Leisure-time physical activity and all-cause mortality and cardiovascular disease in adults with type 2 diabetes:Cross-country comparison of cohort studies

Purpose:This study aimed to quantify the dose-response association and the minimal effective dose of leisure-time physical activity(PA)to prevent mortality and cardiovascular disease in adults with type 2 diabetes.Methods:Cross-country comparison of 2 prospective cohort studies including 14,913 and 17,457 population-based adults with type 2 diabetes from the UK and China.Baseline leisure-time PA was self-reported and categorized by metabolic equivalent hours per week(MET-h/week)according to World Health Organization recommendations:none,below recommendation(>0-7.49 MET-h/week);at recommended level(7.5-14.9 MET-h/week);above recommendation(>15 MET-h/week).Mortality and cardiovascular disease data were obtained from national registries.Results:During a median follow-up of 12.4 and 9.7 years,in the UK and China cohorts,repectively,higher levels of leisure-time PA were inversely associated with all-cause(1571 and 2351 events)and cardiovascular mortality(392 and 1060 events),mostly consistent with a linear dose-response relationship.PA below,at,and above recommendations,compared with no activity,yielded all-cause mortality hazard ratios of0.94(95%confidence interval(95%CI):0.79-1.12),0.90(95%CI:0.74-1.10),and 0.85(95%CI:0.70-1.02)in British adults and 0.87(95%CI:0.68-1.10),0.88(95%CI:0.74-1.03),and 0.77(95%CI:0.70-0.85)in Chinese adults.Associations with cardiovascular mortality were more pronounced in British adults(0.80(95%CI:0.58-1.11),0.75(95%CI:0.52-1.09),and 0.69(95%CI:0.48-0.97))but less pronounced in Chinese adults(1.06(95%CI:0.76-1.47),1.01(95%CI:0.80-1.28),and 0.79(95%CI:0.69-0.92)).PA at recommended levels was not associated with lower rates of major adverse cardiovascular events(2345 and 4458 events).Conclusion:Leisure-time PA at the recommended levels was not convincingly associated with lower mortality and had no association with risk of major adverse cardiovascular events in British or Chinese adults with type 2 diabetes.Leisure-time PA above current recommendations may be needed to prevent cardiovascular disease and premature mortality in adults with type 2 diabetes.

Management of Complex Wounds with Dermal Substitute Assisted by a Negative Pressure System

Introduction: The standard treatment for complex wound care is autografting. The advent of dermal substitutes has provided a novel tool for the preparation of the bed to be grafted. However, most types of dermal matrices require the application of a skin graft a second time. Currently, other strategies have been developed to improve the vascularization process, such as negative pressure wound therapy (NPWT), which has been reported to reduce the time required for vascular growth and dermal matrix integration and thus achieve a shorter waiting period for autologous graft application. The present study aims to evaluate the effectiveness and safety of dermal matrix management associated with NPWT in the treatment of complex wounds. Methods: Seven patients with a diagnosis of complex wounds were enrolled in this study between July 1, 2015, and June 31, 2016. After debridement and having an adequate wound bed, patients who met the criteria for the application of combined therapy were treated with dermal substitutes and a negative pressure system. The percentage of graft integration into the wound bed, complications, length of hospital stay, and duration of therapy were analyzed. Results: The mean age was 42.5 ± 16 (39 - 54) years old;three women and four men were included in the study. The approximate size of skin loss was 120.7 ± 75 cm2 (25 - 250 cm2). The combined therapy of dermal matrix plus NPWT was instituted in all cases for a period of 14 days. There were no complications, with 100% graft integration in 6 of 7 cases. Patients were discharged after a mean hospital stay of 5.4 days. Conclusions: This study demonstrates that the utilization of combined dermal matrix plus NPWT therapy can be performed safely and effectively in patients with complex wounds with low complication rates and a short hospital stay.

