Successful treatment of pyoderma gangrenosum after reducing mammoplasty: a case report

Introduction: Pyoderma gangrenosum is a rare inflammatory disease characterized by the presence of ulcerated lesions. The etiology is unknown but apparently relates to immunological factors. The authors report a case of pyoderma gangrenosum in the postoperative period of a reduction mammoplasty, treatment, and the importance of early diagnosis to obtain a good aesthetic result. Methods: This is an 18-year-old patient who developed pyoderma gangrenosum after a reduction mammoplasty. The initial symptoms were the formation of violet blisters and ulcerated lesions in both breasts. The disease was suspected, and the patient was promptly treated with prednisolone. Cultures, biopsies and blood tests were performed. Hyperbaric therapy and nutritional support were performed. Daily dressings with epidermal growth factors were performed. After 60 days of follow-up, it was possible to achieve adequate wound healing and good aesthetic results. Results: Early diagnosis associated with systemic immunosuppressive therapy and rigorous local care were fundamental for disease stabilization. The association with hyperbaric therapy and nutritional support contributed to the lesion's epithelialization and the clinical picture control. The approximation of the wound edges with subdermal suture and the subsequent intradermal suture was possible due to the recovery of the dermis and stabilization of the disease. Conclusion: Early diagnosis of pyoderma gangrenosum is essential to achieve stabilization of the disease. It is possible to achieve good aesthetic results based on four elements: early systemic corticosteroids, daily local dressings with epidermal growth factor, nutritional support, and hyperbaric therapy

Reverse frontal lifting: alternative for the treatment of pachydermoperiostosis

Introduction: Patient diagnosed with pachydermoperiostosis, presenting a strong cutaneous manifestation, making it impossible to correct the defect by the usual facial lifting techniques. The reverse frontal facelift was the idealized technique for this case. It is an innovative technique, there being no previous publication in the literature. Case report: Italian male patient, 56 years old, with cutaneous manifestation syndrome, especially in the frontal region of the face, with leathery inelastic skin, which generated aesthetic discomfort, predisposing for a syndromic stigma. Methods: The technique developed for this case involves an incision, which starts at the root of the helix (point A), bypasses the eyebrow in a sinuous line distant half a centimeter from the implantation of the eyebrow hair, going to the glabella, curving towards the nasal root and going to meet identical dimensions on the other side. From point A, a curved line also leans towards the medial direction, at a distance of 2 cm. The intention is to reduce the distance between the area to be pulled and the incision area, in order to obtain more traction, thus enabling the correction of the aspect of the face in focus. Results: Caudal traction of the flap by a supraciliary incision made it possible to correct the defect in the frontal region without altering the capillary implantation line or causing excessive eyebrow rise. Conclusion: The reverse frontal lifting technique was created for a specific case of pachydermoperiostosis syndrome. When correctly indicated, this technique can be used to achieve good results

Loxoscelism : case report and literature review

La picadura de la araña del género Loxosceles produce dermonecrosis en el sitio de la lesión y complicaciones sistémicas secundarias a reacciones enzimáticas de su veneno, lo que aumenta la tasa de mortalidad. El objetivo es reportar un caso de loxoscelismo en Bogotá a 2600 msnm, donde el paciente tuvo una evolución satisfactoria a pesar de la inexistencia del antiveneno como manejo ideal de la toxicidad.The bite of Loxosceles spiders is characterized by dermonecrosis and systemic illness due to the presence of some key enzymes in their venom that increase mortality. The aim of this study is to describe a case of loxoscelism at Bogota D. C. which is 2600 masl. The clinical recovery was satisfactory despite the unavailability of antivenom which should be the best treatment.Revista Nacional - Indexad

Validación de un instrumento para medir el nivel de satisfacción de mujeres embarazadas durante el parto

Objetivos: Evaluar la validez y fabilidad de un instrumento adaptado a partir de la escala SERVPERF para medir el nivel de satisfacción en gestantes durante el parto en una Institución de Salud en Lima, Perú. Métodos: Estudio transversal, descriptivo con componentes analíticos de validación del cuestionario SERVPERF adaptado para mujeres gestantes peruanas (GP) durante el parto. Se realizó una prueba piloto con posterior análisis de propiedades psicométricas de validez y fabilidad mediante análisis factorial exploratorio de componentes principales y cálculo de alfa de Cronbach. Resultados: Se reporta una muestra de 345 mujeres, atendidas en la Clínica Good Hope, en el período de febrero a abril del año 2016. La prueba de adecuación de Kaiser-Meyer Olkin fue de 0.919 y la prueba de esfericidad de Barlett de 4008.9 (p<0.000). La varianza acumulada explicada por los 5 factores fue de 65.039%,. La fabilidad mostró un alfa de Cronbach de 0.92. Se clasifcaron 5 factores con 22 items, redefniendose un factor como “calidad clinica”. Conclusión: El instrumento adaptado y validado SERVPERF-GP posee sufcientes propiedades psicométricas para ser considerado una herramienta útil y fable para medir la satisfacción de gestantes durante su experiencia de parto en instituciones privadas de salud y con potencial aplicación a gestantes en los diversos sectores de salud del Perú.   DOI:https://doi.org/10.25176/RFMH.v16.n3.65

Degradation of an Antibiotic from the Fluoroquinolone Group with a New Graphitic Carbon Nitride Photocatalyst

