by l-tryptophan, l-tryptophan methyl ester, l-tyrosine, l-tyrosine methyl ester and l-cysteine (k(q) approximately 10(9) L mol(-1) s(-1)). For l-tryptophan, l-tyrosine and their methyl esters new transients were formed in the quenching process, which were assigned to the corresponding radical pair resulting from an initial electron transfer from the amino acids or their esters to the excited quinone, followed by a fast proton transfer. No measurable quenching rate constants could be observed in the presence of thymine and thymidine. On the other hand, efficient rate constants were obtained when 1-3 were quenched by 2'-deoxyguanosine (k(q) approximately 10(9) L mol(-1) s(-1)). The quantum efficiency of singlet oxygen ((1)O(2)) formation from 1 to 3 was determined employing time-resolved near-IR emission studies upon laser excitation and showed considerably high values in all cases (Phi(Delta) = 0.6), which are fully in accord with the pipi character of these triplets in acetonitrile.

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alpha-Lapachone is a natural 1,4-naphthoquinone with promising biological activity. The fused dihydropyran ring present in its structure, acting as formal 2-alkoxy and 3-alkyl substituents to the quinone moiety, endows this compound with milder redox properties and lower toxicity, when compared with other bioactive 1,4-quinones. Its photochemistry, here reported, seems to originate from the triplet state, which shows pipi* character. Triplet quenching in acetonitrile solution with added hydrogen-atom donors such as 1,4-cyclohexadiene or 2-propanol is inefficient, independent of solvent polarity, and leads to formation of the semiquinone radical. With phenol and indole, quenching rate constants are two orders of magnitude higher, but smaller than the value for triethylamine. In the first two cases the semiquinone radical can be detected by laser flash photolysis and in the last case, the anion radical derived from alpha-lapachone is readily detected. The semiquinone radical can also be observed in the quenching of triplet alpha-lapachone by 2'-deoxyguanosine and by the methyl esters of L-tryptophan and L-tyrosine, whereas for L-cysteine methyl ester the quenching rate constant is very slow. Triplet alpha-lapachone is not quenched by thymine, thymidine, 2'-deoxycytosine or 2'-deoxyadenosine; this is probably due to its pipi* character and low energy, which prevents oxetane formation and triplet-triplet energy transfer, respectively. Steady-state photolysis of aerated solutions of these compounds in the presence of alpha-lapachone does not show evidence of decomposition, whereas similar experiments with 2'-deoxyguanosine result in efficient consumption of the nucleoside. Singlet oxygen is formed from triplet alpha-lapachone, and a quantum yield of 0.68 is measured.

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The photochemical reactivity of beta-lapachone (1), nor-beta-lapachone (2) and beta-lapachone 3-sulfonic acid (3) has been examined by laser flash photolysis. Excitation (lambda = 266 nm) of degassed solutions of , in acetonitrile or dichloromethane, resulted in the formation of detectable transients with absorption maxima at 300, 380 and 650 nm. These transients, with lifetimes of 5.0 micros, were quenched by beta-carotene at a diffusion-controlled rate constant and assigned to the triplet excited states of 1-3. Addition of hydrogen donors, such as 2-propanol, 1,4-cyclohexadiene, 4-methoxyphenol or indole led to the formation of new transients, which were assigned to the corresponding ketyl radicals obtained from the hydrogen abstraction reaction by the triplets 1-3 . In the presence of triethylamine it was observed the formation of the long-lived anion radical derived from , which shows absorption maxima at 300 and 380 nm. The low values observed for the hydrogen abstraction rate constants for the beta-lapachones 1-3 using 2-propanol and 1,4-cyclohexadiene as quenchers led us to conclude that their triplet excited states show pi pi* character.

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Italian universities have been distinguished since their beginnings, within different specialties. One of them, if not the most important, is the teaching of medicine. One of the leaders is the University of Padua, founded in 1222, establishing itself as the second most important institution after the University of Bologna. In spite of the difficulties faced by this university, as with most other universities during the medieval period, it continued to perform and consolidate once again during the Renaissance as one of the most outstanding universities in Europe. The University of Bologna and the University of Padua shared the leadership in teaching during this period. At the University of Padua, the lectures were always full with teachers and students of great fame, such as Andreas Vesalio, Gabriele Falopio, William Harvey, Giovanni Battista Morgagni, Antonio Scarpa, to name just a few. In this article we discuss the rights the University had since it beginnings, from its establishment to the Renaissance, and the great influence of some of the teachers and students in the art and science of medicine.

