Marcelo Wilson Rocha Almeida

Internal Suture Technique for Improving Projection and Stability in Secondary Gluteoplasty

The most common indication for primary gluteoplasty is the aesthetic correction of gluteal hypoplasia; secondary gluteoplasty is directed toward asymmetry from misplaced implants, trauma or infection of the implant, and treatment of congenital and acquired deformities. In this study, the authors describe a new suture maneuver designed to improve the result in secondary gluteoplasties. To reduce the empty pocket spaces and guarantee the stability of the new (smaller) implants, anchoring circular interlocking sutures are placed into the two sheets of the fibrotic capsule, which makes it possible to place the implant in a more favorable position.

Carcinoma de células de Merkel em extremidade inferior

Merkel cells carcinoma is a rare cutaneous neoplasia. Studies revealed an increase in the occurrence from 0.15 to 0.44 cases for every 100.000 inhabitants between 1986 and 2001. Around 50% of the patients, eventually, develop systemic disease, being the most common sites the liver, the bones and the brain. The etiology is still unknown. The present study presents a new case of Merkel cells carcinoma in extremity, treated with local resection and adjuvant radiotherapy.

Linfoma não-Hodgkin de cordão espermático

Non-Hodgkin s lymphoma of the spermatic cord are rare. There is the registration of 14 (fourteen) cases of spermatic cord lymphoma in the literature, all treated with radical orchiectomy with or without radiotherapy. The adjuvant chemotherapy still is not a consensus, therefore the therapy must be individualized and applied according to the stage of the disease. The present study report a new case of primary non-Hodgkin s lymphoma of the spermatic cord treated with radical orchiectomy through inguinal via with precocious ligature of the spermatic cord and adjuvant chemotherapy. Presently found with 2 and a half years of follow-up without recidivation clinical evidence, as the image exams show to be normal.

Influência da idade no tempo de internação e no grau evolutivo das apendicites agudas

BACKGROUND: To study appendicitis evolution grade in comparison with intraoperative inspection and pathological results. Also a relationship between age and hospital stay length is reviewed. METHODS: Retrospective analysis of 199 patients submitted to appendicectomy between October 2003 through August 2004 using: age, sex, length of hospital stay and evolution grade of inflammatory process according to pathological examination was studied. RESULTS: Analysis was possible only in 182 cases. Distribution by sex showed a higher incidence in men (54.4%); median age was 20 years and the most prevalent age range was between 11 - 20 years (36.22%). Hospital median stay length was 3 days. There was a significant difference in hospital stay length according to age and patients older than 60 years; they had the longest hospital stay length. Pathologic examination showed 73.62% as suppurative appendicitis, normal appendix was 13.73%, gangrenous was 7.14%, catarrhal was 4.49% and neoplasm was found in 0.54%. Diagnosis of appendicitis was confirmed in 86.24%. Hospital stay length and age were not significant different between acute appendicitis evolution grades. CONCLUSION: Acute appendicitis is more frequent in young male patients. Older patients stay longer in hospital; however appendicitis evolution grades showed neither correlation with age nor length of stay.

Reconstrução de lábio inferior pós-mordedura equina: descrição de técnica e revisão anatômica

BACKGROUND: The reconstructive surgery of the lip, upper or lower, presents a variety of techniques and procedures. In reconstructive surgery of lip is important to evaluate the characteristics of tissue (skin color, texture), which wherever possible should be used near the site of injury to provide the least morbidity and best tissues in colors and texture. CASE REPORT: This article aims to describe the Bernard-Burow technique for reconstruction of lower lip, and review the anatomy of the lower third of the face, through the case report of a patient who was bitten by a horse and had avulsion of lower lip and mentoniane portion of the face.

Paralisia de Bell subsequente a ritidoplastia

INTRODUCAO: A paralisia facial periferica e uma entidade que pode deixar sequelas esteticas e funcionais importantes nos pacientes. De acordo com a literatura, a paralisia de Bell (PB) e a causa mais comum, representando de 50 a 80% dos casos. Porem deve ser considerada como diagnostico de exclusao. Estima-se uma prevalencia ligeiramente maior entre as mulheres e sua incidencia e bimodal, com picos na terceira e oitava decadas de vida. A maioria dos pacientes evolui para a recuperacao dentro de algumas semanas, embora seja comum uma piora do quadro nas primeiras 48 horas. O tratamento deve ser realizado no sentido de prevenir complicacoes e as condutas medicamentosas nao estao consagradas. Como fatores de risco para a PB tem sido relatados hipertensao arterial, diabete mellitus, gravidez, puerperio e infeccao pelo virus herpes tipo I. Embora existam varios fatores de risco associados a PB, em relacao a cirurgia de face-lifting existe apenas um caso relatado na literatura. RELATO DO CASO: No presente estudo, os autores descrevem o segundo caso de paralisia de Bell apos a cirurgia de face-lifting.

Síndrome de Chilaiditi associada a volvo de cólon sigmóide: relato de caso

INTRODUCTION: This study aims at reporting a case of Chilaiditi Syndrome associated to sigmoid colon volvulus. CASE REPORT: Male patient, white, 51 years old, arrives at an emergency hospital in Pelotas with complaints of stoping the elimination of gases, diffuse abdominal pain, increase of abdominal volume, gradual and progressive inappetence, accepting only liquid. He is diagnosed with mental retardation and a situation of intestinal constipation. An acute abdomen Rx highlighted a diffuse colon distension, suggestive of sigmoid volvulus with tranversum colon image between the liver and the diaphragm. The patient was submitted to exploratory laparotomy being highlighted sigmoid volvulus, diffuse megacolon and interposition of the transverse colon between the liver and the diaphragm. Subtotal colectomy with terminal ascending colon colostomy was proceeded. The patient evolved satisfactorily being discharged on the 9th day. DISCUSSION: The interposition of the colon between the liver and the diaphragmatic cupula (Chilaiditi syndrome) associated to sigmoid colon volvulus constitutes a rare cause of obstructive acute abdomen, though the sigmoid volvulus is one of the main causes of mechanic intestinal obstruction in Brazil. Usually a clinical treatment is done, although when associated to complications the treatment is surgical.