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1.
Plast Reconstr Surg Glob Open ; 12(3): e5695, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38525493

RESUMO

Background: The rejuvenation and restoration of a well-defined jawline contour are crucial for enhancing facial aesthetics in both men and women. Within the jawline aesthetic unit (mandibular angle), the masseter muscle plays a significant role, as it is responsible for mandibular masticatory movements. We propose a new approach using ultrasound-guided intramuscular fat transfer to enhance the mandibular angle and jawline. Methods: The multicenter study included 20 patients from three countries (Peru, Brazil, and Mexico). After fat harvesting, the ultrasound-guided masseteric fat transfer was performed with a 1.5-mm Viaro cannula from an incision beneath the ear lobule. The fat was then injected intramuscularly into the masseter at each side of the mandibular angle. Results: Masseter ultrasound-guided fat transfer was performed on 10 men and 10 women between 2021 and 2022. The patients had a mean age of 34.4 ±â€…6.39 years and a mean body mass index of 22.39 ±â€…2.59 kg per m2. The mean injected volume was 5.83 mL and 5.58 mL on the right and left sides, respectively. Muscle thickness increased in patients immediately postsurgery, but decreased after 1 month. The muscle remained significantly thicker on each side than the presurgery measurements in patients regardless of gender (both P < 0.0001). Conclusions: Ultrasound-guided intramuscular fat transfer is a safe and reproducible technique for enhancing the jawline contour at the mandibular angle. We believe that it could be a more durable solution than other procedures, although further evaluation of long-term results is necessary.

2.
Plast Reconstr Surg Glob Open ; 11(12): e5499, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38115833

RESUMO

Background: Rib remodeling is a surgical technique for waist shaping in women and men. However, one of the main patient complaints is the scar. We aimed to describe a scarless, ultrasound-guided rib remodeling (RibXcar) technique that assessed the degree of angular variation of the fracture by ultrasound and the variation in waist measurement and patient satisfaction through a survey. Methods: The RibXcar technique was performed in 30 women aged 18-35 years in Peru, Colombia, and Mexico between October and December 2022 by three board-certified plastic surgeons trained in ultrasound and in this technique. The plastic surgeons measured costal angles before and immediately, 1 month, and 3 months after the surgery by ultrasound, as well as the waist in the same site and at these time points. Similarly, patient satisfaction was surveyed 3 months after the surgery, in which questions were asked about body aesthetics and the puncture site. Results: Ultrasound angular measurements before and immediately, 1 month, and 3 months after the surgical procedure were 168.00, 158.00, 160.00, and 160.43 degrees in the 10th rib, 170.50, 160.50, 152.50, and 163.50 degrees in the 11th rib, and 172.00, 162.00, 154.00, and 165.00 degrees in the 12th rib, respectively. The satisfaction survey showed that patients were satisfied with the aesthetic results of both the shape of the waist and the puncture site. Conclusions: RibXcar surgery maintains the angular variation over time. Similarly, waist measurements show a sustained reduction. Three months postoperatively, the patients were satisfied with the aesthetic results of the waist and the puncture site.

3.
Plast Reconstr Surg Glob Open ; 11(11): e5390, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37964919

RESUMO

Background: The idea of the anterolateral thoracic musculature in men during the contour procedure is very limited, particularly in terms of surgical techniques that improve its appearance and aesthetics. Therefore, this study aimed to describe a technique of deep definition liposuction with intramuscular grafting of the serratus external oblique muscle complex. Methods: A retrospective case series of a total of 11 cases of male patients aged between 29 and 60 years in the year 2022 is presented. These patients underwent body contouring surgery and subsequently underwent ultrasound-guided intramuscular fat grafting in the serratus external oblique complex. As part of the study, measurements were taken before and immediately after surgery. The data were stored in a database and analyzed with the statistical software SPSS, v23.0. Results: The patients were aged between 29 and 60 years, with a mean age of 38.3 years (±8.5). All cases had a body mass index of 30. Results were matched preinfiltration and postinfiltration; These results were subjected to statistical validation using the Student t test for related samples, and statistically significant differences were obtained in all the measures tested. Conclusions: The technique of fat grafting in the oblique-serratus complex allows for increasing muscle thickness. The measurements were made only immediately after the infiltration; it is important in the future to show the long-term follow-up. No adverse events occurred during the study.

