Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Introduction: Compensatory sweating is a side effect of videothoracoscopic sympathectomy. It presents high incidence and may cause dissatisfaction to operated patients.Objective: To determine the characteristics of compensatory sweating in patients who underwent videothoracoscopic sympathectomy for palmar hyperhidrosis.Methods: A retrospective, cross-sectional and descriptive study was carried out with 42 patients who presented compensatory sweating after surgery for palmar hyperhidrosis. Incidence, location, severity, change in quality of life and level of satisfaction were analyzed.Results: Light compensatory sweating predominated, with location on back and abdomen. There was a high level of tolerance, with only one dissatisfied patient and 100% of improvement in quality of life.Conclusions: Compensatory sweating did not influence negatively the patients' quality of life

Introduction: Lipomas are the most numerous soft tissue tumors. We present a case of Hoffman-Zurhelle disease associated with giant lipoma in the thoracodorsal region and lipomatosis treated surgically in conjunction with the plastic surgery and general surgery specialties of the Ameijeiras Hospital.Objective: To show the results of surgical treatment of excision of a giant tumor of the back.Clinical case: A 34-year-old male patient underwent dissection of the dermographic flap in cephalic direction up to the paravertebral line and neck under general anesthesia. One centimeter thickness was respected, approaching at the level of the trapezius and latissimus dorsi muscle interface. The lipoma capsule was identified and became independent of the muscle fibers and the deep plane until it was excised, as well as the excess skin with superficial cutaneous lipomatous nevus. Closure by planes without tension.Conclusions: Resection of a giant fibrolipoma on the back was achieved with careful planning that respected the vascular supply of the flaps, the skin coverage without tension and preserved muscle function in the absence of complications.

Introduction: Adenoid cystic carcinoma is an uncommon and often aggressive malignant neoplasm that can arise in a variety of gland-bearing organs.Objective: To characterize the presentation of an uncommon aggressive malignancy, adenoid cystic carcinoma.Clinical case: 56-year-old patient who presented to the on-call department with a lesion on the scalp corresponding to malignant cylindroma. She was subsequently studied and lesions were also found in the breast, colon and recurrence in the scalp, which resulted in adenoid cystic carcinoma.Conclusions: It is infrequent; making its diagnosis involves a high index of suspicion and its diagnosis is histopathological. Its prognosis depends on the primary location and it tends to be very aggressive when located outside the breast.

Introduction: Surgical (or operative) site infections are a serious health problem, a reason why their prevention and treatment represent a challenge for hospital institutions.Objective: To describe the characteristics of postoperative infections according to the main causes related to their occurrence.Methods: A descriptive and observational study was carried out with 207 patients admitted and operated on in major surgeries who presented postoperative infections in the general surgery service of Saturnino Lora Provincial Teaching Hospital of Santiago de Cuba, during 2018-2020.Results: The overall rate of postoperative infections was 4.18 %. Superficial incisional infections, followed by deep incisional infections, were the most frequent. The number of infected patients was tripled in those operated on urgently compared to electively, with a predominance of appendectomized patients. Surgical time and average hospital stay were higher in infected patients. 12 members of the casuistics have passed, attributable to generalized infection and septic shock.Conclusions: The occurrence of postoperative infections is related to factors depending on the patient; on the surgery itself, such as the qualification of the surgeon; as well as on the presence of preoperative and intraoperative risk factors. Superficial incisional infection is the most frequent, while most of the patients who die correspond to those with infection of organs and spaces.