Anthropometric Breast Measurements: Analysis of the Average Breast in the Mexican Female Population

Introduction: The elements and perception of beauty vary between populations around the world. To obtain better results, surgical techniques should be planned based on anthropometric characteristics of the race, location, and body mass index (BMI). Objectives: To determine which are the standard measurements and anatomical proportions of the breast in a healthy Mexican women population. Materials and Methods: Female Mexican volunteers between 20 and 60 years of age, without any history of breast illness or breast surgery were studied. Demographic information and standard breast anthropometric measurements were collected manually by one of the authors. For the statistical analysis a Student-T test was performed, and the Pearson correlation coefficient was obtained using the latest version of SPSS software. Results: 78 volunteers were included in the analysis. Mean height, weight and BMI were 1.6 m, 68.9 Kg, and 26.6 Kg/m2 respectively. The mean anthropometric values found were: Supra Sternal notch to nipple distance (SSN:N) 22 cm, Breast volume (BV) 372.6 cm3, Upper breast pole length (UBPL) 11 cm, Lower Breast Pole length (LBPL) 7.7 cm, Midline to Nipple distance (ML:N) 10.2 cm, Transverse diameter of the Nipple areola complex (NAC-T) 4.1 cm, Height of the Nipple Areola Complex (NAC-H) 4.1 cm, Base of the breast (BB) 13.4 cm, Upper Pole to Lower Pole Ratio (UPP:LPP) 58.9:41.1. A statistically significant difference between Right and left breast was not found. The UPP/ LPP ratio in our population is far different from what is considered internationally aesthetic (45:55). A positive correlation was found between weight/ BMI and SSN:N, BV, BB, ML:N and LBPL. Also between age and SSN:N, LBPL, BV and BB. Conclusion: This study sets the Anthropometric grounds in Mexican population for an objective individual patient analysis and comparison with the female population of this and other nations.

Endoluminal solutions to bariatric surgery complications:A review with a focus on technical aspects and results

Obesity is a growing problem in developed countries,and surgery is the most effective treatment in terms of weight loss and improving medical comorbidity in a high proportion of obese patients.Despite the advances in surgical techniques,some patients still develop acute and late postoperative complications,and an endoscopic evaluation is often required for diagnosis.Moreover,the high morbidity related to surgical reintervention,the important enhancement of endoscopic procedures and technological innovations introduced in endoscopic equipment have made the endoscopic approach a minimally-invasive alternative to surgery,and,in many cases,a suitable first-line treatment of bariatric surgery complications.There is now evidence in the literature supporting endoscopic management for some of these complications,such as gastrointestinal bleeding,stomal and marginal ulcers,stomal stenosis,leaks and fistulas or pancreatobiliary disorders.However,endoscopic treatment in this setting is not standardized,and there is no consensus on its optimal timing.In this article,we aim to analyze the secondary complications of the most expanded techniques of bariatric surgery with special emphasis on those where more solid evidence exists in favor of the endoscopic treatment.Based on a thorough review of the literature,we evaluated the performance and safety of different endoscopic options for every type of complication,highlighting the most recent innovations and including comparative data with surgical alternatives whenever feasible.

Utility of central venous pressure measurement in renal transplantation: Is it evidence based?

Adequate intravenous fluid therapy is essential in renal transplant recipients to ensure a good allograft perfusion. Central venous pressure(CVP) has been cons-idered the corners-tone to guide the fluid therapy for decades; it was the only available simple tool worldwide. However, the revolutionary advances in assessing the dynamic preload variables together with the availability of new equipment to precisely measure the effect of intravenous fluids on the cardiac output had created a question mark on the future role of CVP. Des-pite the critical role of fluid therapy in the field of tra-nsplantation. There are only a few clinical studies that compared the CVP guided fluid therapy with the other modern techniques and their relation to the outcome in renal transplantation. Our work sheds some light on the available published data in renal transplantation, together with data from other disciplines evaluating the utility of central venous pressure measurement. Although lager well-designed studies are still required to consolidate the role of new techniques in the field of renal transplantation, we can confidently declare that the new techniques have the advantages of providing more accurate haemodynamic assessment, which results in a better patient outcome.