4.
Plast Reconstr Surg Glob Open ; 11(11): e5431, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38025643

RESUMO

Background: Body contouring surgery and surgical drawings are usually performed based on the surgeon's experience without considering the nature of the unique anatomical structures of each patient. Thus, we propose a more reliable surgical design approach that considers the anatomical structures of each patient. Ultrasonography is increasingly used in plastic surgery and helps plastic surgeons to highlight anatomical features representing results in their interventions by providing a better understanding of the patients' unique structures. Methods: This study presents a series of cases involving 100 recruited patients (36 men and 64 women) between 18 and 60 years of age. Five surgeons examined the patients and created a presurgical design based on palpation, which was validated later by a physician skilled in evaluating the anterior wall of the abdomen using ultrasonography. The concordance between the findings of the palpation and ultrasonography was assessed for each patient. Results: The concordance rate for each structure in both evaluations was midline (49%) (P > 0.92), diastasis recti (15%), semilunar line (23%), upper edge of rectus abdominis muscles (12%), lower edge of pectoral muscles (16%), border of oblique muscle (13%), number of tendinous intersections (12%), shape of tendinous intersections (11%), serratus anterior muscle (15%), subcostal triangle (15%), and oblique triangle (26%) (P < 0.0001). Conclusion: All the structures evaluated by palpation in comparison with ultrasound show discordance, except the midline where agreement is evident, with a very good level of statistical significance.

5.
Plast Reconstr Surg Glob Open ; 11(11): e5376, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38025649

RESUMO

Background: Knowing the anatomy of the ribs is crucial for understanding various rib procedures. The present study is aimed at describing radiological measurements and ratios of 83 Latin American patients undergoing thoracoabdominal computed tomography (CT). Methods: A total of 83 thoracoabdominal computed tomography scans of women aged 18-35 conducted at a medical center in Lima, Peru, were reviewed from January 2022 to January 2023. The resulting measurements and ratios were used to calculate frequency distributions. All data were stored in a Microsoft Excel database and analyzed using statistical analysis software SPSS version 28. Results: Ratios and measures of the tenth, eleventh, and twelfth ribs are shown in the different tables, and costal characteristics with an adequate statistical significance are defined. Conclusions: Using radiological measurements and rib ratios, we were able to find key anatomical relationships with an adequate level of significance, which could help establish objective results in rib procedures.

6.
Appl Radiat Isot ; 200: 110978, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37603966

RESUMO

This work aims to model and characterize the radiation beam of one Accuray tomotherapy equipment using the Monte Carlo Code MCNP5 (Monte Carlo N-Particle). This tomotherapy equipment is used for delivering high doses of radiation in tumor regions to kill cancer cells and shrink the tumor during radiation therapy of cancer patients, however, the radiation can damage surrounding areas and nearby organs at risk (OAR) if the radiation field is not well delimited. In particular, intensity-modulated radiotherapy treatments (IMRT) with tomotherapy equipment offer great benefits to patients allowing treatment of tumor regions without affecting surrounding areas and OAR. Nowadays, it is well known that a correct simulation of transport of radiation in tomotherapy equipment facilitates considerably the estimation of ideal doses in the tumor, surrounding regions, and OAR. For that reason, in this work, we simulated the geometry of the 6 MV ACCURAY Tomotherapy equipment of the CECAN using the MCNP5. The model includes a TomoLINAC consisting of an electron source that emits Gaussian distribution particles with an average energy of 5.7 MeV and width of 0.3 MeV. The emitted particles impact the tungsten target and pass through primary collimators and jaws that define the irradiation field in the isocenter. To validate the geometry and radiation transport in the TomoLINAC the curves of depth dose percentage (PDD) estimated by simulation and the curves measured experimentally were tuned. In the same way, the simulated transverse and longitudinal profiles were compared with the experimental results. In addition, a comparison between the qualities of the radiation beam characterized with MCNP and measured experimentally in CECAN showed a deviation of 1%. For the simulations, cylindrical detectors located inside a water phantom were considered and it was employed the tally *F8. A good agreement was observed between the PDD's curves obtained from the simulation and those measured experimentally for a field of 5 × 10 cm2 in the isocenter and SSD (distance from the source to the surface) of 85 cm. Also, the comparison between the simulated and experimental transverse profiles obtained at 1.5 cm, 10 cm and 15 cm depth with a radiation field of 5 × 40 cm2 showed very good agreement. The longitudinal profiles were estimated with the same depths as the transverse ones, but for each of them, the openings of the jaws were 5.0 cm, 2.5 cm and 1.0 cm in the longitudinal direction, which corresponds to the direction in which the patient's table moves. The comparison between the simulated and experimental longitudinal profiles showed good concordance too. Once the radiation beam of the ACCURAY tomotherapy equipment had been characterized, experimental dose measurements were made using a Cheese phantom and two A1SL ionization chambers. These results obtained experimentally were compared with those estimated with MCNP for a field of 5 × 40 cm2 at the isocenter and SAD of 85 cm and, it was concluded that both results were similar considering the regions of uncertainty. Finally, we must highlight that the modeling and characterization of the radiation beam of CECAN's ACCURAY tomotherapy equipment can be a key tool for dose estimations in different cancer treatment plans and future research.

