Minimally invasive mastectomy: minimal incisions for better aesthetic quality of breast reconstruction.

BACKGROUND: Women with a family history of breast cancer who develop this disease are confronted with important situations regarding the increased risk for development of a second cancer in the contralateral breast. Prophylactic contralateral mastectomy (PCM) reduces by approximately 95% the risk for contralateral breast cancer. In spite of an increase in indications for PCM, the technical difficulties are many regarding the accomplishment of these procedures. The aim of this study is to describe the technique of mastectomy with preservation of the nipple-areola complex and a small incision, reducing surgical difficulties and complications attributed to this technique, thus allowing better aesthetic results in breast reconstruction. METHODS: Forty-six patients with indications for PCM (28 bilateral) were submitted to minimally invasive mastectomy from March 2005 to November 2007. A small incision in the superior pole of the areola, sufficient to pass a liposuction 4 mm cannula is made. With the help of this cannula, detachment of the skin from the gland tissue is performed. Then a 3.5 to 4.5-cm long incision in the inframammary fold is made. Glandular detachment is completed using cautery in the subglandular portion and scissors in the upper breast portion cutting the restraints left by the cannula. The mammary gland tissue is removed through this incision. RESULTS: Seventy-four breasts were operated on. The resected breast mass ranged from 285 g to 475 g. All 43 patients were reconstructed with prostheses. There was no necrosis of the nipple-areola complex or of the skin. CONCLUSIONS: This technique is an option for cases of patients with indications for PCM.

Female pelvic pain: a case report of mucocele of the appendix.

OBJECTIVE: To describe a rare case of mucocele of the appendix that simulated a cystic image by pelvic ultrasound (US). CASE: A patient with pelvic pain for two months and cystic image on the right ovary by US. After laparoscopy, the image showed a mucocele of the appendix. The patient underwent right colectomy. CONCLUSION: Mucocele may be a cause of pelvic pain and may simulate a cystic image on the right adnexa.

Memória seqüencial verbal de três e quatro sílabas em escolares / Sequential verbal memory for three and four syllables in school children

BACKGROUND: Auditory memory ability. AIM: To characterize the auditory memory ability for verbal sequences in children with ages ranging from 3 to 12 years. METHOD: A memory test for verbal sequences was used, as well as a variation with the addition of one syllable to each sequence. Participants were 223 students of public and private schools. RESULTS: All subjects repeated at least two out of the three sequences of three syllables. At the age of nine, they were capable of repeating all of the three sequences. At the age of six, they repeated at least two out of the three sequences of four syllables. CONCLUSION: The behavioral responses to verbal sounds presented in sequences, improves as children grow older. Children of private schools demonstrated an earlier development of this ability.

Tema: habilidade auditiva de memória. Objetivo: caracterizar a habilidade auditiva de memória seqüencial verbal em crianças de três a 12 anos. Método: aplicou-se o teste de memória seqüencial verbal e uma modificação deste pelo acréscimo de uma sílaba a cada seqüência, em 223 escolares, do ensino público e privado. Resultados: todos repetiram corretamente pelo menos duas das três seqüências de três sílabas. Aos nove anos, foram capazes derepetir as três seqüências. Aos seis anos, repetiram pelo menos duas das três seqüências de quatro sílabas. Conclusão: as respostas comportamentais para sons verbais emseqüência melhoram com o avanço da idade. As crianças de escola privada apresentaram evolução mais precoce dessa habilidade.