Midiabdominoplasty: indications and technique.

In the treatment of aesthetic deformities of the abdomen there are three points we should analyze: the skin, the fat tissue, and the muscles. Based on these points we can classify it into six groups. Midiabdominoplasty is indicated in the correction of deformities of groups 2, 3, and 4. A small fusiform resection of skin is done in the lower abdomen, undermining of the skin up to the umbilicus (or to the xiphoid appendix if necessary to treat diastasis of the rectus muscles in the supraumbilical region), and desinsertion of the umbilicus, with no external scar, are the main points in this technique. The main complication was the formation of seroma. No necrosis of the flap or unsightly scars were observed. The results were good, with the patients satisfied with their new abdomens.

Tuberous breast: a new approach.

The authors make a historical summary of the pathologic condition of tuberous breast and describe a new procedure for its correction. The method involves a periareolar approach, dividing the breast in two portions to disrupt the constricting ring, and making an inferiorly based flap or pedicle, as described and used by the senior author since 1969, with publication in 1973. The main goal is to correct the deformity at a one-stage operation, resulting in a periareolar scar only, without the use of alloplastic elements such as prostheses, mesh, or tissue expanders. The authors emphasize that Brazilian patients prefer having small breasts rather than large ones, even though the procedure allows the implantation of pre- or retromuscular implants through the periareolar incision.

[Neurocysticercosis in childhood. I. Clinical and laboratory diagnosis]. / Neurocisticercose na infância. I. Diagnóstico clínico e laboratorial.

Clinical and laboratory findings among 34 children (age range from 15 months to 13 years) with neurocysticercosis were reviewed. The main symptoms were: intracranial hypertension, 21 cases (62%); epilepsy, 20 cases (59%); hemiplegia, 4 cases (12%). Computed tomography (CT) in 33 children showed typical brain active cysts in 26 patients (79%) and calcifications in 2 (6%). The complement fixation reaction or the indirect immunofluorescent test for cysticercus antibody were positive in CSF in 77% (20 out of 26 patients) and serum in 78% (18 out of 23 patients). CSF pleocytosis was found in 57% of the cases (15/26 patients) with eosinophil cells in 27% (7/26 patients). The most efficient diagnostic test was CT scan of the head, and was confirmed immunologically by measurement of cysticercus antibody titers in CSF and serum.

[Neurocysticercosis in childhood. II. Computed tomography of 24 patients according to symptomatic and praziquantel treatment]. / Neurocisticercose na infância. II. Tomografia computadorizada de 24 pacientes em relação ao tratamento sintomático e com praziquantel.

We studied 24 children (15 months to 13 years old) which clinical, CSF and CT findings were compatible to the diagnosis of active neurocysticercosis. The patients were divided into three groups based on the type of treatment: Group I (10 patients) treated with analgesics and/or anticonvulsants; Group II (4 patients) treated with analgesics and or anticonvulsants and corticosteroids; Group III (10 patients) treated with analgesics and/or anticonvulsants, corticosteroids and praziquantel. The first patients CT scan were compared with the sequential CT scan findings (1 month to 5 years). The initial CT scan of 12 patients showed multiple active cysts, in 5 patients an isolated active cyst, in 3 patients partial calcified cysts, in 2 patients cerebral edema and in 2 patients were normal. The final results of the three groups of patients, as far as concern the normalization of CSF abnormalities or calcification of the cysts were the same, no matter the type of treatment applied to them. These results, although the small number of patients, showed that most of the children have good final results, with improvement of clinical symptoms and CT findings. We suggest that neurocysticercosis in children need multicenter study. So, a great number of patients can be followed and better definition can be established on the treatment of neurocysticercosis.

Neurocisticercose na infância: I. Diagnóstico clínico e laboratorial / Neurocysticercosis in childhood: I. Clinical and laboratory diagnosis

Foram revisados aspectos clínicos e laboratoriais de 34 casos de neurocisticercose na infância (15 meses a 13 anos). Os principais sintomas foram: hipertensäo intracraniana, 21 casos (62%); epilepsia, 20 casos (59%); hemiplegia, 4 casos (12%). A tomografia computadorizada de crânio (TAC) (33 pacientes) mostrou cistos em atividade em 26 (79%) e calcificaçöes em 2 (6%). A reaçäo de fixaçäo de complemento ou imunofluorescência para cisticercos foi reagente em 77% no LCR (20/26 pacientes) e 78% no soro (18/23 pacientes. Pleocitose no LCR ocorreu em 57% dos casos (15/26 pacientes) e eosinofilorraquia em 27% (7/26 pacientes. A TAC foi o melhor exame para o diagnóstico, confirmado pelos testes imunológicos no LCR e soro

Neurocisticercose na infância: II. Tomografia computadorizada de 24 pacientes em relaçäo ao tratamento sintomático e com praziquantel / Neurocysticercosis in childhood: II. Computed tomography of 24 patients according to symptomatic treatment and with praziquantel

Foram estudadas 24 crianças (15 meses a 13 anos) com neurocisticercose em atividade diagnosticada pela clínica, líquido cefalorraquidiano e tomografia computadorizada de crânio (TAC). Os pacientes foram divididos em três grupos, de acordo ao tipo de tratamento: Grupo I (10 pacientes) com medicaçäo sintomática: Grupo II (4 pacientes), com tratamento sintomático e corticosteróides: Grupo III (10 pacientes) com medicaçäo sintomática, corticosteróides e praziquantel. Os achados da TAC foram analisados inicialmente e na evoluçäo (1 mês a 5 anos). A TAC inicial mostrou cistos múltiplos em 12 pacientes, cisto único em 5, cistos parcialmente calcificados em 3, edema cerebral em 2 e foi normal em 2. Na evoluçäo, os achados foram semelhantes nos tres grupos de tratamento em relaçäo à normalizaçäo do exame ou calcificaçäo dos cistos. Esta observaçäo, apesar do pequeno número de casos, mostrou-nos que crianças com neurocisticercose em atividade apresentaram evoluçäo para melhora clínica e tomográfica independente do tratamento. Assim devemos realizar estudos mulcêntricos, com maior número de casos, para maior definiçäo do tratamento da neurocisticercose