7.
Plast Reconstr Surg Glob Open ; 11(5): e5001, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37250835

RESUMO

It is generally accepted that liposuction requires a significant amount of energy from surgeons. This procedure involves the use of specialized equipment and techniques to remove fat cells from the body, which can be physically demanding for surgeons. The amount of effort required for liposuction must be evaluated in terms of energy consumption. Our goal was to conduct a study to record the energy that the surgeon uses during liposuction and correlate these results with the volume of fat obtained as well as other variables. Methods: A series of cases was carried out from April 2022 to November 1, 2022, in three different plastic surgery centers. Three plastic surgeons recorded the procedures using an Apple Watch, choosing from among Apple Watch training options and free indoor walking. The surgeon then concluded the registration at the time of finishing the surgery and removed the surgical gloves and gowns. Results: Complete data were obtained for 63 patients. The average fat obtained per 1 kcal of energy was 6.14 cm3 of fat, and 160 cal to obtain 1 cm3 of fat by liposuction. Other data that demonstrated statistically significant correlations were fat volume versus average pace (km), total fat volume versus average heart rate, fat volume versus surgical time, and fat volume versus distance. Conclusions: Liposuction is a surgical procedure that requires considerable effort. This study demonstrates the amount of energy required for regular liposuction. Compared with other single procedures, three times more energy is required to complete liposuction.

8.
Plast Reconstr Surg Glob Open ; 11(4): e4918, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37020987

RESUMO

The gluteal region remains the preferred site for fat grafting. However, the transition from the gluteal region to the thighs has not been well studied. This study aimed to describe an echographic guidance hamstring volumization procedure (Hv-FAT) as a complement to body contouring surgery. Methods: Hv-FAT was performed in 19 patients from four countries (Peru, Argentina, Brazil, and Mexico) from May to June 2022 by four surgeons trained in soft-tissue ultrasound and in the aforementioned technique. All the patients met the following criteria: age older than 18 years and younger than 60 years; a body mass index of 30 kg/m² or less, and a surgical risk score of 2 or less, according to the Goldman index. Results: A total of four men and 15 women were included in this study, whose ages ranged from 22 to 58 years (mean: 36.37 years). After fat grafting, on average, the thickness of the right biceps femoris increased by 54.07%, maintaining 95.02% of this thickness one month postoperatively, whereas the thickness of the left biceps femoris increased by 46.57%, maintaining 94.86% of this thickness in the same postoperative period. In turn, the right semitendinosus muscle thickness increased by 181.90%, maintaining 97.42% of this thickness, whereas the left semitendinosus muscle increased by 111.90%, maintaining 95.29% of this thickness 1 month postoperatively (P < 0.0001). Conclusion: Hv-FAT is an effective and reproducible procedure for volumizing the biceps femoris and semitendinosus muscles, maintaining significant results one month postoperatively.

