Hoodplasty: Individualized Approach for Labiaplasties.

INTRODUCTION: Hoodplasties and labia minora reductions are some of the most requested operative procedures by women distressed with the appearance of their vulvar region. In the majority of cases, a concomitant hoodplasty (HP) is performed to achieve a better aesthetic appearance. Various surgical methods have been described for the removal of excess tissue within the clitoris hood area. MATERIALS AND METHOD: This study aims to describe a single surgeon's preference and results in her private practise in 630 patients who underwent labiaplasty mainly because of dissatisfaction with the aesthetic appearance. RESULTS: Of the 630 labiaplasties performed, 303 had clitoris hood excess, 44% of cases with concomitant HP and in 7.9% of cases only a HP was performed. The study was done between September 2009 and December 2021 and the HP technique was longitudinal excision in 97% of patients and horseshoe excision in 4.95% of them. Surgeries lasted between 30 and 60 min. 98% of the patients claimed an improvement in self-esteem and 96% claimed improvement in sex life post-surgery. No major complications occurred. DISCUSSION: An isolated labiaplasty technique in patients with hood excess results in disharmony in the area. HP can be considered as a subdivision of a labioplasty. Extended central wedge labia minora resection (V-plasty) is a commonly used procedure in LP operations but can limit the excess clitoris hood resection. Edge labia minora resection can easily be combined with longitudinal excision of the clitoral hood, and when also horizontal clitoris hood excess is present can also be addressed by converting the resection from longitudinal into a horse hose resection. Limitations in the study include lack of use of validated assessments for the satisfaction of aesthetic outcomes and that all the procedures were performed by a single senior surgeon, which can be seen as a strength but also a limitation because of the high risk of bias. Moreover, there was no comparative cohort for the study population. Furthermore, we could not find comparative cohorts in previously reported techniques in the literature either. CONCLUSION: Clitoris hood resections should be treated on an individualized approach and adapted according to the excess present. It is important when a patient requests a labiaplasty to always address the clitoris hood during the consultation to avoid unsatisfied patients afterwards. Many patients come just focussed on their labia minora excess and when corrected, realize the clitoris hood excess was also part of the problem. LEVEL OF EVIDENCE III: 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 .

Complications of Fat Grafting Versus Implants in Gluteal Augmentation: A Retrospective Review and Lessons Learnt.

There have been various studies and literature reviews about gluteal augmentation, possibly due to the high complication rates associated with the procedure. But in the recent past, there has been extensive work in an effort to reduce the complications and various different methods have been developed for this purpose. This article brings to view the procedure followed in our surgery centre for fat grafting and implants for gluteal augmentation. We have compiled the complications we encountered with these procedures and the lessons we learnt to prevent them. LEVEL OF EVIDENCE III: 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 .

Vaginal Tightening.

The natural aging process and pregnancies come with certain body changes that influence overall our performance and the vagina is no different. Today more and more patients seek for new ways to enhance their sexual gratification. It is important to listen and examine the patient to look for vagina wall looseness and if a big prolapse is present it is not an ideal case for the procedure. Only tightening the vagina entrance is no enough to really impact female sexual gratification. Treating a loose vagina, loose vagina walls, really impacts sexual gratification on the woman improving their quality of life.

Recommendations for the diagnosis and management of persons with suspected vaccine-induced immune thrombotic thrombocytopenia (VITT) / Recomendaciones para diagnostico y manejo de personas con trombocitopenia trombotica inmune inducida por vacunas (VITT)

Abstract In recent months, rare cases of thrombosis at unusual sites associated with thrombocytopenia, occurring within a typical risk window (i.e., 4-28 days) after receiving SARS CoV2 vaccines, have been reported. Healthcare professionals should be prepared to detect these cases on time. The Expert Panel of the Knowledge Management and Transfer Network conducted a free search of the related literature. With the available information and the clinical expertise of the working group, we formulated, reviewed, and endorsed recommendations for the timely suspicion, diagnosis (case definitions, the use of initial laboratory and imaging tests, specific tests), and management of these thrombotic conditions. This document is considered a living document that will be updated as new evidence emerges, and recommendations may change over time.

