Proctocolitis From Coffee Enema.

Coffee enemas are often used by naturopathic practitioners to treat a number of diseases, including cancer. However, there is no supportive evidence, and its use comes with major risks. We report a case of proctocolitis in a healthy patient after coffee enema treatment. To our knowledge, only 3 other cases of this adverse effect exist in the literature.

[Giant cervical angioma caused by "malignant" arteriovenous fistulae]. / Angioma cervical gigante por fístulas arteriovenosas "malignas".

A case of angioma by malignant AV fistula (described by F. Martorell in 1970) is reported. Such kind of fistulas have usually a lethal course. The case reported underwent a surgical correction, and after a following of 10 years, no major complications have been reported.

Hypoxaemia after nebulised salbutamol in wheezy infants: the importance of aerosol acidity.

The effect of nebulised iso-osmolar, preservative free, but acidic salbutamol solution was studied in 34 acutely wheezing infants aged 1-17 months. Transcutaneous oxygen pressure (TcPO2) and oxygen saturation (SO2) fell significantly during the first five minutes after nebulisation with further deterioration at 15-20 minutes. Ten of these infants were followed up for another two hours and showed slight improvement. Even after the second hour TcPO2 had not reached baseline values. Three months later the response to salbutamol and a placebo of equal acidity (pH 3.9) was studied in 11 infants from the same group, now free of symptoms. Lung function tests were included and showed no significant changes in specific conductance and volume corrected maximum expiratory flows (Vmax at functional residual capacity/thoracic gas volume). However, hypoxaemia occurred after the acidic placebo with a significant drop of TcPO2 (mean 0.9 kPa); SO2 decreased similarly but this did not reach significance. After salbutamol there was a further significant deterioration of mean TcPO2 (1.4 kPa) and of SO2. These results show that beside a possible pharmacological effect of salbutamol the acidity of the aerosol also induces hypoxaemia in infants.

Dissection of the medial crura as a standard procedure in rhinoplasty: case studies.

In the systematic approach to rhinoplasty, the author routinely uses an intercartilaginous columellar incision for dissection and reconstruction of the nasal tip, especially to facilitate separation of the tip cartilages from other tissues in the lower third of the nose. This technique has been used by the author for more than ten years and its advantages are demonstrated.

The value of preoperative thermography in patients undergoing reduction mammaplasty and mastopexy.

The authors present telethermography as a complementary preoperative test. The procedure helps us choose the technique to be used, eliminating cases in which cutaneous glandular dissection is not advisable because of anomalous irrigation (deficient internal mammary artery). It also offers us a guide to the safe level of dissection and extirpation of the inferior internal sector of the breast, depending on the point of exit of the internal mammary vascular pedicles. Finally, it tells us which breast must be reconstructed first (the one with the least vascularization in its internal hemiglandula). Postoperative comparative telethermography may also be used to detect any pathological process that appears later.