9.
Rev. cuba. med. trop ; 75(1)abr. 2023.
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1550874

RESUMO

La endocarditis bacteriana secundaria a la infección por Brucella spp., en este caso B. melitensis, como complicación de la brucelosis humana tiene una incidencia baja y, aunque es la presentación clínica con la que se asocia más frecuentemente la mortalidad, no todos los casos son letales, si son tratados oportunamente. Se describe el caso clínico de una endocarditis bacteriana por B. melitensis, diagnosticada en un adulto por el aislamiento del microorganismo en el hemocultivo. Paciente del sexo masculino, de 40 años, con antecedentes de realizar partos en el ganado bovino y consumir leche no pasteurizada. Acudió al médico por presentar durante siete días de evolución de las siguientes manifestaciones clínicas: fiebre, mialgias, artralgias, tos seca y pérdida de peso (15 kg). El hemograma informa: leucopenia, trombocitopenia y anemia; mientras que en un ecocardiograma transesofágico se observó vegetación en la válvula aórtica con una disminución de la función sistólica y en el hemocultivo se aisló B. melitensis. Debido a estos antecedentes, se inició el tratamiento antibacteriano con rifampicina, doxiciclina y gentamicina. El paciente se recuperó y tuvo una evolución clínica satisfactoria. La brucelosis es una enfermedad infrecuente. Debe considerarse en toda persona con fiebre de foco desconocido que resida en zonas endémicas o esté expuesto al cuidado de animales de granja. En esta enfermedad se impone un diagnóstico y tratamiento preciso, por ser una complicación con alta letalidad.


Bacterial endocarditis, secondary to Brucella spp. infection, in this case by B. melitensis, as a complication of human brucellosis has a low incidence. Although it is the clinical presentation most frequently associated with mortality, not all cases are lethal if timely treatment is provided. We describe a clinical case of bacterial endocarditis due to B. melitensis in a 40-year-old male patient with a history of conducting cattle deliveries and consuming unpasteurized milk, diagnosed after isolating the microorganism in blood culture. He presented with the following clinical manifestations after seven days of evolution: fever, myalgias, arthralgias, dry cough and weight loss (15 kg). The hemogram revealed leukopenia, thrombocytopenia, and anemia; while a transesophageal echocardiogram showed vegetation on the aortic valve with decreased systolic function, and B. melitensis was isolated in a blood culture. Considering this medical history, antibacterial treatment was initiated with rifampicin, doxycycline and gentamicin. The patient recovered and had satisfactory clinical evolution. Brucellosis is a rare disease. It should be considered in any person with a fever of unknown origin who lives in endemic areas or is exposed to the care of farm animals. Endocarditis is a highly lethal complication of human brucellosis; therefore, it requires a precise diagnosis and treatment.


Assuntos
Humanos , Masculino , Adulto , Gentamicinas/uso terapêutico , Brucella melitensis/patogenicidade , Endocardite Bacteriana/complicações
10.
Phys Chem Chem Phys ; 25(13): 9656-9668, 2023 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-36943209

RESUMO

DFT calculations were performed to study the effect on energetic and magnetic stability when clusters with up to 24 lithium atoms were doped with one and two atoms of yttrium. In this, the effect of the charge was considered. As a result, some stable structures were identified as possible magnetic superatoms, among them, the YLi12+ cluster with an icosahedron geometry with a spin magnetic moment of 4 bohr magnetons. The participation of yttrium in the electron density of the unpaired electrons providing magnetism in clusters was corroborated at the level of a density of states (DOS) calculation and a spin density calculation. In particular, in the Y2Li12+ superatom, it was found that the encapsulated yttrium atom participates with 35.02% and the second yttrium atom with 15.04%. These percentages, with a contribution from p orbitals, but to a greater extent by d orbitals. The complementation to these percentages is due to the participation of the s and p orbitals of the lithium atoms. In general, doping with a second yttrium atom allowed to obtain a greater amount of high magnetic moments, and considering charged clusters allowed to obtain also high magnetic moments.

