ABSTRACT
Introducción y Objetivos. Los defectos craneales que llegan a nuestro hospital generalmente son secundarios a trauma o bien a su tratamiento neuroquirúrgico. La craneoplastia no suele ser inmediata, sin embargo el síndrome de trepanación o el deseo del paciente por mejorar su apariencia, son mandatorios para poder realizar la reconstrucción. El material ideal para una craneoplastia debe ser biocompatible, fácil de fabricar y biomecánicamente estable. En nuestro Servicio llevamos a cabo la reconstrucción craneal con una prótesis de metil-metacrilato diseñada mediante estereolitografía, cubierta completamente por un injerto de fascia lata. En nuestra experiencia esta nos brinda resultados predecibles, seguros y satisfactorios para los pacientes. Material y Método. Presentamos nuestra experiencia inicial en el uso de esta técnica a través de un análisis retrospectivo sobre 32 pacientes operados por un equipo multidisciplinario entre enero de 1996 y junio de 2014 en el Hospital General de México Dr. Eduardo Liceaga. Resultados. No tuvimos complicaciones importantes relacionadas con infección, hematoma o seroma. Los resultados estéticos obtenidos fueron de aceptables a buenos. Conclusiones. En esta serie de pacientes usando la técnica descrita, recogimos una tasa de complicaciones muy baja y un excelente grado de satisfacción de los pacientes en el seguimiento a largo plazo (AU)
Background and Objective. The skull defects in our center result from descompressive craniectomy after trauma, bony involvement by tumors or infarction, and the cranioplasty will be mandatory if the patient have the syndrome of the trephined or wish to improve their appearance. The ideal material for cranioplasty there will be biocompatible, simple to manufacture, and biomechanically reliable, at least. In our Department, the skull reconstruction is performed with methylmethacrylate prosthesis, designed by stereolithography, and then covered with an onlay fascia lata tendon graft. In our experience this kind of skull reconstruction has been demonstrated secure, predictable and satisfactory results. Methods. We report our initial experience using this technique with a retrospective analysis of 32 patients operated from January 1996 to June 2014 by a multidisciplinary team in the General Hospital of Mexico Dr. Eduardo Liceaga. Results. There were no significant complications related to infection, hematoma or seroma. The aesthetic results have been considered acceptable, to excellent. Conclusions. In our patient series using this technique we collected an extremely low complication rate and an excellent grade of patient satisfaction on long-term follow up (AU)
Subject(s)
Humans , Plastic Surgery Procedures/methods , Skull/surgery , Methylmethacrylate/therapeutic use , Prosthesis Implantation/methods , Skull/injuries , Bone Substitutes/analysis , Fascia Lata/transplantation , Surgical FlapsABSTRACT
BACKGROUND: In recent years, advances in molecular biology have resulted in innovations in breast cancer diagnostics and therapeutics. The development of genomics has revolutionized our understanding of this disease. MammaPrint® was developed as a diagnostic tool to predict risk of breast cancer recurrence using the expression of 70 genes altering the clinicopathologic paradigm of selection of patients for adjuvant cytotoxic chemotherapy. MATERIALS AND METHODS: A study of stage i-ii breast cancer patients on whom the MammaPrint® genomic assay was performed. RESULTS: The use of the MammaPrint® assay was a decisive factor for the recommendation of adjuvant treatment with chemotherapy and/or hormone therapy in patients with high risk for relapse. In our group, the patients with low-risk have not presented local or systemic recurrences DISCUSSION: The determination of the genetic characteristics and its alterations in breast cancer, is fundamentally important for a better identification of risk, as well as a better selection of cancer therapy. CONCLUSION: MammaPrint® is an effective study to determine risk of recurrence of in early stage breast cancer.
Subject(s)
Breast Neoplasms/genetics , Genetic Testing , Adult , Aged , Female , Genomics , Humans , Longitudinal Studies , Middle Aged , Prospective StudiesABSTRACT
El pie es una parte sumamente importante en la función humana ya que es responsable de la sustentación y deambulación. Su adecuada función depende de distintas estructuras que pueden verse afectadas por infección, trauma o enfermedad vascular periférica, entre otras. Ante una lesión en el pie la meta óptima es la reconstrucción con preservación de la función. Se menciona ampliamente en la literatura el uso de colgajos libres para la reconstrucción de defectos del tercio distal del miembro pélvico; sin embargo, su uso implica recursos humanos entrenados, equipamiento hospitalario especial y tiempos quirúrgicos prolongados. Consideramos que se debe tener en cuenta el uso de colgajos locales de acuerdo al concepto de la escalera reconstructiva. Es por esto que presentamos un caso de reconstrucción de defecto en la superficie inframaleolar lateral del pie por medio de un colgajo muscular pediculado de abductor digiti minimi con aceptable resultado estético y funcional (AU)
The foot is an extremely important part in human function as it is responsible for suport and walking. Its proper function depends on various structures that may be affected by infection, trauma or peripheral vascular disease among others. Faced with a foot injury, optimal goal is the reconstruction with preservation of function. The use of free flaps for reconstruction of defects of the distal lower limb is widely mentioned in the literature; however, the use of these techniques involves trained human resources, special hospital equipment and prolonged surgical time. We consider that the use of local flaps should be taken into account according to the concept of reconstructive ladder. This is why we present a case of reconstruction of a defect in the lateral surface in the inframaleolar area by means of the pedicled muscle flap abductor digiti minimi with acceptable functional and aesthetic result (AU)