Innovative surgical approaches for hepatocellular carcinoma

Hepatocellular carcinoma(HCC)is the sixth most common cancer worldwide,with an increasing diffusion in Europe and the United States.The management of such a cancer is continuously progressing and the objective of this paper is to evaluate innovation in the surgical treatment of HCC.In this review,we will analyze the modern concept of preoperative management,the role of laparoscopic and robotic surgery,the intraoperative use of three dimensional models and augmented reality,as well as the potential application of fluorescence.

A New Method for Measurement of Helium Mass Flow Rate in the Cryogenic System of TORE SUPRA

The TORE SUPRA Tokamak was built by EURATOM-CEA association. The NbTi conductor of superconducting coils is inserted in a tight enclosure filled with pressurized superfluid helium of 0.125 MPa at 1.8 K. The thick casing is cooled to 4.5 K by 1.8 MPa in 4.5 K supercritical helium circulation. Around this thick casing, a 80 K thermal shield protects the parts at very low temperatures from the thermal radiation, which is cooled by pressurized helium at 80 K and 1.8 MPa. A new measurement method for helium mass flow rate of 80 K shield and 4.5 K casing is described in this paper. The commissioning was done on the two helium loops of the cryoplant: the supercritical 4.5 K thick casing and 80 K shields. The purpose is to improve control of the 4.5 K and 80 K refrigeration loops.

Survival effect of probiotics in a rat model of colorectal cancer treated with capecitabine

BACKGROUND Probiotics are used to manage a number of gastrointestinal disorders due to their beneficial properties.Clinical reports showed that probiotics also improve the life quality of patients with colorectal cancer(CRC)subjected to oncologic treatment.In a CRC animal model,probiotics supplementation has the potential to decrease the formation of aberrant crypts and ameliorate tumor malignancy,enhancing the antitumor effect of 5-fluorouracil(5-FU)chemotherapy.Based on these data,we hypothesize that the administration of probiotics impact positively in the overall survival and life quality of rats with CRC under the treatment of capecitabine,which is the pro drug of 5-FU.AIM To evaluate the probiotics effects in a rat CRC model treated with capecitabine and followed until the end of life.METHODS 1,2-Dimethylhidrazine dihydrochloride(1,2-DMH)was employed as carcinogen inductor of CRC.Fifty male Wistar-Lewis rats were randomly assigned to one of five following groups:Control(n=5),Control+probiotics(Control-P group,n=5),1,2-DMH alone(DMH group,n=10),1,2-DMH+capecitabine(DMH-C group,n=10),1,2-DMH+probiotics(DMH-P group,n=10)and 1,2-DMH+capecitabine+probiotics(DMH-C-P group,n=10).All parametric data were expressed as the mean±SD.The statistical significance of differences was analyzed using one-way ANOVA.Data were analyzed with InfoStat software.The results were considered statistically significant at P<0.05.Overall survival was evaluated with the Kaplan-Meier estimator with the log-rank test.RESULTS The data of mean overall survival for DMH,DMH-P,DMH-C,DMH-C-P,Control and Control-P groups were 250 d[95%confidence interval(CI):242.5-253.1],268 d(95%CI:246.3-271.4),380 d(95%CI:337.8-421.9),480 d(95%CI:436.9-530.7),588 d(95%CI:565.8-609.3)and 590 d(95%CI:564.3-612.9),respectively,with a significant difference between DMH-C and DMH-C-P groups(P=0.001).Comparing all groups by Kaplan-Meier estimator,we found a significantly different in the overall survival of DMH and DMH-P groups respect to DMH-C(P=0.001)and DMH-C-P(P=0.001)groups;interestingly,there were no meaningful differences between Control,Control-P and DMH-C-P groups(P=0.012).The tendency of change in body weight gain of the rats at 90 d of finishing DMH administration was similar in Control group compared with DMH-C and DMHC-P groups;however,and of relevance,DMH-C-P group has experienced a higher body weight gain at the end of animal’s life than DMH-C group(P=0.001).In DMH-C-P group we found a positive effect of probiotics in clinical manifestations since diarrhea,constipation and blood stool were absenting.Also,the tumor burden was lower in DMH-C-P than DMH-C,DMH-P or DMH groups(1.25 vs 1.81 vs 3.9 vs 4.8 cm2,respectively).DMH-C and DMH-C-P groups showed only mucinous carcinoma type while in other DMH groups the tumor types were variable.However,mucinous carcinoma from DMH-C-P group showed invasion until muscularis propria layer.Interestingly,metastatic lymph node was observed in DMH,DMH-C and DMH-P groups but not in DMH-C-P.All animals in Control group died from natural causes without objective injuries.All animals of DMH and DMH-P groups died from tumor complications(i.e.,obstruction or intestinal perforation);however,this cause was seen only in 44.5%of DMH-C and DMH-C-P groups CONCLUSION Probiotics administration improves life quality of rats with CRC under capecitabine treatment and also has a positive effect in the overall survival of these animals treated with this drug.