12.
Artigo em Espanhol | LILACS, UY-BNMED, BNUY | ID: biblio-1520020

RESUMO

La sífilis es causada por Treponema pallidum, es reconocida por la variedad de sus manifestaciones clínicas; compromete el sistema nervioso, tegumentario y cardiovascular. Las alteraciones cardiovasculares ocurren en 70% de los casos con sífilis no tratada, el 71% de las aortitis sifilíticas desarrollan aneurismas aórticos y la complicación más frecuente es la insuficiencia aórtica. El tratamiento va dirigido a la enfermedad subyacente, con manejo antibiótico para la sífilis terciaria y las complicaciones tromboembólicas y si requiere reparación quirúrgica. Presentamos un caso poco frecuente de un paciente diagnosticado de infección por el virus de la inmunodeficiencia humana y complicaciones cardiovasculares típicas de la sífilis terciaria, que precisó tratamiento médico y quirúrgico, que fue exitoso. Destacamos la pericia clínica de los profesionales de nuestra institución para diagnosticar e identificar las complicaciones cardiovasculares de la sífilis terciaria.


Syphilis is caused by Treponema pallidum and is recognized by the variety of its clinical manifestations; it involves the nervous, integumentary and cardiovascular systems. Cardiovascular alterations occur in 70% of cases with untreated syphilis, 71% of syphilitic aortitis develop aortic aneurysms and the most frequent complication is aortic insufficiency. Treatment is directed at the underlying disease, with antibiotic treatment for tertiary syphilis and thromboembolic complications and if necessary surgical repair. We present a rare case of a patient diagnosed with human immunodeficiency virus infection and cardiovascular complications typical of tertiary syphilis, who required medical and surgical treatment, which was successful. We highlight the clinical experience of our institution's professionals in the diagnosis and identification of cardiovascular complications of tertiary syphilis.


A sífilis é causada pelo Treponema pallidum e é reconhecida pela variedade de suas manifestações clínicas; ela afeta os sistemas nervoso, tegumentar e cardiovascular. As alterações cardiovasculares ocorrem em 70% dos casos de sífilis não tratada, 71% dos casos de aortite sifilítica desenvolvem aneurismas aórticos e a complicação mais frequente é a insuficiência aórtica. O tratamento é direcionado para a doença subjacente, com tratamento antibiótico para sífilis terciária e complicações tromboembólicas e, se necessário, reparo cirúrgico. Apresentamos um caso raro de um paciente diagnosticado com infecção pelo vírus da imunodeficiência humana e complicações cardiovasculares típicas da sífilis terciária, que precisou de tratamento médico e cirúrgico, que foi bem-sucedido. Apresentamos um caso raro de um paciente com diagnóstico de infecção pelo vírus da imunodeficiência humana e complicações cardiovasculares típicas da sífilis terciária, que necessitou de tratamento médico e cirúrgico, o qual foi bem-sucedido. Destacamos a experiência clínica dos profissionais de nossa instituição no diagnóstico e na identificação das complicações cardiovasculares da sífilis terciária.


Assuntos
Humanos , Masculino , Adulto , Aneurisma Aórtico/cirurgia , Aneurisma Aórtico/diagnóstico por imagem , Insuficiência da Valva Aórtica/cirurgia , Insuficiência da Valva Aórtica/diagnóstico por imagem , Aneurisma Aórtico/etiologia , Insuficiência da Valva Aórtica/etiologia , Penicilina G Benzatina/uso terapêutico , Sífilis Cardiovascular/complicações , Sífilis Cardiovascular/diagnóstico , Sífilis Cardiovascular/tratamento farmacológico
13.
Plast Reconstr Surg Glob Open ; 10(7): e4447, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35923994

RESUMO

High-definition liposuction is now a reliable procedure that provides more athletic results. It is a trend among plastic surgeons and patients. The ultrasound-guided rectus abdominis fat transfer (UGRAFT) technique has expanded the range of patients who can benefit from rectus abdominis fat grafting, including those without skin laxity. Its advantage over isolated high-definition liposuction is a more natural-looking result because it increases muscle volume and provides a contoured abdomen even during movement, regardless of the patient's position. In this article, we describe one patient undergoing the UGRAFT technique after high-definition liposuction, versus one patient undergoing only high-definition liposuction. We determined that the use of the UGRAFT technique provides greater muscle definition over those in which this technique has not been performed. The UGRAFT technique opens the possibility of developing more complete body structures regarding definition, providing volume to muscular areas. The more muscle mass and less body fat, the greater the body definition in a liposuction. The less muscle mass and more body fat, the less definition a patient will have in a liposuction. Under these principles, we improve the result by increasing the volume of muscle mass.

