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La radiografía de tórax sigue siendo fundamental para la evaluación de patologías torácicas en lactantes. Antes de iniciar su interpretación, muchos autores sugieren revisar la técnica radiológica, ya que a esta edad se presentan varias particularidades técnicas que deben tenerse en cuenta para evitar errores interpretativos y no confundir hallazgos técnicos con patologías. Entre estas particularidades técnicas se deben evaluar: el centraje transversal o rotación, el centraje longitudinal o posición lordótica, el grado de inspiración, la posición de la vía aérea superior, la penetración o exposición de la radiografía, tipos de proyecciones y el movimiento. El objetivo de esta revisión es comentar y ejemplificar las peculiaridades técnicas que presenta la radiografía de tórax en lactantes y que pueden llevar a interpretaciones erróneas.

The chest X-ray remains essential for evaluating thoracic pathology in infants. Before beginning its interpretation, many authors recommend assessing the radiographic technique, as several technical peculiarities must be considered at this age to avoid interpretive errors and prevent mistaking technical artifacts for pathology. The technical aspects to be evaluated include transverse centering or rotation, longitudinal centering or lordotic position, degree of inspiration, upper airway positioning, radiograph penetration or exposure, projection types, and movement. The objective of this review is to discuss and illustrate the technical peculiarities of infant chest X-rays that can lead to erroneous interpretations.

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Introduction: Cicatricial alopecia (CA) poses a challenge for dermatologists due to irreversible hair follicle damage. While pharmacological treatments offer limited efficacy, surgical interventions aim to improve aesthetic outcomes. This article explores the serial excision technique (SET) as a viable option for stable cases of inflammatory CA. Case Report/Case Presentation: Three adult females with different forms of CA underwent staged surgeries to correct CA patches. Procedures included different incision and closure methods based on individual characteristics such as age, type and extent of alopecia, location, and tissue mobility in the scarred area. Discussion: CA significantly impacts patients' quality of life, demanding comprehensive treatment approaches. SET emerges as an encouraging possibility for stable cases, providing notable cosmetic improvements and enhancing patients' well-being. This technique offers cost-effective benefits with potential standalone efficacy or in combination with hair transplantation, providing promising outcomes for individuals with CA.

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A maxillary sinus lift was performed without bone grafting in a 23-year-old female patient who required the placement of a dental implant in the edentulous area of tooth 16. The clinical and tomographic evaluation made it possible to plan and perform the maxillary sinus lift using the transcrestal approach and without the need for bone grafting. The residual ridge of 6mm allowed the placement of a simultaneous dental implant. After 6 months of tomographic follow-up, before prosthetic loading, a vertical bone height of 8.83 mm was achieved, resulting in a vertical bone gain of 2.83 mm. Additionally, an adequate integration of the dental implant was observed without postoperative complications. Transcrestal sinus lift without the use of bone graft is shown to be a viable, safe and effective technique for the simultaneous placement of dental implants in patients with bone atrophy in the maxillary area. This technique offers advantages such as reduced surgical time, less morbidity, lower cost and a faster healing process compared to conventional methods.

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Introduction: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used. Materials and Methods: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer. Results: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device (P<0.001). Conclusion: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device.

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BACKGROUND: A recent Lancet commission called for more research on palliative care in low- and middle-income (LMIC) countries such as Colombia. A research priority setting approach has been recommended by The Global Forum for Health Research to address the huge gap in research output between LMIC and high-income countries, with influential health service bodies recommending the active involvement of non-research expert stakeholders in establishing research priorities to address service user needs. METHOD: Priority setting partnership (PSP) following the four stages of the James Lind Alliance methodology; establishing the partnership, identifying evidence uncertainties, refining questions and uncertainties, and prioritization. Data from MS forms were analysed using descriptive statistics. RESULTS: A total of 33 stakeholders attended an online PSP workshop and completed the Mentimeter exercise in Microsoft Teams. A total of 48 attended the subsequent in person prioritisation exercise in urban Bogota (n = 22) and rural Popayan (n = 25). The stakeholders were a diverse group of health professionals (physicians, medical students, nurses, dentists, physiotherapists, nutritionist, occupational and speech therapists), financial and administrative staff and patients with life-limiting illness and caregivers. Top research priorities included patient and caregiver needs, service provider education and training, and better integration of palliative care with cancer and non-cancer services. The key challenges included a lack of interest in palliative care research, along with funding, time and resource constraints. Key solutions included collaboration across disciplines and settings, highlighting benefits of palliative research to help secure adequate resources, and multicentre, mixed method research, with patient involvement from the research development stage. CONCLUSION: The findings of this PSP should be disseminated among palliative care associations worldwide to inform international multicentre studies, and among governmental and nongovernmental organisations that promote research in Colombia. A focus on patient and family caregiver palliative care needs in Colombia should be prioritised.