Polycaprolactone (PCL) Chains Grafting on the Surface of Cellulose Nanocrystals (CNCs) during <i>In Situ</i>Polymerization of <i>ε</i>-Caprolactone at Room Temperature

This work aimed at investigating the feasibility of surface modification of cellulose nanocrystals (CNCs) using in situ ring opening polymerization of ε-caprolactone (ε-CL) at room temperature. Residues of flax and milkweed (Asclepias syriaca) stem fibers were used as a source of cellulose to obtain and isolate CNCs. The cationic ring opening polymerization (CROP) of the monomer ε-CL was used to covalently graft polycaprolactone (PCL) chains at the CNCs surface. Silver hexafluoroantimonate (AgSbF6) was used in combination with the extracted CNCs to initiate, at room temperature, the polymerization and the grafting reactions with no other stimulus. Fourier-Transform InfraRed (FTIR), X-ray Photoelectron Spectrometry (XPS), UV/visible absorption and Gel Permeation Chromatography (GPC) analyses evidenced the presence of PCL chains covalently grafted at CNCs surface, the formation of Ag(0) particles as well as low or moderate molecular weight free PCL chains.

Effects of Finer Scale Soil Survey and Land-Use Classification on SWAT Hydrological Modelling Accuracy in Data-Poor Study Areas

The limited availability of high-quality spatial data often limits the development of hydrological modelling in developing countries. Hydrological models with data at different scales may generate large uncertainties in modelling outputs. This study analysed the accuracy of four SWAT built models that combine soil and land use/land cover (LULC) data at the scale of 1:250,000 and 1:100,000 in a basin of Mexico. SWAT model allowed determining that large-scale maps produced better results than data from small-scale. Sensitivity analysis with different soil data was less than LULC data. However, the small-scale can be used for exploratory purposes when testing SWAT performance.

The Evolution of Pore Water Pressure in a Saturated Soil Layer between Two Draining Zones by Analytical and Numerical Methods

The building of the infrastructure on the compressible and saturated soils presents sometimes major difficulties. The infrastructure undergoes strong settlement that can be due to several phenomena of consolidation of the soils. The latter results from the dissipation of the excess pore pressure and deformation of the solid skeleton. Terzaghi theory led to the equation modeling the dissipation of excess pore pressure. The objective of this study is to establish solutions, by analytical and numerical method, of the equation of the pore water pressure. We considered a compressible saturated soil layer, between two drainage areas and subjected to a uniform load. Separation of variables is used to obtain an analytical solution and the finite element method for the numerical solution. The results obtained by the finite element method have validated those of analytical resolution.

Upper Blepharoplasty Scar and Patient Satisfaction Evaluation in a Plastic Surgery Center in Mexico

Background: Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most common procedures performed in plastic surgery. Standardized tools allow for measurement of outcomes through patient satisfaction and surgeon experience. Objectives: Our objective was to measure the satisfaction index and scar quality of patients who underwent upper blepharoplasty using the Patient-reported Outcome Measure Questionnaire (PROM-Q) and Patient and Observer Scar Assessment Scale (POSAS). Methods: A retrospective review of patients that underwent upper blepharoplasty in our institution was performed. We included those with a preoperative anthropometric analysis, standardized incision markings (developed in our center), same operative technique and a 3-month postoperative evaluation with PROM-Q and POSAS. The sample for this study consists of 67 patients, all of them operated between January 1 2019 and June 30 2019 at the Department of Plastic Surgery, South Central High Specialty Hospital, Pemex, Mexico City, Mexico. Results: A total of 67 patients were included, 73% female and 27% male. The most frequent indication for surgery was functional visual symptoms. The index of PROM-Q at 3 months demonstrated an increased satisfaction above 90%, and the evaluation with POSAS reported an almost imperceptible scar. Conclusion: Evaluating outcomes with objective tools provides data useful to improve the surgical protocols of patients subjecting to aesthetic procedures.