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BACKGROUND: Calciphylaxis is a serious condition characterized by ischemic ulceration of the skin and necrosis secondary to dystrophic calcification of the subcutaneous tissue and small arteries. It affects primarily patients with end-stage renal disease with prevalence up to 4%. However, penile calciphylaxis has been reported in only 37 cases in the international literature. We report one case, to review the literature and to provide the basis for a rational treatment of calciphylaxis of the penis that reduces the associated mortality. CASE REPORT: We report the case of an 82-year-old male with a 15-year history of type 2 diabetes mellitus and renal insufficiency during the past 2 years. He presented an increase of consistency of the distal portion in the penis' glans and scrotal swelling, evolving to complete penile glans necrosis. CONCLUSIONS: With the increase of the number of patients on dialysis treatment, the prevalence of calciphylaxis will increase. A high index of suspicion is warranted in all patients with end-stage renal disease and who present the characteristic genital lesions. Treatment of this complication must include avoidance of all exogenous calcium, administration of calcitriol analogues to offset the PTH, emergency parathyroidectomy in the case of overt hyperparathyroidism and aggressive surgical treatment with total or partial penectomy.

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Gaspare Tagliacozzi is known because of his great contributions to plastic surgery. He is considered a pioneer in the field, which has had more influence in his career than his other transcendental activity as a surgery and anatomy teacher in Bologna for almost 30 years. The aim of the present manuscript is to analyze his teaching activities which were equally important for us, and to recreate, with pictorial means, three unpublished historic moments in the life of this great man of science. Gaspare Tagliacozzi was born in Bologna in 1545 and is considered the father of plastic surgery. He obtained a degree in medicine and philosophy at the University. He was named surgery professor in 1576, and worked as such until his death in 1599. His De Curtorum Chirurgia per Insitionem treatise was published in 1589 and was considered the first exclusive treatise on plastic surgery. Bologna built a permanent operating theater (amphitheater) within the Archiginnasio in 1595. Because of his success, he increased his earnings; his first university teaching salary was 100 lire, but his earning increased to 1,140 lire later. Tagliacozzi's contributions, together with that of others such as Vesalius, Aldrovandi, Fallopian and Eustachian advanced the field and knowledge of anatomy.

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Gaspare Tagliacozzi es tan conocido por sus grandes aportaciones como pionero de la Cirugía Plástica, que ha opacado en buena parte otra actividad trascendental que desarrolló, durante casi 30 años fue profesor de Cirugía y Anatomía en Bolonia. El objetivo de este artículo es analizar su actividad docente, considerada igualmente importante, y recrear mediante recursos pictóricos, tres momentos históricos importantes en la vida académica de este personaje. Gaspare Tagliacozzi nació en Bolonia en 1545. Es considerado padre de la cirugía plástica. Obtuvo el grado de Doctor en Medicina y Filosofía en la universidad. Fue nombrado profesor de Cirugía en 1576, actividad que realizó hasta su muerte en 1599. Publicó su libro De Curtorum Chirurgia per Insitionem considerado el primer tratado exclusivo de Cirugía Plástica. Como profesor, Tagliacozzi realizó disecciones formales en la universidad. Su éxito docente lo revela su estipendio: él comenzó ganando 100 liras, que se elevaron a 1140. Sus aportaciones, junto a las de muchos otros (Vesalio, Aldrovani, Falopio, Eustaquio etc.) dieron brillo a los conocimientos anatómicos.

Gaspare Tagliacozzi is known because of his great contributions to plastic surgery. He is considered a pioneer in the field, which has had more influence in his career than his other transcendental activity as a surgery and anatomy teacher in Bologna for almost 30 years. The aim of the present manuscript is to analyze his teaching activities which were equally important for us, and to recreate, with pictorial means, three unpublished historic moments in the life of this great man of science. Gaspare Tagliacozzi was born in Bologna in 1545 and is considered the father of plastic surgery. He obtained a degree in medicine and philosophy at the University. He was named surgery professor in 1576, and worked as such until his death in 1599. His De Curtorum Chirurgia per Insitionem treatise was published in 1589 and was considered the first exclusive treatise on plastic surgery. Bologna built a permanent operating theater (amphitheater) within the Archiginnasio in 1595. Because of his success, he increased his earnings; his first university teaching salary was 100 lire, but his earning increased to 1,140 lire later. Tagliacozzi's contributions, together with that of others such as Vesalius, Aldrovandi, Fallopian and Eustachian advanced the field and knowledge of anatomy.

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