14.
ARS med. (Santiago, En línea) ; 46(4): 25-31, dic. 07, 2021.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1366312

RESUMO

Introducción: la enseñanza de cursos de ciencias básicas en carreras de la salud es un desafío por no estar directa e inmediatamente rela-cionada con el ámbito profesional. Por otra parte, las condiciones de estrés que ha impuesto el trabajo a distancia requiere de metodologías motivantes, y, que a su vez permitan una evaluación significativa. Objetivos: reportar las adaptaciones metodológicas y los resultados de una adaptación local de la metodología de especificaciones de las calificaciones y retroalimentación del trabajo. Métodos: se aplica una metodología de formación basada en la retroalimentación en el curso de Física para estudiantes de Tecnología Médica (N=106) durante un semestre. Las calificaciones promedio de los estudiantes fueron comparadas con las obtenidas en años anteriores. Para evaluar el desempeño docente se realizaron 2 encuestas a los estudiantes. El cumplimiento de los logros de aprendizaje se midió mediante auto-evaluación (escala likert 1 a 5) al inicio y término de cada uno de los cuatro capítulos. Resultados: las reprobaciones y eliminaciones de estudiantes en el curso fueron menores a años anteriores, siendo las notas significativamente mayores subiendo desde 4,89 a 6,29 (escala de 1 a 7, p<0,001). Los estudiantes se mostraron en un 95% satisfechos con el desempeño docente y finalmente, la auto-evaluación de logros de aprendizaje mostró un aumento promedio de 1 punto. Conclusiones: la metodología de evaluación basada en especificaciones adaptada a dos entregas y con evaluaciones en una escala no-binaria mejoró el rendimiento, los logros de los aprendizajes esperados y la motivación de los estudiantes.


Background: Teaching basic science courses in health careers is a challenge because these courses are not directly linked to professional practice. On the other hand, the stressful conditions imposed by distance work require motivating methodologies and a meaningful evaluation. Objectives: To report the methodological adaptations and the results of a local adaptation of the specifications grading and feedback methodology. Methods: A training methodology based on feedback is applied in the Physics course for Medical Technology students (N = 106) during one semester. We compared the students' average grades to those obtained in previous years with the same topics. To evaluate the teaching performance, we conducted two student surveys. We measure compliance with learning achievements by self-assessment (Likert scale 1 to 5) at the beginning and end of each of the four chapters. Results: Failures and eliminations of students in the course were lower than previous years, with significantly higher grades from 4.89 to 6.29 (p <0.001). The students were 95% satisfied with the teaching performance, and finally, the self-evaluation of learning achievements showed an average increase of 1 point. Conclusion: The evaluation methodology based on specifications adapted to two deliveries and evaluations on a non-binary scale improved the performance, expected learning achievements, and students' motivation.

16.
Aesthetic Plast Surg ; 42(5): 1421-1428, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29770862

RESUMO

INTRODUCTION: Anaplastic large cell lymphoma associated with breast implants is receiving increased attention. Most cases have been reported in Europe, North America (USA and Canada), Australia and New Zealand. Fewer cases have been reported in Latin America (including Mexico), Africa and Asia. METHODS: This report was delivered during our national plastic surgery meeting in Cancun in May 2017. Before the meeting, two participants reviewed the literature. The review was performed using the following information sources: PubMed, Embase, Cochrane, Fisterra, Google Scholar and LILACS, with entries from 1980 to August 2015 in several languages (English, Spanish, French and Portuguese). The results were revealed during the meeting to the other participants. The consensus was divided into two parts. The first part included an open-ended question regarding the incidence and prevalence of the problem. The second part included clinical scenarios with different items that were rated by the participants. After this activity, accordance among the responses was evaluated. RESULTS: Seven cases were reported during the meeting (3 from Mexico, 3 from Chile and 1 from Argentina). Fifty percent of the participants reported consulting with guidelines and clinical centers to help with potential cases. Most agreed that further studies must be done in cases of chronic seroma where the capsule plays an important role. DISCUSSION: A current debate exists about the incidence of this problem in Latin America because we did not report the same number of cases as Europe, Australia or North America. More studies are required to determine the differences among reports in Latin America. CONCLUSION: Most representatives agreed that further studies must be done. Concern is increasing, and the problem is known. Other factors involved may be considered, and the problem must not be ignored. NO LEVEL ASSIGNED: 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 .