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PURPOSE: This two-arm parallel randomized controlled trial aimed to evaluate and compare periodontal changes due to rapid maxillary expansion (RME) using tooth-bone-borne and tooth-borne devices in growing patients via clinical examinations and cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Forty-two eligible patients (aged 11-14 years; transverse maxillary deficiency, posterior crossbite) were screened and divided into two groups based on the treatment received (randomization was performed using computer-generated numeric sequences): hybrid hyrax tooth-bone-borne group (TBB) and hyrax tooth-borne group (TB). The primary outcome was the change in cortical bone thickness (by CBCT). In addition, the clinical attachment level (CAL), gingival recession, and bleeding were assessed. Both examinations were performed before and 3 months after the activation phase. Intergroup comparisons were performed using analysis of covariance (ANCOVA; P < 0.05). RESULTS: Twenty-one patients (12 girls and 9 boys; mean initial age, 13.3 years) were included in the TBB group and 21 (5 girls and 16 boys; mean initial age, 13.2 years) were included in the TB group. The TB group exhibited a decrease in buccal bone thickness in the first premolars and first molars at all three evaluated levels. Specifically, tooth 14 at 3 mm from the enamel-cement junction showed a significant width reduction (0.7 mm; p < 0.001), accompanied by a notable increase in palatal cortical thickness at 6 mm of enamel-cement junction (1.13 mm; p < 0.001). CONCLUSIONS: RME resulted in buccal bone thickness reduction at the first premolar with hyrax treatment. In the molar region, both devices resulted in cortical bone alterations that were less pronounced in the TBB group.

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The article addresses the diagnostic value of the combined use of computed tomography (CT) perfusion and dual-energy CT (DECT) in patients with neuroendocrine tumors. It emphasizes the heterogeneity and complexity of these neoplasms, primarily affecting the gastrointestinal tract, bronchopulmonary system, and pancreas. While conventional CT is widely employed in their diagnosis, the combination of CT perfusion and dual-energy CT offers greater precision, particularly in detecting synchronous tumors and characterizing their vascularization. A clinical case of a patient with chronic abdominal symptoms, whose diagnosis was facilitated using both combined techniques, is presented. The discussion explores how CT perfusion assesses tumor vascularization and how dual-energy CT improves soft tissue differentiation, resulting in increased diagnostic accuracy. It is highlighted that this approach not only enhances detection rates but also positively impacts clinical management and healthcare costs. Therefore, the importance of considering these advanced tools in the diagnosis of neuroendocrine tumors to improve diagnostic precision and efficiency in patient care is underscored.

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La terapéutica endodóntica se apoya básicamente en dos modelos teóricos o paradigmas: el concepto de "tubo hueco" técnico y quirúrgico esencialmente mecanicista, y el modelo terapéutico para conductos radiculares, que busca la restitución ad integrum de los tejidos apicales y el hueso alveolar que los rodea. La instrumentación debe complementarse con la limpieza por irrigación abundante y la obturación con un biomaterial bioactivo, con características reológicas que permitan su adaptación plástica a las paredes del conducto radicular y module la respuesta de los tejidos hacia la regeneración con aposición de tejido calcificado en el foramen apical (AU)

Endodontic therapy is basically based on two theoretical models or paradigms, which are the concept of the technical and surgical "hollow tube", essentially mechanistic, and the therapeutic model of root canals, which seeks the ad integrum restitution of the apical tissues and bone. alveolar that surrounds them. The instrumentation must be complemented with cleaning by abundant irrigation, and with a bioactive biomaterial, with rheological characteristics that allows its plastic adaptation to the walls of the root canal and modulates the response of the tissues towards regeneration with apposition of calcified tissue in the apical foramen (AU)

