Orejas en asa. Presentación de casos y revisión bibliográfica / Earpining. Presentation of cases and bibliographic review

Las orejas prominentes se deben a una o varias anomalías congénitas que pueden asociarse entre sí en grados diversos. Los pabellones auriculares son considerados demasiado visibles tanto por la falta de plegamiento del antihélix, la abertura del ángulo cefaloconchal y la hipertrofia de la concha, según la clasificación de Davis. Son un problema estético frecuente, observándose en el 5% de la población. El conocimiento de la anatomía del pabellón normal y de los criterios antropométricos es indispensable. El grosor del cartílago condiciona la rigidez y la elasticidad del pabellón, mientras que sus relieves definen la forma y la posición. La finalidad en la otoplastia es corregir estas anomalías, remodelando el cartílago para obtener unas orejas con una plicatura adecuada, situadas y orientadas según parámetros estéticos, simétricas, con un tamaño y aspecto natural. Se pueden combinar distintos procedimientos quirúrgicos los cuales deben ser simples, rápidos, tener un resultado armonioso y duradero. Se realizó una revisión retrospectiva entre los años 2018 a 2020 en el Servicio de Cirugía Plástica del Hospital Tornú, en la que se presentan 4 casos de orejas prominentes a los cuales se les realizaron diferentes técnicas quirúrgicas de otoplastia (Davis, Stentstrom y Furnas). El total de los pacientes (n=4) tratados presentó un resultado satisfactorio tanto para el paciente como para el equipo quirúrgico, sin complicaciones significativas. La resolución quirúrgica de las orejas prominentes puede realizarse mediante numerosas técnicas; estas se dividen entre aquellas que realizan un procedimiento agresivo sobre el cartílago (resectivas) y las que intentan ser más conservadoras, sin resección del mismo para evitar al máximo las complicaciones. La diversidad de enfoques indica que no existe una técnica definitiva para corregir estos problemas. Las orejas prominentes o en asa, si bien no presentan alteraciones funcionales, tienen consecuencias sobre los efectos estéticos y psicológicos en el paciente que pueden ser sustanciales. Es importante conocer su base anatómica y realizar una adecuada evaluación, elegir técnicas para la corrección de la deformidad y conocer las posibles complicaciones del procedimiento para obtener un buen resultado estético y duradero.

Prominent ears are due to one or more congenital anomalies that may be associated with each other to varying degrees. The pinnae are considered too visible due to the lack of folding of the antihelix, the opening of the cephalo-conchal angle and the hypertrophy of the concha, according to the Davis classification. They are a frequent esthetic problem, being observed in 5% of the population. Knowledge of normal pinna anatomy and anthropometric criteria is essential. The thickness of the cartilage determines the rigidity and elasticity of the pinna, while its relief defines its shape and position. The purpose of otoplasty is to correct these anomalies, remodeling the cartilage to obtain ears with an adequate plication, positioned and oriented according to aesthetic parameters, symmetrical, with a natural size and appearance. Different surgical procedures can be combined, which must be simple, fast, have a harmonious and lasting result. A retrospective review was performed from 2018 to 2020 in the Plastic Surgery Department of the Tornú Hospital, presenting 4 cases of prominent ears which underwent different otoplasty surgical techniques (Davis, Stentstrom and Furnas). The total number of patients (n=4) treated presented a satisfactory result for both the patient and the surgical team without significant complications. Surgical resolution of protruding ears can be performed by numerous techniques, divided between those that perform an aggressive procedure on the cartilage (resective) and those that try to be more conservative, without resection of the cartilage to avoid complications as much as possible. The diversity of approaches indicates that there is no definitive technique to correct these problems. Prominent or protruding ears, although they do not present functional alterations, the consequences on the esthetic and psychological effects on the patient can be substantial. It is important to know their anatomical basis and to perform an adequate evaluation, to choose techniques for the correction of the deformity and to know the possible complications of the procedure in order to obtain a good esthetic and lasting result.

Preauricular incision outlining during a face-lift: a step-by-step description.