Assuntos
Implante Mamário/efeitos adversos , Implantes de Mama/efeitos adversos , Neoplasias da Mama/etiologia , Linfoma Anaplásico de Células Grandes/etiologia , Guias de Prática Clínica como Assunto , Adulto , Implante Mamário/métodos , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Consenso , Feminino , Humanos , Incidência , América Latina/epidemiologia , Linfoma Anaplásico de Células Grandes/epidemiologia , Linfoma Anaplásico de Células Grandes/patologia , Pessoa de Meia-Idade , Medição de Risco
17.
Cir Cir ; 83(3): 265-70, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-26055283

RESUMO

BACKGROUND: Evidence-based surgery is a tool that has been adopted worldwide by surgeons. As all decisions must be current and have a scientific basis, the approach for performing it must be standardised. Five important steps are required to perform surgery based on evidence. Convert the need for information into a question that can be answered, finding the best information to answer that question, critical evaluation of the evidence, and its validity, impact and applicability, integrating the evidence with your own experience, and with the evaluation of the patients. This should take into account their biology, values and specific circumstances, as well as to evaluate the effectiveness and efficiency of the execution of steps 1-4 and propose how to improve them. CONCLUSION: This article presents the main tools to perform surgery properly based on evidence.


Assuntos
Medicina Baseada em Evidências , Procedimentos Cirúrgicos Operatórios/normas , Humanos
18.
Rev. crim ; 56(1): 9-34, 20140401.
Artigo em Espanhol | LILACS | ID: lil-736505

RESUMO

Introducción: en la actualidad, la constante victimización de personas por delitos sexuales es uno de los fenómenos que más afectan a la comunidad, la cual, pese al apoyo de las áreas clínica, jurídica y social, entre otras (Meng & Thomas, 2010; ICBF & OIM, 2007), no logra disminuir su accionar, en especial el delito sexual serial o asalto sexual repetitivo, cuya dinámica criminal y conducta desviada se examina en este estudio. Objetivos: establecer características conductuales y rasgos particulares de agresores sexuales seriales, condenados en cárceles de Bogotá, D. C., por delitos cometidos entre los años 2008 y 2012.Material y métodos: a través de lectura de expedientes judiciales, entrevistas semiestructuradas, elaboración de una estructura lógica para análisis conductual, modus operandi, firma criminal, victimología y análisis del lugar del hecho. Resultados: se determinó la forma en que estos delincuentes actúan y sus motivaciones, lo cual resulta indispensable para los perfiladores criminales en la aplicación de herramientas analíticas en los casos, y la orientación a los investigadores en la formulación de estrategias investigativas para llegar de manera efectiva a los resultados anhelados (Chambers, Horvath & Kelly, 2010; Norza, Morales, Merchán & Meléndez, 2013)


Introduction: Currently, the growing number of people being victimized by sexual crimes is one of the most common phenomena affecting the community. However, and despite of the support received from clinical, legal and social areas among others (Meng & Thomas, 2010; ICBF & OIM, 2007), it has not been possible to reduce the criminal action, especially that of serial sexual offenders and perpetrators of repetitive sexual assault or rape, whose criminal dynamics and deviant behavior are examined in this study. Objectives: To establish behavioral features and particular characteristics of convicted serial sexual aggressors serving in jails in Bogota for crimes committed between 2008 and 2012.Material and methods: The above is achieved through the reading of legal dossiers, semi-structured interviews, the preparation of a logical structure for behavioral analysis, modus operandi, criminal signature, victimology, and analysis of the place of the event or crime scene. Results: The way the offenders operate and their motivations was determined, this being essential for criminal profilers in the application of analytical tools in the cases in question, as well as the orientation of the investigators in the formulation of investigative strategies aimed at effectively achieving the desired results (Chambers, Horvath & Kelly, 2010; Norza, Morales, Merchan & Melendez, 2013).