Introduction: Cervical esophageal perforations for external trauma are rare injuries associated with a significant morbidity. The primary mechanisms are penetrating trauma for gunshot wounds, accounting for about 80 % of cases, followed by sharp weapon injuries, accounting for 15 % to 20 %.Objective: To describe the current criteria on the behavior and therapeutic approach to cervical esophageal penetrating trauma.Methods: A descriptive narrative review was carried out of primary and secondary sources that addressed the subject during the first semester of the year 2021. The selection criteria of the articles to be examined were determined, among others, by the objective of the current review.Development: The standard diagnosis for these lesions, in the absence of hemodynamic instability, was based on studies such as esophagogram, endoscopy and tomography. Primary repair with or without reinforcement was the most commonly used option, although local conditions and type of lesion in cervical esophagus largely mark the procedure to be performed.Conclusions: Traumatic cervical esophageal injuries are rare but very morbid. Their treatment depends on the location of the perforation and any concurrent injury. Most cases are amenable to primary repair with flap reinforcement. Other principles of treatment include adequate drainage around the repair, decompression of the esophagus and stomach (by nasogastric tube or gastrostomy tube), as well as distal enteral nutrition (feeding jejunostomy). The surgeon must be incisive in efforts to discover the injury early and manage it appropriately.

Introduction: Nasal deformity associated with cleft lip has been seen as one of the most challenging reconstructive problems in rhinoplasty; up to date, no single method has been agreed upon to quantify management success. In 2006, the protocol for managing complex nasal deformities was officially approved by Hermanos Ameijeiras Clinical Surgical Hospital, which includes secondary congenital nasal deformities in adults; however, there is no history of outcomes in this group of patients based on objective measurements.Objective: To assess the aesthetic outcomes of secondary rhinoplasty in patients with cleft lip and palate.Methods: An analytical study was carried out through linear and angular nasal measurements, compared in standardized photographs between the pre- and postoperative period; while the asymmetry index was determined according to Nakamura's formula. A panel of experts used the Asher McDade scale and performed the subjective assessment of the images, which allowed calculation of the esthetic index before and after the procedure.Results: A marked reduction was obtained in all nasal asymmetry indexes between the pre- and postoperative periods; as well as an improvement in the postoperative aesthetic index, from a poor appearance to a very good appearance.Conclusions: With the application of the protocol for managing nasal deformities of the adult cleft patient of Hermanos Ameijeiras Clinical Surgical Hospital, good esthetic outcomes are obtained

Introduction: In the modern concept of facial rejuvenation, the main thing is to achieve a natural result without surgical marks. The endoscopic fronto-temporo-orbital lifting is currently the best method to achieve this.Objective: To determine the effectiveness of the endoscopic frontoplasty technique for the treatment of facial aging.Methods: A descriptive observational study of a series of 28 cases with a diagnosis of facial aging treated at the National Center for Minimal Access Surgery in the period from January 2014 to January 2017 was carried out. The variables of: sex, age, marital status, schooling, race, surgical time and intraoperative complications.Results: The mean age was 54.4 (40-73) years. The female sex prevailed (89.3%). The average level of schooling 61.5%, married marital status 52.0%. Ptosis of the eyebrows with the presence of frontal and glabellar wrinkles was the most frequent diagnosis 13; 46.4%. The mean surgical time was 80.9 (40-120) minutes. There were no intraoperative complications, conversions, or reinterventions. In 27 patients (96.4%) there was permanence of the results over time. Complications occurred in 4 patients (14.3%). There were 19 patients treated as outpatients (67.9%), with a hospital stay of one day (32.1%). All showed satisfaction with the results obtained.Conclusions: Endoscopic foreheadoplasty is a minimally invasive and very effective method for repositioning lowered eyebrows, as well as treating frontal and glabellar wrinkles.Keywords: endoscopic frontoplasty; facial rejuvenation; facial aging; lifting fronto-temporo-orbital endoscope; endoscopic surgery.