UNLABELLED: The data on the proper way to establish the preauricular incision (PAI) line and manage skin tension during lifting are limited. Undoubtedly, proper tissue handling represents a true challenge during a lifting procedure and is a crucial step in avoiding disfiguration. The authors describe their approach to PAI demarcation and local skin tension management performed in 165 cases since 2007. 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 at www.springer.com/00266.

Pulmonary myofibroblastic pseudotumor: a rare surgical pathology.

Pulmonary myofibroblastic pseudotumors are rare surgical pathologies, of unknown origin, with benign behavior and a good prognosis if completely resected. We present a 21-year-old male with a solitary pulmonary nodule found during a routine chest X-ray with CT scan confirmation. After a 16-month follow-up, the nodule increased in size and the patient developed mild dyspnea. He underwent an elective left postero-lateral thoracotomy and excision of the mass with an upper lobectomy. Pathologic studies revealed a pulmonary myofibroblastic pseudotumor.

Identification of carcass and meat quality quantitative trait loci in a Landrace pig population selected for growth and leanness.

The identification of QTL related to production traits that are relevant for the pig industry has been mostly performed by using divergent crosses. The main objective of the current study was to investigate whether these growth, fatness, and meat quality QTL, previously described in diverse experimental populations, were segregating in a Landrace commercial population selected for litter size, backfat thickness, and growth performance. We have found QTL for carcass weight (posterior P > 0.75), cutlet weight (posterior P > 0.99), weight of ham (posterior P > 0.75), shoulders weight (posterior probability > 0.99), and shear firm-ness (posterior P > 0.99) on pig Chromosome 2. Moreover, QTL with posterior P > 0.75 for fat thickness between the 3rd and 4th ribs (Chromosome 7), rib weights (Chromosome 8), backfat thickness (Chromosomes 8, 9, and 10), and b Minolta color component (Chromosome 7) were identified. These results indicate that commercial purebred populations retain a significant amount of genetic variation, even for traits that have been selected for many generations.

Identification of quantitative trait loci for production traits in commercial pig populations.

The aim of this study was to investigate methods for detecting QTL in outbred commercial pig populations. Several QTL for back fat and growth rate, previously detected in experimental resource populations, were examined for segregation in 10 different populations. Two hundred trait-by-population-by-chromosome tests were performed, resulting in 20 tests being significant at the 5% level. In addition, 53 QTL tests for 11 meat quality traits were declared significant, using a subset of the populations. These results show that a considerable amount of phenotypic variance observed in these populations can be explained by major alleles segregating at several of the loci described. Thus, despite a relatively strong selection pressure for growth and back fat traits in these populations, these alleles have not yet reached fixation. The approaches used here demonstrate that it is possible to verify segregation of QTL in commercial populations by limited genotyping of a selection of informative animals. Such verified QTL may be directly exploited in marker-assisted selection (MAS) programs in commercial populations and their molecular basis may be revealed by positional candidate cloning.

Reoperación coronaria por toracotomía izquierda sin circulación extracorpórea después de laringuectomía: seguimiento a nueve años / No disponible

La toracotomía izquierda es una vía de acceso alternativa en las reoperaciones coronarias en algunos enfermos en los cuales la reesternotomía puede ser peligrosa. Presentamos un enfermo en quien realizamos una reoperación coronaria sin circulación extracorpórea a través de una toracotomía izquierda para evitar una incisión quirúrgica en las proximidades de una traqueotomía permanente. Nueve años después el enfermo permanece asintomático. En casos seleccionados se pueden realizar reoperaciones coronarias sin circulación extracorpórea a través de una toracotomía izquierda con morbilidad y mortalidad bajas y con buenos resultados a largo plazo (AU)

The use of left thoracotomy is an alternative approach in redo coronary surgery in selected patients for whom median sternotomy is potentially hazardous. We present a patient in whom a redo reoperative coronary revascularization was performed off-pump via left thoracotomy to avoid a tracheal stoma. Nine years after reoperation the patient remains free of cardiac symptoms. In selected patients, redo coronary bypass grafting can be performed without cardiopulmonary bypass through a left thoracotomy, with a low perioperative morbidity and mortality rate and good long-term symptomatic improvement (AU)