Resumen En meses recientes se han reportado casos raros de trombocitopenia y trombosis en sitios inusuales, que ocurren dentro de una ventana de riesgo típica ( por ejemplo de 4 a 28 días) luego de recibir vacunas de SARS CoV 2. Los profesionales de la salud deben estar preparados para detectar estos casos a tiempo. Un panel de expertos y una red de transferencia de conocimiento realizó una búsqueda libre de literatura seleccionada. Con la información disponible y la experticia clínica del grupo de trabajo revisamos y dimos recomendaciones para la sospecha temprana, el diagnostico (definición de caso, el uso de pruebas de laboratorio especificas y de imágenes diagnósticas) para le manejo de estas condiciones tromboticas. Este documento es considerado un documento vivo que debe ser actualizado a medida que surja nueva evidencia y las recomendaciones vayan cambiando con el tiempo

Prevalencia y variables asociadas a la transmisión de Enterobius vermicularis en niños en edad preescolar y escolar en dos municipios de Cundinamarca, Colombia / Prevalence and Variables Associated with Enterobius vermicularis Transmission in Preschool and School Children in Two Municipalities of Cundinamarca, Colombia / Prevalência e variáveis associadas à transmissão de Enterobius vermicularis em crianças pré-escolares e escolares em dois municípios de Cundinamarca, Colômbia

Resumen: El presente artículo busca determinar la prevalência de Enterobius vermicularis y variables asociadas en población preescolar y escolar del área urbana del municipio de Chaguaní y dos jardines en Cajicá, Cundinamarca, Colombia. Para esto se realizó un estudio descriptivo, de corte transversal con toma única de muestra en la población mencionada en 44 y 42 participantes, respectivamente, cuyos padres aceptaron participar voluntariamente firmando un consentimiento para desarrollar una encuesta epidemiológica estructurada, que indagó condiciones socioeconómicas, epidemiológicas y medioambientales. El diagnóstico parasitológico se realizó con la técnica de Graham. Los participantes se distribuyeron por grupo etario: el primero estuvo conformado por 76 niños (88,4 %) con edades entre 1,5 y 8 años; el segundo, por 7 niños mayores de 8 años (8,1%), y el tercero, por 3 niños (3,5 %) sin información al respecto. La variable con significancia estadística (p≤0.05) y posible asociación protectora fue la asistencia médica trimestral y como posible riesgo el contacto con fómites. Así, se encontró que la oxiuriasis es una parasitosis prevalente en la población preescolar y escolar, asociada a condiciones higiénico-sanitarias deficientes.

Abstract: This article seeks to determine the prevalence of Enterobius vermicularis and associated variables in preschool and school population in the urban area of the municipality of Chaguaní and two kindergartens in Cajicá, Cundinamarca, Colombia. To this end, a descriptive, cross-sectional study was conducted by taking a single sample from 44 and 42 participants from such populations, respectively, whose parents agreed to participate voluntarily by signing a consent to respond to a structured epidemiological survey. This survey inquired into their socioeconomic, epidemiological, and environmental conditions. Parasitological diagnosis was made using Graham's test. Participants were distributed by age group: the first one was made up of 76 children (88.4%) between 1.5 and 8 years old; the second one, of seven children (8.1 %) over 8; and the third one, of three children (3.5 %) with no age information. A statistically significant variable (p ≤ 0.05) and possible protection factor was quarterly medical care. A possible risk factor was contact with fomites. Therefore, it was found that oxyuriasis is a prevalent form of parasitosis in preschool and school population associated with poor hygienic and sanitary conditions.

Resumo: Este artigo pretende determinar a prevalência de Enterobius vermicularis e de variáveis associadas em população pré-escolar e escolar da área urbana do município de Chaguaní e de dois jardins de infância em Cajicá, Cundinamarca, Colômbia. Para isso, foi realizado um estudo descritivo, de corte transversal, com tomada única de amostras na população em 44 e 42 participantes, respectivamente, cujos responsáveis aceitaram a participar de forma voluntária e assinaram o consentimento para responder a um questionário epidemiológico estruturado, que indagou sobre condições socioeconómicas, epidemiológicas e meio ambientais. O diagnóstico parasitológico foi realizado com a técnica Graham. Os participantes foram distribuídos por grupo de idade: o primeiro formado por 76 crianças (88,4%) entre 1,5 e 8 anos; o segundo, por 7 crianças com maios de 8 anos (8,1%), e o terceiro, por 3 crianças (3,5%) sem informação a respeito. A variável com significância estatística (p≤0,05) e possível associação protetora foi a assistência médica trimestral e, como possível risco, o contato com fômites. Assim, foi verificado que a oxiuriase é uma parasitose prevalente na população pré-escolar e escolar, associada a condições higiênico-sanitárias deficientes.