Taxonomic Distinctness of the Intertidal Fish Community on the Pacific Coast of Baja California Sur, México

The intertidal zone is a complex coastal area exposed to a wide variety of environmental factors. During low tide, rocky pools are exposed to air for several hours throughout the day, and environmental conditions such as temperature and salinity are highly variable. Fish communities that inhabit these tide pools are also exposed to environmental variability;therefore it is important to look at fish community structure in relation to important environmental factors such as temperature, salinity and dissolved oxygen on tide pools during spring tides, time of greater exposure to air. Therefore, the aim of the present study was to analyze the variation of the taxonomic distinctness of intertidal fish communities considering temperature, salinity and dissolved oxygen of the water that remains trapped in the tide pools during low tide. Visual census surveys were carried out monthly, from January to December 2015, in the intertidal zone of El Faro during spring tides on full moon days, when fluctuations of environmental variables are significant. Total extension of the census surveys was 156 × 5 m (780 m2). A total of 145 tide pools were sampled and divided in three groups (small, medium and large) according to size and depths that ranged from 20 to 45 cm. Temperature, salinity and dissolved oxygen fluctuate throughout the year of study. Thermal difference between open ocean and tide pools ranged from 3.5°C to 4.5°C. A total of 3757 organisms from 22 species, 12 families, four orders and one class were recorded. When comparing taxonomic distinctness and average taxonomic distinctness between months and tide pools of different sizes, values fell within the confidence intervals in the tunnel and were located close to the mean.

Determination of the Fish Community Structure of an Intertidal Rocky Zone of the Pacific Coast of Baja California Sur

The intertidal zone (also known as seashore) are transition areas between land and sea, that are greatly influenced by the tide cycle, therefore, environmental parameters, such as temperature and salinity, oscillate according to the periods in which these areas are exposed to air. Intertidal zones are highly diverse, which makes them key ecosystems for the development of sea life (both flora and fauna) exposed to drastic environmental change. The 59 visual censuses campaigns were carried out during the full moon of each month from 2015 to 2019. Temperature, salinity and dissolved oxygen were recorded during each visual census and showed variations between years. Temperature showed two distinct seasons, warm and cold. A total of 14,995 organisms were recorded, belonging to 30 species, 28 genera, 15 families, five orders and one class. Ecological indices like species richness (SR), Shannon-Wiener’s diversity (H') and Fisher’s alpha (α-Fisher) showed significant differences between years, 2015 and 2016 recorded as the most diverse years, while the lowest values were recorded in 2019. Therefore, fish communities of tide pools showed to be highly diverse, with 30 species recording similar relative abundances, and according to the BVI, only 11 species were dominant. Spatio-temporal variations of temperature, salinity and dissolved oxygen were highly correlated to changes in fish community structure, and the dominance of certain species, which are of great importance for the structure and dynamic of the tide pool communities. Therefore, the aim of the present study was to determine the fish community structure of tide pools during the low tide in the intertidal zone of a locality known as El Faro, on the west coast of La Paz, B. C. S., Mexico.