Traumatismo craneo-encefálico en el servicio de emergencia del Hospital Abel Gilbert Ponton de Guayaquil

El presente es un estudio retrospectivo realizado mediante la revisión de casos que ingresaron al servicio de emergencia del Hospital Abel Gilbert Pontón, presentando algún tipo de traumatismo cráneo encefálico, durante los años comprendidos entre 1990 y 1995, un total de 435 pacientes; 276 (63.45 por ciento) correspondió al sexo femenino; 199 (36.55 por ciento)al sexo masculino; en relación con la edad, el grupo que mayor porcentaje de pacientes de TCE presentó fue el comprendido entre 0 y 10 años con 285 (21.15 por ciento). Entre las causas, los accidentes de tránsito originaron el 50 por ciento de los casos, seguidos de caídas y golpes fortuitos con el 32.8 por ciento, siendo el principal factor presdisponente el alcohol con el 10.2 por ciento. El dato clínico más frecuente fue el déficit de conciencia con el 93 por ciento, seguido de las cefaleas con el 6 por ciento los hematomas subdurales unilaterales tuvieron un 4.3 por ciento y como secuelas las neurósis con el 5.59 por ciento. El área donde mayor porcentaje se atendieron pacientes fue en cirugía con un porcentaje de 54.48 por ciento, luego fue el área de pediatría con 29.20 por ciento. El 1.15 por ciento de los pacientes fallecieron...

Use of biventricular circulatory support as bridge to simultaneous heart and kidney transplantation.

A 64-year-old man with dilated cardiomyopathy and chronic renal insufficiency (without dialysis) was admitted in cardiogenic shock urgently requiring a circulatory biventricular assist device (Thoratec). Twenty-nine days later we performed orthotopic cardiac and heterotopic renal transplantations with organs from the same donor. Postoperatively secondary renal insufficiency occurred due to rejection of the graft, bleeding ulcer with hypovolemic shock, and peritonitis due to Streptococcus faecalis and Candida. In the postoperative course only one rejection of the cardiac graft was detected. The patient was discharged after 4 months, resuming a normal life.

Gonadotropins and prolactin serum levels during the perimenopausal period: correlation with diverse factors.

We studied 490 women aged 35 to 55 years randomly selected from the urban population of León, México. The mean age for the onset of menopause, calculated with a probit regression was 48.5 years. The median of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) increased with the rate of menopause women, but the 10th percentile for both hormones did not increase above 15 IU/L in older groups. Meanwhile, prolactin did not change. In menopause women FSH correlated positively with cigarette smoking, and negatively with body mass index. Luteinizing hormone had negative correlation with the number of pregnancies. Most symptoms studied were not associated with menopause or gonadotropins levels, except hot flushes, and the empty nest syndrome. It was concluded that during menopause, FSH increases with the smoking habit, and decreases with overweight.

Uso de aines y analgésico antipirético en pacientes que acuden a Consulta Externa del Hospital Baca Ortíz 1996

El presente es un estudio para determinar si existe o no uso inadecuado de AINES y analgésicos antipiréticos en pacientes que acuden a consulta externa del hospital de niños Baca Ortíz, con patologías que pueden causar fiebre, dolor, inflamación. Se realizaron 500 encuestas en los meses comprendidos entre abril y mayo de 1996 en niños menores de 14 años; de los cuales 125 fueron menores de 1 año, 130 de 13 meses a 3 años, 98 de 4 a 6 años y 147 de 7 a 14 años. Se obtuvo los siguientes resultados: se utilizaron AINES y analgésicos antipiréticos en 54 casos (10.8 por ciento), de estos en 20 casos (38.5 por ciento) se prescribió más frecuentemente fue entre 1 a 7 años (38.9 por ciento), seguido de mayores de 7 a 14 años...