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Este artículo es una actualización de uno publicado en la Revista del Ateneo Argentino de Odontología (RAAO) en el número 2 de 2016, titulado: "Implantes retrosinusales como alternativa al levantamiento del piso del seno maxilar" donde se presentan casos con implantes colocados con técnica mínimamente invasiva sin colgajo (flapless) en posición inclinada, que, en ese momento, tenían 10 años de evolución. Teniendo en cuenta que son pacientes de mi prácti- ca privada, con los cuales mantengo un seguimiento continuo, me pareció interesante enfocarme en un paciente que participó en el artículo arriba mencio- nado, que sufrió pérdida de un implante a los 14 años de instalado. El objetivo del presente trabajo será mostrar el resul- tado favorable del caso con técnicas mínimamente invasivas. Cabe destacar que el paciente de referencia tiene implantes desde hace más de 20 años, por lo que se evaluarán otros implantes inmediatos postextrac- ción, tratados con la misma técnica (AU)

This article is an actualization of one published in the Argentine Ateneo of Dentistry Journal, in 2016, number 2, titled: "Retro Sinusal Implants as an Alternative to lifting the Maxillary Sinus Bottom" in which several cases of implants were placed with a flapless minimum invasive technique, in an inclined position, which at that moment had a 10-year evolution. Considering that these patients are from my private practice of whom I keep a permanent follow up, it seemed interesting to me to focus on a particular patient that was mentioned in the previous article, who suffered the loss of an implant placed 14 years before. The objective of the present work will be to show the positive outcome of this case with minimum invasive techniques. It should be noted that the patient named above, has twenty years old implants placed with success, so new inmediate post extraction implants have been evaluated, placed with the same technique (AU)

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PURPOSE: Currently, inguinal hernias are highly prevalent in the Brazilian population, accounting for 75% of all abdominal wall hernias. The recommended treatment to correct them is inguinal herniorrhaphy, which can be performed through open surgery, mainly using the Lichtenstein technique, or laparoscopically, primarily through Transabdominal Preperitoneal Repair (TAPP) or Total Extraperitoneal Repair (TEP) approaches. Like any surgery, these procedures have post-operative complications, with pain being the most common and debilitating. Currently, in European and Brazilian guidelines, the open Lichtenstein and endoscopic inguinal hernia techniques are recommended as best evidence-based options for repair of a primary unilateral hernia providing the surgeon is sufficiently experienced in the specific procedure. In that matter, the surgeon should make a choice based on assessment of the benefits and risks of performing each of them, and practice shared making decision with it patient. Therefore, the objective of this review was to assess the incidence of chronic postoperative pain by comparing the aforementioned surgical approaches to evaluate which procedure causes less disability to the patient. METHODS: The search conducted until May 2024 was performed on Medline (PubMed), Cochrane (CENTRAL), and Lilacs databases. The selection was limited to randomized clinical trials, nonrandomized clinical trials and cohort studies comparing TAPP or TEP to LC, evaluating the incidence of chronic postoperative pain published between 2017 and 2023. Evidence certainty was assessed using the GRADE Pro tool, and bias risk was evaluated with the RoB 2.0 tool and ROBINS I tool. Thirteen studies were included.  RESULTS: The meta-analysis showed a significant difference between the groups in both techniques, favoring the laparoscopic approach, which had a lower occurrence of postoperative inguinodynia with a relative risk of 0.49 (95% CI = 0.32, 0.75; I2 = 66% (P = 0.001); Z = 3.28 (P = 0.001) with low certainty of evidence. CONCLUSION: The presence of chronic postoperative pain was lower in laparoscopic TEP/TAPP techniques when compared to the open Lichtenstein technique, meaning that the former can bring more benefits to patients who requires inguinal herniorrhaphy. Nevertheless, further randomized clinical trials are needed to optimize the analysis, minimizing the bias.

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Supravalvular aortic stenosis (SVAS) is a congenital malformation associated with Williams-Beuren syndrome. It is characterized by severe stenosis of the sinotubular junction. The smooth muscle layer is thickened due to an alteration of the Elastin gene. The treatment is surgical and there are several techniques to relieve obstruction which range from the single-patch technique to the replacement of all three aortic sinuses with three patches. However, the optimal technique is still unclear. The objective of this article is to carry out a bibliographic review of surgical techniques for SVAS and the description of the application of the Doty technique for a 4-year-old infant at the Roberto Gilbert Elizalde Hospital.