Prognostic value of ^(13)C-phenylalanine breath test on predicting survival in patients with chronic liver failure

AIM: To evaluate the prognostic value of percentage of 13C-phenylalanine oxidation (13C-PheOx) obtained by 13C-phenylalanine breath test (13C-PheBT) on the survival of patients with chronic liver failure. METHODS: The hepatic function was determined by standard liver blood tests and the percentage of 13C-PheOx in 118 chronic liver failure patients. The follow-up period was of 64 mo. Survival analysis was performed by the Kaplan-Meier method and variables that were significant (P < 0.10) in univariate analysis and subsequently introduced in a multivariate analysis according to the hazard model proposed by Cox. RESULTS: Forty-one patients died due to progressive liver failure during the follow-up period. The probability of survival at 12, 24, 36, 48 and 64 mo was 0.88, 0.78, 0.66, 0.57 and 0.19, respectively. Multivariate analysis demonstrated that Child-Pugh classes, age, creatinine and the percentage of 13C-PheOx (HR 0.338, 95% CI: 0.150-0.762, P = 0.009) were independent predictors of survival. When Child-Pugh classes were replaced by all the parameters of the score, only albumin, bilirubin, creatinine, age and the percentage of 13C-PheOx (HR 0.449, 95% CI: 0.206-0.979, P = 0.034) were found to be independent predictors of survival.CONCLUSION: Percentage of 13C-PheOx obtained by 13C-PheBT is a strong predictor of survival in patients with chronic liver disease.

Anthropometric Analysis of the Upper Eyelid and Eyebrow in Patients Attended by the Plastic and Reconstructive Surgery Service of the Hospital Central Sur De Petróleos Mexicanos

Upper eyelid blepharoplasty is one of the most frequently performed surgeries by plastic surgeons worldwide. A prospective observational study was conducted to describe the anthropometric measurements of the upper eyelid and eyebrow in a Mexican population. The researcher measured the anthropometry of the eyelids and eyebrows to establish the diagnosis and surgical plan according to the checklist created and applied by the plastic and reconstructive surgery service. In anatomical position with a caliper instrument, the marginal reflex distance (MRD1), the tarsal thickness, the length of the vertical and horizontal slit, and finally the distance at which the external canthus is located with respect to the internal canthus were measured in millimeters. For the anthropometry of the eyebrows, the distance from the eyebrows to the hairline, the position in millimeters of the orbital rim with respect to the eyebrow, and the angle of its apex were measured. A sample of 210 patients was obtained, of which 65 were male and 145 females, divided by age groups. It was observed that in the three age groups, females presented a vertical palpebral fissure with a higher mean than males. Similar is the case of tarsal thickness, in which the difference was significantly greater in the female of the three age groups. On the other hand, it was observed that the horizontal slit in males was higher than that of females, while the MDR1 was similar in both sexes. Finally, it was identified that in the group of 41 to 50 years old significant decreases are observed both in the vertical cleft, tarsal thickness and the position of the external canthus compared to the group of 20 to 30 years old, this is due to the aging process. When evaluating the anthropometrics of the eyebrows, a greater distance from the trichion to the eyebrow was observed in males than in females, in contrast to the position of the eyebrow with respect to the supraorbital rim and its apex, in which it was shown that in females there is a greater distance. In the other groups, the trends were maintained;however, a decrease was observed in the angle of the apex of the eyebrow and the RSO-eyebrow distance in males and females with advancing age, being more important in the group of 41 to 50 years. Systematized palpebral and periorbital anthropometric analysis is fundamental in the evaluation consultation. It allows us to make a precise diagnosis of the functional and aesthetic alterations that must be corrected during a surgical procedure, according to the concept of beauty of each culture or ethnicity.

Breast Reconstruction: Does It Worth to Start If the Patient Is Not Sure to Take All the Process Along?