Ofloxacin (OFL), a fluoroquinolone, is an antibiotic found in hospital wastewater, groundwater, and other water bodies. Its occurrence in water results in several environmental problems, such as the emergence of antibiotic-resistant bacteria. This research is focused on determining the viability of removing and mineralizing OFL by photocatalysis under visible radiation with a graphitic carbon nitride photocatalyst (GCNP) synthesized from the pyrolysis of urea and calcium oxalate at 600°C. The photocatalyst was characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Moreover, the point of zero charge (PZC) of the photocatalyst was determined, and the adsorption isotherms were obtained. The photocatalytic activity of this new material was tested with a synthetic aqueous solution of OFL (20 mg/L) exposed to visible radiation. Three pH values (5, 7, and 10) and three doses of H2O2 (41.7, 83.3, and 333.2 mg/L) were considered. The achieved mineralization was evaluated through the decrease in the content of total organic carbon (TOC). The highest degradation of OFL was 23.9% after 40 min, with an initial concentration of H2O2 of 83.3 mg/L and a pH value of 10. It was confirmed that the reaction follows a kinetics of pseudo-first order.Ofloxacin (OFL), a fluoroquinolone, is an antibiotic found in hospital wastewater, groundwater, and other water bodies. Its occurrence in water results in several environmental problems, such as the emergence of antibiotic-resistant bacteria. This research is focused on determining the viability of removing and mineralizing OFL by photocatalysis under visible radiation with a graphitic carbon nitride photocatalyst (GCNP) synthesized from the pyrolysis of urea and calcium oxalate at 600°C. The photocatalyst was characterized by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Moreover, the point of zero charge (PZC) of the photocatalyst was determined, and the adsorption isotherms were obtained. The photocatalytic activity of this new material was tested with a synthetic aqueous solution of OFL (20 mg/L) exposed to visible radiation. Three pH values (5, 7, and 10) and three doses of H2O2 (41.7, 83.3, and 333.2 mg/L) were considered. The achieved mineralization was evaluated through the decrease in the content of total organic carbon (TOC). The highest degradation of OFL was 23.9% after 40 min, with an initial concentration of H2O2 of 83.3 mg/L and a pH value of 10. It was confirmed that the reaction follows a kinetics of pseudo-first order

Guías colombianas de electrofisiología no invasiva

Los métodos diagnósticos no invasivos son el pilar inicial del estudio de cualquier paciente con una patología en particular, de ahí que sean los exámenes más solicitados y constituyan una importante carga en costos para un sistema de salud.Q4Guías1-12

1er. Coloquio de educación para el diseño en la sociedad 5.0

Las memorias del 1er. Coloquio de Educación para el Diseño en la Sociedad 5.0 debenser entendidas como un esfuerzo colectivo de la comunidad de académicos de la División de Ciencias y Artes para el Diseño, que pone de manifiesto los retos y oportunidades que enfrenta la educación en diseño en un contexto de cambio acelerado y rompimiento de paradigmas.El evento se realizó el pasado mes de mayo de 2018 y se recibieron más de 50 ponencias por parte de las profesoras y profesores de la División.Las experiencias y/o propuestas innovadoras en cuanto a procesos de enseñanza y aprendizaje que presentan los autores en cada uno de sus textos son una invitación a reflexionar sobre nuestra situación actual en la materia, y emprender acciones en la División para continuar brindando una educación de calidad en diseño a nuestras alumnas, alumnos y la sociedad.Adicionalmente, se organizaron tres conferencias magistrales sobre la situación actual de la educación en Diseño y de las Instituciones de Educación Superior, impartidas por el Mtro. Luis Sarale, profesor de la Universidad Nacional de Cuyo en Mendoza (Argentina), y Presidente en su momento, de la Red de Carreras de Diseño en Universidades Públicas Latinoamericanas (DISUR), el Dr. Romualdo López Zárate, Rector de la Unidad Azcapotzalco, así como del Mtro. Luis Antonio Rivera Díaz, Jefe de Departamento de Teoría y Procesos del Diseño de la División de la Ciencias de la Comunicación y Diseño, en la Unidad Cuajimalpa de nuestra institución.La publicación de estas memorias son un esfuerzo divisional, organizado desde la Coordinación de Docencia Divisional y la Coordinación de Tecnologías del Aprendizaje, del Conocimiento y la Comunicación, para contribuir a los objetivos planteados en el documento ACCIONES:Agenda CyAD2021, en particular al eje de Innovación Educativa. Es necesario impulsar a todos los niveles de la División espacios de discusión orientados a reflexionar sobre el presente y futuro en la educación del diseñador, que contribuya a mejorar la calidad de la docencia y favorezca al fortalecimiento de los procesos de enseñanza y aprendizaje.Finalmente, extiendo un amplio reconocimiento a todos los miembros de la División que hicieron posible este evento, así como a todos los ponentes y participantes por compartir su conocimiento para que la División sea cada día mejor

Guía Mexicana para el Diagnóstico y el Tratamiento de la Urticaria

La urticaria es una enfermedad que padece una quinta parte de la población en algún momento de su vida. Las guías inter- nacionales recientes han propuesto unos cambios de fondo en su diagnóstico y tratamiento, por lo que había la necesidad de crear una guía nacional y multidisciplinaria, con base amplia en los gremios de especialistas y médicos de primer contacto en México. ABSTRACT Urticaria is a disease that a fifth of the population shall suffer once in a lifetime. Recent clinical guidelines have proposed some fundamental changes in the diagnosis and treatment of urticaria, making the development of a national, multidisciplinary guideline, with wide acceptability among different professional groups –both specialists and primary health care workers–, necessary in Mexico

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years