Introducción: La enfermedad periodontal comprende un conjunto de trastornos asociados a la inflamación y a la pérdida de estructuras del soporte dental de origen infeccioso multifactorial. La investigación científica expone un abanico de cepas bacterianas probióticas en el tratamiento periodontal, con propiedades en la inhibición del crecimiento de periodontopatógenos, y mejoras significativas en los parámetros clínicos, cuando se combina con el tratamiento periodontal mecánico.Objetivo: Describir el efecto de la terapia combinada entre el tratamiento periodontal mecánico tradicional y un gel probiótico multicepa, aplicado a un caso de periodontitis.Presentación de caso: Paciente femenino de 53 años de edad, procedente de la comunidad de El Portachuelo, zona rural aledaña a la ciudad de Mérida. Presentó agrandamiento gingival, enrojecimiento y dolor espontáneo en la encía palatina, con concomitantes de sangrado y exudado purulento desde hace seis meses. La realización de un examen clínico periodontal, análisis radiográfico y análisis microbiológico permitieron diagnosticar periodontitis estadio IV grado B. Se aplicó tratamiento periodontal convencional no quirúrgico en combinación con cepas probióticas de Lactobacillus rhamnosus, L acidophilus y L. plantarum, en presentación de un gel adhesivo para la aplicación supra y subgingival y en suspensión vía oral para obtener un efecto sistémico durante 45 días. Los resultados obtenidos fueron favorables con mejoramiento de los parámetros clínicos como índice de sangrado periodontal y profundidad de los sacos periodontales.Conclusiones: En concordancia con diversos estudios, se ha demostrado que la terapia probiótica puede ser usada como tratamiento coadyuvante en casos de periodontitis. Se observa una franca y rápida mejoría al utilizar terapias multicepas.

Introduction: Gingival recession is a very common gum condition which may result in aesthetic alterations and dentin hypersensitivity, and increase the probability of cervical lesions. It is necessary to cover the root surface using periodontal regeneration techniques.Objective: Compare the amount of root coverage, probing depth and clinical insertion level, using coronally repositioned flap techniques with and without connective tissue graft in patients with Miller I and II gingival recessions.Methods: A total 16 patients with Miller class I and II gingival recessions were included in the study, from whom 50 teeth were selected which had been treated surgically to cover the recessions. The techniques used were coronally repositioned flap with and without connective tissue graft. Clinical measurements were compared at the start of the postoperative period and three months later.Results: Three months after surgery, root coverage, probing depth and clinical insertion level were 0.96 ± 1.33; 0.87 ± 0.63; 1.83 ± 1.7, respectively, for coronally repositioned flap with connective tissue graft, and 1.44 ± 1.19; 1.04 ± 0.52; 2.48 ± 1.48, respectively, for coronally repositioned flap. Root coverage intergroup comparison did not find any significant differences (p = 0.11). However, intergroup comparison of probing depth (p = 0.04) and clinical insertion level (p = 0.001), and all the intragroup clinical measurements (p = 0.001) did find significant differences.Conclusions: Coronally repositioned flap technique with and without connective tissue graft showed significant differences in terms of probing depth and clinical insertion level in Miller I and II gingival recessions. At three months' follow-up, no root coverage significant differences were observed for either technique.

Introduction: With the increase in infectious diseases during health care, the application of biosecurity standards is essential to avoid cross-contamination. Students in Professional Specialization programs must adhere to a set of standards called standard precautions during patient care.Objective: Determine the degree of application of standard precautions by students of a specialization program during patient care.Materials and methods: A descriptive observational study was conducted. The sample size was 15 students from the Professional Specialization Program in Endodontics of the Faculty of Dentistry of the University of Chile, divided into two groups, day (8-17 h) and evening (18-22 h), who signed an informed consent to participate. They were evaluated in 4 dimensions: “hand washing”, “protective barriers” (gloves, mask, hat, protective lenses, breastplate), “risks control of sharp accidents and splashes”, and “handling of materials and surfaces”. A 60% was established to determine minimum compliance with the standard by comparing both groups.Results: In handwashing, both groups did not reach the minimum compliance with the standard, with an average of 12%. For “protective barriers” both groups achieved minimum compliance, with an average of 63%. In "risk control of sharp accidents and splashes" and "surface handling", none of the groups reached the minimum compliance in these dimensions, with a compliance percentage of 50% and 43% respectively.Conclusions: Most students in the Professional Specialization Program in Endodontics do not correctly apply all standard precautions during care. It is necessary to reinforce in the students the contents related to biosecurity and to increase the supervision and demand in its fulfillment by the teachers.