La estenosis aórtica supravalvular es una malformación congénita asociada al síndrome de Williams-Beuren. Se caracteriza por una severa estenosis en la unión sinotubular. La capa de músculo liso se engrosa debido a una alteración en el gen Elastina. El tratamiento es quirúrgico y existen varias técnicas para aliviar la obstrucción, que van desde la técnica de un solo parche hasta el reemplazo de los tres senos aórticos con tres parches. Sin embargo, la técnica óptima aún no está clara. El objetivo de este artículo es realizar una revisión bibliográfica de las técnicas quirúrgicas para estenosis valvular aórtica supravalvular y describir la aplicación de la técnica de Doty en una niña de 4 años en el Hospital Roberto Gilbert Elizalde.

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OBJECTIVES: To investigate long-term alveolar ridge bone changes in patients treated with the split-crest technique (SCT) with simultaneous implant placement. MATERIALS AND METHODS: Alveolar ridge width (ARW) was measured with a caliper immediately before (ARW1) and after SCT (ARW2) with a caliper. Existing CBCT scans taken at least 5 years postoperatively were used to assess the healed ARW (ARWF), buccal bone thickness (BBT), and lingual/palatal bone thickness (L/PBT) at 0, 3, and 5 mm apically from implant platform level (IPL). The distance between IPL and buccal bone crest (IPL-BBC) was also measured. Findings were compared with Wilcoxon and Student's t tests (p < .05). RESULTS: Records of thirty patients with 85 implants were included. Eleven patients (31 implants) presented CBCT scans taken in two separate occasions, resulting in 116 measurements. Tomographic follow-up ranged from 5 to 18 years (11.5 ± 4.18 years). Mean ARW increased from 3.2 ± 0.6 to 6.6 ± 0.48 mm after SCT, but significantly reduced overtime to 4.46 ± 0.83 mm (ARWF) (p < .0001). Mean BBT was 0.5 ± 0.9, 1.3 ± 0.9, and 2.0 ± 1.2 mm, while mean L/PBT was 0.9 ± 0.7, 1.6 ± 0.9, and 2.1 ± 1.0 mm at 0, 3, and 5 mm from IPL, respectively. IPL-BBC distance varied up to 8.7 mm (1.4 ± 2.0 mm), with 56/116 measurements (51/85 implants) showing IPL-BBC = 0 mm. CONCLUSION: Although SCT with simultaneous implant placement can predictably increase ARW postoperatively, ARW tended to significantly reduce over time, due to reductions in BBT and L/PBT, especially coronally. Nonetheless, 60% of the implants still presented some buccal bone at IPL.

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INTRODUCTION: IncobotulinumtoxinA (Xeomin®) is used in the treatment of dynamic wrinkles and the aesthetic repositioning of facial structures. The duration of its muscular effect typically extends for around 4 months. However, the residual aesthetic benefit can be observed for a longer period. To date, the long-term aesthetic benefit of incobotulinumtoxinA in facial aesthetics has not been systematically evaluated. This study aimed to evaluate longitudinally the duration and aesthetic benefits of incobotulinumtoxinA in the treatment of the upper face in adult women. METHODS: A quasi-experimental, evaluator-blind, clinical trial involving 28 adult women (30-60 years old) with facial movement lines, undergoing treatment of the upper face with incobotulinumtoxinA by two injectors, following an individualized protocol (ONE21 and glabellar contraction patterns) was performed. Participants were evaluated on the day of the intervention (day 0) and days 30, 120, 180, and 240, and subjected to standardized photographs. The following outcomes were evaluated blindly at each visit: Merz Aesthetics Facial Contraction Scale (MAS), GAIS (Global Aesthetic Improvement Scale), and patient satisfaction. Adverse effects were evaluated at each visit. RESULTS: Participants ranged in age from 30 to 60 years, 93% were self-declared white, and most of their baseline MAS scores for dynamic lines were moderate and severe. All the parameters presented significative reduction from baseline until day 180. At day 240, the dynamic MAS scores were lower than baseline for forehead lines in 15.4% (95% confidence interval (CI) 0.8-30.0%) of the participants, for glabellar lines in 38.5% (95% CI 18.8-58.1%), and for crow's feet lines in 26.9% (95% CI 9.0-44.8%). Aesthetic improvement compared to baseline was identified in 35% (CI 95% 23‒50%) of the participants at day 240, and 62% (CI 95% 42‒81%) of the sample kept reporting some satisfaction with the procedure. CONCLUSION: The aesthetic treatment of the upper face with incobotulinumtoxinA demonstrates enduring clinical benefits, and patient satisfaction lasting up to 180 days in most participants. The length of efficacy, which exceeded those reported in the literature, may be attributed to the use of techniques based on individualized assessment such as ONE21 and glabellar patterns of contraction.

