Tratamento estético da columela nasal: columela oculta e columela pendente / Aesthetic treatment of retracted and hanging nasal columellas

Os autores revelam, no presente trabalho, suas abordagens frente às alterações estéticas da columela nasal, mais observadas em sua prática clínica, a columela oculta e a columela pendente. Para a columela oculta os autores descrevem o uso de um retalho condro-mucopericondral do septo nasal como escolha preferencial. Para o tratamento da columela pendente os autores utilizam as abordagens, direta e indireta, descritas por Randall, nos casos leves a moderados, e para os casos mais acentuados utilizam uma associação de táticas além de uma modificação do que é descrito por Armstrong e Joseph. Suas opções de tratamento são confrontadas com o que há descrito na literatura da especialidade e seus resultados comparativos são apresentados.

This study discusses approaches for aesthetic correction of nasal columellas, i.e. retracted and hanging columellas, most commonly observed in clinical practice. We describe a chondral-mucoperichondrial nasal septal flap and direct or indirect approaches described by Randall as our preferred procedures to correct retracted and mild to moderate hanging columella, respectively. A combination of procedures is used in more severe cases, in addition to modified Armstrong and Joseph's approaches. These treatment options are compared to other literature reports on this specialty.

¿Hubo infectólogos en la Antigua Roma? / Were there infections diseases specialists in the Ancient Rome?

The existence of infectious diseases specialists in Ancient Rome is unlikely, but there were at least three authors able of keen observations on infectious matters, with enough merit to be considered our predecessors: Varro, Columella and Vitruvius, none of them physicians. Varro, in his first Book on Agriculture recommended, "Build the houses distant from swamps, because certain minute creatures are bred which cannot be followed with the eyes but which float in the air and enter the body through the mouth and nose, giving rise to severe diseases". Also in a text of agriculture and in the same sense, Columella says "that with heat a swamp releases a pestilential vapor and produces a very dense swarm of insects, which come flying over us armed with harmful stings Vitruvius, the great architect was worried about drinkable water: its sources and properties, how to obtain it and the methods for testing its quality. The concern on its distribution and disposal of sewage started on 614 B.C., little after the foundation of Rome, with the building of the first aqueduct, the Aqua Marcia. This aqueduct in Trajan's times (century II A.D.), reached a total of 443 km, with 49,500 meters of arcades, which were up to 32 meters high, plus 2.4 Km. of an underground net. This system released 947.200 m3 of water per day, two thirds of which were for public use and one third for private customers.

Si mal pudo haber infectólogos en la Antigua Roma, hubo al menos intelectuales capaces de agudas observaciones en materia de infecciones, con merecimientos suficientes para postularse como nuestros predecesores: Varrón, Columela y Vitruvio, ninguno de ellos médico. Varrón, en el primero de sus Libros de Agricultura, recomendaba ubicar la casa evitando los pantanos, porque allí crecen ciertos animales, tan diminutos que no se pueden seguir con los ojos y flotan en el aire y entran al cuerpo por la boca y la nariz causando graves enfermedades. También en un texto de agricultura y en el mismo sentido, Columela dice que una laguna desprende con los calores un vapor pestilencial y produce enjambres espesísimos de insectos, que vienen volando sobre nosotros armados de aguijones dañinos... Vitruvio, el gran arquitecto, se ocupó del agua potable: sus fuentes y sus cualidades, cómo obtenerla y los métodos para probar su calidad. Esta preocupación por la distribución de aguas y disposición de excretas había nacido en el 614 A.C., poco después de la fundación de Roma, con la construcción del primer acueducto, el Aqua Marcia, para alcanzar en tiempos de Trajano (siglo II D.C.) un total de 443 km, con 49.500 metros de arcadas de hasta 32 metros de altura, más 2,4 km de red subterránea. Éstos entregaban 947.200 m³ por día, de los cuales dos tercios eran para uso público y un tercio privado.