Assessment of Female Genital Surgery Education in Plastic Surgery Training: Report of an Expert Opinion Survey.

BACKGROUND: Patient demand for aesthetic genital surgery has markedly increased. The International Society of Aesthetic Plastic Surgery reported 95,010 labiaplasties and 50,086 vaginal rejuvenation procedures in 2015. METHODS: We performed an online anonymous survey to evaluate the teaching of female genital procedures in plastic surgery training programs worldwide. RESULTS: A total of 1033 board certified plastic surgeons answered the survey. Most respondents were from the USA, Brazil, Mexico and Colombia. The majority of plastic surgeons performing these procedures were in private practice (77.62%) and (22.38%) in academic settings. Most plastic surgeons (75.63%) did not receive formal education in female genital rejuvenation procedures however 54.31% did receive education in reconstruction procedures. During their training, most were exposed to vaginal reconstruction (15.94%), labia minora reduction (11.9%), vulva reconstruction (11.53%), flaps for vaginal agenesis (11.39%) and monsplasty (7.98%). Additional training for female genital procedures was mostly at meetings and shadowing experts. Sixty-two percent reported that patients seldom requested those procedures, and 63.73% reported these procedures comprised less than 5% of their practice. The most commonly performed procedures were labia minora reduction, labia majora augmentation or reduction and monsplasty. The materials used were mostly fat grafting, hyaluronic acid injections and lasers. CONCLUSION: Additional formal training during residency for aesthetic genital surgery would be beneficial. Additionally, courses at meetings would be useful for plastic surgeons who have had insufficient training. More studies need to be conducted on the different female genital rejuvenation procedures offered in order to evaluate patients' long-term outcomes and satisfaction. 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 .

Thorax masculinization in a transsexual patient: Inferior pedicle mastectomy without an inverted T scar.

Transsexual individuals with gender dysphoria or gender identity disorder are rare, with a prevalence reported to range from 0.002% to 0.014%. Studies have shown that mastectomy yields significant improvements in body image and self-esteem in female-to-male transsexual patients. In patients with grade III breast ptosis, mastectomy with a nipple-areolar complex (NAC) graft is the most commonly used technique, although it has several disadvantages. In the case described herein, a bilateral mastectomy preserving the NAC in an inferior pedicle was performed. Additionally, a thin superior thoracic dermal-fat flap was preserved and eventually sutured at the previous inframammary fold, preventing an inverted T scar. This case shows the advantage of this technique for preserving the blood supply and innervation of the NAC, with a low hypopigmentation risk. Furthermore, in this technique, the patch effect does not impair the results of the NAC graft, and there is no need to use an inverted T scar that may result in thoracic feminization.

Laser Resurfacing for Latin Skins: The Experience with 665 Cases.

BACKGROUND: CO2 resurfacing and CO2 microfractionated laser systems are reliable tools to improve different facial pathologic skin conditions but are associated with a high rate of complications specially in Fitzpatrick III, IV, and V skin phototypes, predominant in the Latin population, which has pushed many surgeons to change technologies and abandon its use. OBJECTIVE: To compare patient results with the CO2 resurfacing laser and microfractionated CO2 laser resurfacing in all skin types and show similar results to those obtained worldwide in patients with phototypes III, IV, and V. METHODS: Standardized review of medical records from a database of private practice patients treated since January 1998 to July 2012 with SlimE30 MiXto SX(®) CO2 laser. Evaluation of outcomes, complications, and satisfaction of three different modalities of treatment (CO2 ablative laser, CO2 microfractionated and a combination of both) was made. RESULTS: A total of 665 treated patients were included. Ablative CO2 was applied to 80.3 %, CO2 microfractionated to 15.1 %, and mixed treatment to 4.5 % of cases. Globally, hyperpigmentation rates were 30.4 % in the CO2 resurfacing group, 16.3 % when a combination of modalities was applied and 11 % in microfractionated CO2 cases. A steady increase of these rates is shown as the phototype becomes higher. Satisfaction rates were high for all groups: 86.7 % in the mixed group, 82.2 % in the microfractionated CO2, and 79.6 % in the CO2 ablative. CONCLUSIONS: Good results and an acceptable rate of complications in latin skins are obtainable after treating patients with CO2 ablative and microfractionated CO2 systems alone or in combination. Staged treatments and adequate post-procedure care reduce these complications.