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BACKGROUND: Shoulder dislocation, particularly anterior dislocation, is a common orthopedic injury often presenting in emergency care settings, characterized by significant pain and muscle spasms. Prompt reduction is essential to alleviate symptoms and restore function. The Cunningham technique employs gentle pulling and massage motions targeted at the muscles and has emerged as a promising method for reducing anterior shoulder dislocations. However, its reported success rates vary widely across studies, and questions remain regarding its efficacy, particularly in cases of failure. This study aims to evaluate the effectiveness of the Cunningham technique for reducing anterior shoulder dislocations and its potential role in providing analgesia and muscle relaxation as an adjunctive method. METHODS: A retrospective study was conducted on patients presenting with acute anterior shoulder dislocation at a single center. Reduction using the Cunningham technique was performed initially, followed by the external rotation technique if unsuccessful. Procedural sedation and analgesia were administered if the reduction was still not achieved, and shoulder dislocation reduction was performed again through the external rotation method. The patients' VAS scores were recorded and evaluated the Cunningham technique's effectiveness in reduction and whether it increases the effectiveness of other techniques applied for reduction by lowering the VAS score, even in cases where it is not effective. RESULTS: A total of 61 patients were included in the study. The reduction was performed using the Cunningham technique in 34.4% (21/61) patients, the external rotation technique in 47.5% (29/61) patients, and the external rotation technique with PSA in 18% (11/61) patients. Significant differences were observed in the duration of hospital stay among the three techniques, with ER with PSA resulting in the longest stay. VAS scores showed significant improvements from initial presentation to post-reduction in all three groups. A significant decrease in pre-reduction VAS scores was observed during the transition from the Cunningham technique to other techniques. CONCLUSION: The Cunningham technique showed effectiveness in reducing anterior shoulder dislocations, providing analgesia, and muscle relaxation. It demonstrated favorable outcomes as an initial reduction technique, with the external rotation technique used as a subsequent option. Further studies comparing the success rates and complications of the Cunningham technique with other reduction methods are warranted to establish its role in clinical practice.

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The treatment of Gustilo-Anderson type III open femoral fracture with large segmental bone defect remains a challenge for orthopedic trauma surgeons. The aims of management are first to prevent the risk of infection and then to reconstruct the bone loss with correct alignment and length. The induced membrane technique (or Masquelet technique) was initially described for tibia nonunion but became over the years an established procedure to treat any kind of large bone defect. The case of a 22-year old male who sustained an open femoral shaft fracture with a circumferential 7-cm bone defect after a car accident is presented. Given the critical size of the bone loss, we chose to manage this patient using a modified-Masquelet technique, in which we stabilized the fracture by an intramedullary femoral nail and filled only the lateral side of the defect with a cement spacer. He went on to have a full and successful union of his fracture 16-weeks after the second stage surgery. The final functional outcomes were excellent allowing the patient to resume all activities without restriction.

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Dysphagia lusoria occurs due to compression of the esophagus as an aberrant right subclavian artery (ARSA) crosses the mediastinum. Surgical management includes open, hybrid, and endovascular techniques, with no consensus gold standard. There are few reports of robotic-assisted ARSA resection. We describe the innovative technique and outcomes for two patients who successfully underwent robotic-assisted transthoracic resection of an ARSA after right carotid-subclavian bypass for dysphagia lusoria. Both patients experienced improvement or resolution of their dysphagia and no major complications. In select patients with a noncalcified origin of the ARSA without aneurysmal degeneration, the robotic-assisted approach represents a viable option.