Assuntos
Humanos , Criminologia , Comportamento
19.
Br J Nutr ; 104(12): 1735-9, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20650016

RESUMO

In the present pilot study, we evaluated the effect of maternal adiposity on the plasma concentration of adipocytokines in pregnant women and their newborns. Twenty patients with term gestations without labour were initially selected by pregestational BMI and then classified into two study groups (n 10 each), according to their median value of adiposity (total body fat). Concentrations of TNF-α, IL-1ß, IL-6, leptin and adiponectin in plasma of maternal peripheral blood and fetal cord blood were measured and correlated to maternal adiposity. Maternal adiposity showed a significant negative correlation with fetal adiponectin (r - 0·587, P = 0·01) and IL-6 (r - 0·466, P = 0·05), a significant positive correlation with maternal leptin (r 0·527, P = 0·02) and no correlation with TNF-α or IL-1ß. Adiponectin was higher in fetal plasma than in maternal plasma (P = 0·043), but significantly lower in newborns from women with high adiposity than in newborns from women with low adiposity (P = 0·040). Our results suggest that fetuses from obese women may be less able to control inflammation, due to lower circulating anti-inflammatory adipocytokines, which could limit their optimal development or even increase the risk of abortion or preterm labour.


Assuntos
Adipocinas/sangue , Adiposidade/fisiologia , Citocinas/sangue , Inflamação/sangue , Adiponectina/sangue , Adulto , Biomarcadores/sangue , Peso ao Nascer , Feminino , Sangue Fetal/química , Idade Gestacional , Humanos , Recém-Nascido , Leptina/sangue , Masculino , Idade Materna , México , Projetos Piloto , Gravidez , Adulto Jovem
20.
J Gene Med ; 12(1): 107-16, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19866482

RESUMO

BACKGROUND: In the present study, we evaluated the safety of CIGB-230, a novel vaccine candidate based on the mixture of a plasmid for DNA immunization, expressing hepatitis C virus (HCV) structural antigens, with a recombinant HCV Core protein. METHODS: Fifteen HCV chronically-infected volunteers with detectable levels of HCV RNA genotype 1b, who were nonresponders to previous treatment with interferon plus ribavirin, were intramuscularly injected with CIGB-230 on weeks 0, 4, 8, 12, 16 and 20. Individuals were also immunized at weeks 28, 32 and 36 with a recombinant vaccine against hepatitis B. Adverse events were recorded and analyzed. Blood samples were taken every 4 weeks up to month 12 for hematological, biochemical, virological and immunological analysis. RESULTS: All patients completed the treatment with CIGB-230. Adverse events were only slight (83.6%) or moderate (16.4%). No significant differences in hematological and biochemical parameters, including serum aminotransferases, were detected between the baseline and post-treatment state. Induction of a CD4+ T lymphocyte response against a particular region in HCV E1, spanning amino acids 230-312 in HCV polyprotein, was detected in 42.8% of patients during treatment with CIGB-230. The ability of T cells to proliferate in response to mitogenic stimulation was not weakened. Most individuals (78.6%) were seroprotected after anti-hepatitis B vaccination and 42.8% were hyper-responders (antibody titers > 100 UI/ml). No anti-mitochondrial, anti-nuclear and anti-extractable nuclear antigen antibodies were generated during immunization with CIGB-230. CONCLUSIONS: Vaccination with CIGB-230 in HCV chronically-infected individuals was safe, well tolerated and did not impair the ability to respond to non-HCV antigens.


Assuntos
Vacinas contra Hepatite B/imunologia , Hepatite B/prevenção & controle , Hepatite C Crônica/prevenção & controle , Imunidade/imunologia , Vacinação/efeitos adversos , Vacinas de DNA/imunologia , Adulto , Anticorpos Antinucleares/imunologia , Formação de Anticorpos/efeitos dos fármacos , Formação de Anticorpos/imunologia , Proliferação de Células/efeitos dos fármacos , Epitopos/imunologia , Feminino , Hepatite B/imunologia , Anticorpos Anti-Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Hepatite C Crônica/imunologia , Humanos , Imunidade/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Mitógenos/farmacologia , Linfócitos T/citologia , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologia , Proteínas do Envelope Viral/imunologia
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