Introduction: Breast cancer is the most common cancer in women worldwide, representing a major public health problem. There is still little information comparing the satisfaction of the patients who finished their process against the ones who start it but did not finish it. The aim of our retrospective study was to analyze the results in terms of satisfaction after one year of undergoing to complete breast reconstruction (CBR) vs incomplete breast reconstruction (IBR). Materials and Methods: Retrospective study of patients that underwent breast reconstruction (BR) surgery after mastectomy for breast cancer treatment. Performed at Hospital Central Sur de Alta Especialidad PEMEX in Mexico City, including patients from January 1, 2015 to January 01, 2020. Demographic baseline variables were included. BREAST-Q satisfaction questionnaires one year after the last reconstructive procedure were analyzed. Results: A total of 44 patients fulfilled the inclusion criteria. Of these 44 patients, 11 were included in the IBR group, and 33 patients in the CBR group. There were no statistically significant differences between the two groups in terms of age (IBR 56.09 vs CBR 53.06 years, p = 0.321);BMI (IBR 27.94 vs CBR 26.40, p = 0.253), time from mastectomy to first reconstructive procedure (IBR 22.8 vs CBR 31 months, p = 0.957), history of chemotherapy (IBR 27.3% vs CBR 33.3%, p = 0.709) and radiotherapy (IBR 54.5% vs CBR 42.4%, p = 0.484), additionally type of reconstruction, affected side or complication rate were not significantly different. Regarding postoperative satisfaction, only the second module of satisfaction with breasts displayed statistically significant differences, with a higher score in the CBR group (46.27 vs 52.27, p = 0.019). Other items explored didn’t show significant differences. Discussion: The data reported in this study suggest that regardless of whether the last stage of a BR is reached, the results in these settings can be very similar in terms of psychosocial well-being, sexual well-being, physical well-being regarding the chest area, with some degree of better perception of her breasts. Conclusion: This study suggests that the results in terms of satisfaction in BR after mastectomy for breast cancer are quite similar for patients who decide to take only the first reconstructive stage, compared with those that finished all the process along, this may be a valuable tool for decision making.

Patient Satisfaction Index and Quality of Life Measurement with Breast-Q after Breast Reconstruction in a Plastic Surgery Center in Mexico

Introduction: Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of life. BREAST-Q is a PROM (Patient Reported Outcome Measures) that has proven useful in measuring satisfaction with breast reconstruction results from the patient’s point of view. Objectives: To measure the satisfaction index and improvement in quality of life after breast reconstruction for breast cancer sequelae in our hospital in the last 5 years. Materials and Methods: Descriptive Study that includes patients with Breast cancer diagnosis that underwent mastectomy and breast reconstruction (prosthesis or autologous tissue) in “Hospital Central Sur de Petroleos Mexicanos” (January 2015 to January 2020), whose satisfaction index was measured with BREAST-Q one year after reconstruction. Results: 153 patients were included in the analysis. Mean global satisfaction was 74 points. We observed a tendency towards higher psychosocial, sexual and appearance satisfaction in patients who underwent reconstruction with autologous tissue. The mean satisfaction with provided information was 64 points and with the medical team > 90 points. Conclusion: Breast reconstruction is associated to a high satisfaction index and quality of life improvement regardless of the technique. BREAST-Q proved to be useful in evaluating patient experience and it helped us identify areas of opportunity to improve our care.

Isolation of Microorganisms According to Burned Body Surface: Experience in a Reference Center in Mexico City

Background: Burns is one of the most common and severe forms of trauma, as they cause an alteration in the protective barrier exerted by the skin. The objective of this work is to describe the bacterial pathogens that cause infections in the different body segments as well as to know the susceptibility in patients with burns during a period of two years. Methods: This study was conducted over a period of 2 years, January 2017 to January 2019. The analysis of the isolated microbiological agents was obtained from culture samples in different anatomic areas. The variables were measured in the general population and also by groups, considering: age, sex, TBSA with Wallace's rule of nine, anatomic area affected, type of burn, depth of burn, microorganism reported in cultures, antibiotics empirically administered and mortality rate. Results: Regardless of the anatomical segment studied, the most frequently isolated microorganism was Pseudomonas aeruginosa. Conclusions: Identification of the microorganisms that cause infection reduces the hospital stay, as well as the admission to the ICU. A fundamental research guideline is to pay more attention to the post-burn consequences, and the sequelae and functional limitations that it entails, since few since few studies focus on this aspect.

TRAITEMENT DE L'HEPATITE VIRALE FULMINANTE PAR TRANSPLANTATION DES CELLULES HEPATIQUES FOETALES HUMAINES——ETUDE PRELIMINAIRE SUR 8 CAS

The authors achieved a clinical study on the treatment of fulminant viral hepatitis by the transplantation of human fetal liver cells. 47fetal livers were used for 8 patients with a survival of 6 cases. The side-effects of this new therapy were analysed and the mechanism of action of fetal liver cells discussed.