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Pancreas transplant (PTx) is the only treatment that establishes normal glucose levels for patients diagnosed with diabetes types 1 and 2. The paper aims to review and analyze graft survival, patient survival, and the impact on diabetic complications. We describe that the graft survival was 82-98% at 1 year, 90% at 5 years, and 75-54% at 10 years for simultaneous pancreas-kidney recipient; 71% pancreas after kidney (PAK), and 62% PTx alone at 1 year. Patient survival: At 1 year for recipients was 96.9% simultaneous pancreas-kidney transplantation (SPK); for PAK transplantation recipients, 96.3%; and for PTx alone recipients, 98.3%. In general, the pancreas transplantation improves and reverses diabetic complications. Finally, the pancreatic transplant is a morbid procedure and emerges as a significant alternative in diabetes management, directly competing with conventional insulin therapies. Results so far suggest that the most effective transplant model is the SPK. While more patients could benefit from this procedure, surgical complications and the need for immunosuppression pose significant challenges.

El trasplante de páncreas es el único tratamiento que estabiliza los niveles normales de glucosa en los pacientes diagnosticados con diabetes tipo 1 o tipo 2. En esta revisión se analizan la supervivencia del injerto, la supervivencia del paciente y el impacto en las complicaciones diabéticas. Se describe la supervivencia del injerto: 82-98% al año para los receptores de trasplante simultáneo de páncreas y riñón, 71% para trasplante páncreas después de riñón y 62% para trasplante de páncreas solitario al año. Supervivencia de los pacientes a 1 año: 96.9% para los receptores de trasplante simultáneo de páncreas y riñón, 96.3% para los receptores de trasplante de páncreas después de riñón y 98.3% para los receptores de páncreas solitario. En general, el trasplante de páncreas mejora y revierte las complicaciones diabéticas. Finalmente, el trasplante de páncreas, un procedimiento mórbido, surge como una alternativa significativa en el manejo de la diabetes, compitiendo directamente con las terapias convencionales de insulina. Hasta ahora, los resultados indican que el modelo de trasplante más efectivo es el simultáneo de páncreas y riñón. Aunque más pacientes podrían beneficiarse de este procedimiento, las complicaciones quirúrgicas y la necesidad de inmunosupresión plantean desafíos significativos.

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Inulin is a carbohydrate that belongs to fructans; due to its health benefits, it is widely used in the food and pharmaceutical industries. In this research, cabuya (Agave americana) was employed to obtain inulin by pulsed electric field-assisted extraction (PEFAE) and FTIR analysis confirmed its presence. The influence of PEFAE operating parameters, namely, electric field strength (1, 3 and 5 kV/cm), pulse duration (0.1, 0.2 and 0.5 ms), number of pulses (10,000, 20,000 and 40,000) and work cycle (20, 50 and 80%) on the permeabilization index and energy expenditure were tested. Also, once the operating conditions for PEFAE were set, the temperature for conventional extraction (CE) and PEFAE were defined by comparing extraction kinetics. The cabuya meristem slices were exposed to PEFAE to obtain extracts that were quantified, purified and concentrated. The inulin was isolated by fractional precipitation with ethanol to be characterized. The highest permeabilization index and the lowest energy consumption were reached at 5 kV/cm, 0.5 ms, 10,000 pulses and 20%. The same extraction yield and approximately the same amount of inulin were obtained by PEFAE at 60 °C compared to CE at 80 °C. Despite, the lower amount of inulin obtained by PEFAE in comparison to CE, its quality was better because it is mainly constituted of inulin of high average polymerization degree with more than 38 fructose units. In addition, TGA analyses showed that inulin obtained by PEFAE has a lower thermal degradation rate than the obtained by CE and to the standard.

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Hemispheric epilepsy is quite frequent in children, compared with adults, and encompasses pathological substrates as diverse as hemimegalencephaly, Rasmussen encephalitis, Sturge-Weber syndrome, and porencephaly, among others. These patients most often become pharmacoresistant and thus require surgical management. Although anatomical hemispherectomy is a possibility, the technique that is favored by most epilepsy surgery centers worldwide is functional hemispherotomy, which results in equivalent outcomes with fewer postoperative complications. Therefore, it is essential that pediatric epilepsy neurosurgeons become familiar with these techniques. The present video describes in detail all surgical aspects of the perisylvian hemispherotomy.