Aesthetic surgery of female external genitalia.

Aesthetic surgery of the external genitalia in women encompasses many procedures and may address the labia minora, clitoral hood, labia majora, mons pubis, or vaginal opening. During the initial evaluation, the surgeon should consider all aspects of the external genitalia to develop an appropriate surgical plan. It may be necessary to perform 2 or more procedures during the same surgical session to achieve the desired aesthetic result. In this continuing medical education (CME) article, we review the literature and summarize the available cosmetic techniques for female external genitalia. Resection of the labia minora has been described in several peer-reviewed reports. We also discuss the procedures and modifications to direct resection, wedge resection, and deepithelialization of the labia minora. Aesthetic surgery of the clitoral hood may involve straight-line resection, extended wedge resection, or inverted V hoodoplasty. The mons pubis may be treated with mons pubis pexy, wedge resection, or lipomodeling. The labia majora can be managed with direct resection or lipomodeling, and hymenoplasty may be performed to correct a wide vaginal opening.

Caracterización morfológica de incisivos y molares de un grupo de afrodescendientes de Cali, Valle del Cauca (Colombia) / Morphological characterization of incisors and molars of an african descent group of Cali, Valle del Cauca (Colombia)

Objetivos: Determinar la frecuencia, la variabilidad, el dimorfismo sexual, la co - rrespondencia y la simetría bilateral de 13 rasgos morfológicos Dentales coronales (rm Dc) en dientes incisivos y molares de un grupo de afrodescendientes de cali, Valle del cauca (colombia). Materiales y métodos: estudio descriptivo transversal cuantitativo que caracterizó la morfología dental de los primeros y segundos incisivos superiores (11, 12, 21, 22) y de los primeros y segundos molares superiores e inferiores (16, 17, 26, 27, 36, 37, 46, 47) mediante el sistema de observa - ción, registro y análisis AsuDA s; a partir de 60 modelos de estudio (34 femeninos y 26 masculinos) obtenidos de un grupo de afrodescendientes con edades comprendi - das entre los 7 y los 17 años. Resultados: se obtuvieron frecuencias medias de winging y crowding , altas fre- cuencia de incisivos centrales y laterales en pala, baja frecuencia de cúspide de carabe - lli, baja frecuencia de metacónulo, ausencia de reducción del hipocono; expresión del punto P del protostílido, baja frecuencia del pliegue acodado, configuración del patrón cuspídeo y5 (primero molar inferior) y +5 y +6 (segundo molar inferior). Los rmDc no presentan dimorfismo sexual (excepto reducción del hipocono y patrón cuspídeo), tienen baja correspondencia y cuentan con simetría bilateral. una p<0.05 se consideró estadísticamente significativa. Conclusiones: La frecuencia y variabilidad de los 13 rmDc permitió determinar que el grupo de afrodescendientes hace parte del complejo Dental caucasoide con in- fluencia del Complejo Dental Mongoloide debido al mestizaje producto de los proce- sos etno-históricos de asentamiento de la región suroriental de cali.

Objectives: to determine the frequency, variability, sexual dimorphism, correlation and bilateral symmetry of 13 non-metric dental crown traits (NmDct) in incisors and molars of afro descent group of cali, Valle del cauca (colombia) Material and methods: Quantitative cross-sectional study that characterizes the dental morphology of the central and lateral upper incisors (11, 12, 21, 22) and first and second upper and lower molars (16, 17, 26, 27, 36, 37, 46, 47) by Asu- DAs system of observation, recording and analysis reported in the literature; from 60 models of study (34 female and 26 male) obtained from a afro descent group with aged between 7 to 17 years. Results: Was obtained winging and crowding mid frequencies, high frequen- cy of shovel-shape in central and lateral incisors, low frequency of carabelli cusp, low frequency of metaconule, reduction of hypocone absent, P point expression of protostylid, low frequency of deflecting wrinkle, groove pattern configuration Y5 (lower first molar) and +5 and +6 (lower second molar). NMDCT not sexually di - morphic (except hypocone reduction and groove pattern), have low correspondence and have bilateral symmetry. A p<0.05 was considered statistically significant. Conclusions: the frequency and variabili - ty of the 13 NmDct allowed determining that the group of African descent is part of Caucasoid Dental Complex with Mon - goloid Dental Complex influence, due to mixing processes and ethno historic sett - lement of the southeastern region of cali

Violencia de la pareja íntima durante el embarazo y sus repercusiones en la salud mental / Intimate partner violence during pregnancy and its impact on the mental health / Violência por parceiro íntimo durante a gravidez e seu impacto sobre a saúde mental

Este artículo presenta un estado del arte sobre violencia de la pareja íntima durante el embarazo y sus implicaciones en la salud mental de la madre, partiendo de 13 artículos publicados entre 2000 y 2014, obtenidos mediante búsqueda en bases de datos (Pubmed, Medline, Nursing Consult, sCielo, Dialnet, Redalyc, Lilacs, Index y Bireme), utilizando como palabras clave: embarazo, violencia de la pareja íntima, salud mental e implicaciones. Los hallazgos de este estudio, muestran que la violencia de la pareja íntima durante el embarazo incrementa la depresión y depresión posparto, así como el malestar emocional en la gestante.

This article presents a state of the art on intimate partner violence during pregnancy and its implications for the mental health of the mother, based on 13 articles published between 2000 and 2014, they were gotten by looking for databases (PubMed, Medline, Nursing Consult, SciELO, Dialnet, Redalyc, Lilacs, Index and Bireme), using as keywords: pregnancy, intimate partner violence, mental health and implications. The findings of this study show that intimate partner violence during pregnancy increases depression and postpartum depression, and emotional distress in pregnant women.

Este artigo apresenta um estado da arte sobre a violência por parceiro íntimo durante a gravidez e suas implicações para a saúde mental da mãe, com base em 13 artigos publicados entre 2000 e 2014, obtidos através de pesquisa bases de dados (PubMed, Medline, Enfermagem Consult, SciELO, Dialnet, Redalyc, Lilacs, Índice e Bireme), usando como palavras-chave: gravidez, violência por parceiro íntimo, saúde mental e implicações. Os resultados deste estudo mostram que a violência por parceiro íntimo durante a gravidez aumenta a depressão e depressão pós-parto, e problemas emocionais em mulheres grávidas.

Bienestar psicológico de personas con síndrome de Cushing / Psychological Well-Being of People with Cushing Syndrome

El objetivo de este estudio exploratorio es analizar la relación entre el bienestar psicológico y las condiciones médicas y terapéuticas de personas con diagnóstico de síndrome de Cushing. Los instrumentos utilizados fueron el Índice de Bienestar subjetivo (The Psychological Well-Being Index; Dupuy, 1984) y el Cushing's Syndrome Severity Index (CSI). La selección de la muestra se realizó por conveniencia; considerando que es un síndrome de muy baja incidencia, se estableció contacto con cinco pacientes. Se utilizaron estadísticos descriptivos que facilitaron la obtención de información sobre la muestra. Los resultados permiten concluir que la severidad de los síntomas asociados al síndrome, evaluados a través del CSI, implican malestar moderado en el bienestar psicológico, corroborando lo señalado por la literatura, así como que las alteraciones de orden psicológico influyen en el proceso de enfermedad o recuperación.

The objective of this exploratory study is to analyze the relationship between the psychological well-being and medical conditions and treatment of people diagnosed with Cushing's syndrome. The instruments used were the Psychological Well-Being Index (PWBI) (Dupuy, 1984) and Cushing's Syndrome Severity Index (CSI). The sample selection was done for convenience, considering that there is a very low incidence syndrome, 5 patients were contacted. Descriptive statistics were used to obtain information provided on the sample.