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Epidemiological study of burns in children treated at a tertiary hospital in São Paulo Epidemiological study of burns in children treated at a tertiary hospital in São Paulo Estudo epidemiológico de queimaduras em crianças atendidas em hospital terciário na cidade de São Paulo

Multiple previously described advantages associated with internal pudendal artery perforator flap were also observed here, reinforcing the idea that it is reliable, versatile, and a useful option for perineal reconstruction after abdominoperineal excision of the rectum. Therefore, we propose that this flap could be considered as the first choice for perineal reconstruction in selected patients with moderate and some large defects after abdominoperineal excision of the rectum. See Video Abstract at http://links.lww.com/DCR/A367.

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Millan LS et al. Bloodstream infections by multidrug-resistant bacteria in patients in an intensive care unit for the treatment of burns: a 4-year-experience Infecções de corrente sanguínea por bactérias multirresistentes em UTI de tratamento de queimados: experiência de 4 anos ABSTRACT Background: Knowledge of the profile of antibiotic resistance in bacteria in a hospital is essential for guiding appropriate patient treatment. This is especially important for the severely ill patients, because treatment must be initiated before the results of cultures can be obtained. In this study, we aimed to analyze the profile of multidrug-resistant bacteria (MR) found in blood cultures from patients admitted to the intensive care unit (ICU) of the Burns Unit of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Methods: We evaluated 178 patients (131 men) admitted to the ICU for the treatment of burns from 2009 to 2011, with a mean age of 29.2 years. Results: Eighty (44.9%) patients indicated positive results in peripheral blood cultures, and there were 66 (82.5%) cases with MR bacteria. Staphylococcus sp. was isolated in 48 cases, of which 33 cases showed resistance to oxacillin. Acinetobacter baumannii was isolated in 11 cases, and 8 of these cases were resistant to imipenem. Pseudomonas sp. was isolated in 19 cases, and 16 of these cases were resistant to imipenem. Enterobacter sp. was isolated in 10 cases, and 2 of these cases were resistant to ciprofloxacin and amikacin. The presence of MR bacteria was not associated with a higher incidence of deaths but was associated with longer hospital stay (52.6 vs. 36.3 days for those with and without MR bacteria, respectively, P = 0.0306). There was no significant association between burned body surface and the presence of MR bacteria. Conclusions: The presence of MR bacteria is an important problem, because of the prevalence and associated morbidity and mortality.

In 2019, breast augmentation was among the top five cosmetic surgical procedures performed by plastic surgeons in the United States, with 193,073 reported cases. 1 Decision-making with regard to implant selection and preoperative planning has been widely debated in the literature, with a broad range of reported approaches and published aesthetic breast surgery algorithms. A recent systematic review by Adams and Mckee critically examined many of these studies and supported tissue-based planning as the optimal method for preoperative planning. 2 Despite this focus on tissue-based planning, no previously published algorithm has specifically addressed the role of the native inframammary fold in primary breast augmentation. Inframammary fold location is one of the tenets of the "high five" methodology; however, baseline inframammary fold characteristics are not taken into consideration. 3 The method described by Hedén relies on thoughtful evaluation of breast width and skin envelope laxity before primary breast augmentation, but it does not include inframammary fold

A alta mortalidade na lista de espera por transplante de fígado (Tx) tem estimulado a adoção de critérios degravidade para alocação de órgãos. O objetivo desse trabalho é investigar qual o efeito da classificação MELD (Modelfor End-Stage Liver Disease) na mortalidade após o Tx. Foram revisados 237 casos de Tx eletivo com doador cadáverrealizados entre 1º/11/1995 e 30/7/2001. Na análise de regressão logística, foi encontrada uma interação significanteentre a pontuação MELD e a mortalidade nos primeiros 6 meses após o transplante (odds ratio = 1,052; IC95% = 1,015 a 1,090; p = 0,02). Para estudar o efeito da escala MELD na sobrevida atuarial, os pacientes foram divididos em dois grupos: Grupo A (n = 126) com valores de MELD abaixo da média da casuística global (14,4) e Grupo B (n = 111) compontuação MELD acima desse valor. Existe uma diferença significante entre a sobrevida ao longo do tempo nos doisgrupos (p = 0,0374). A análise de regressão proporcional de Cox indicou risco 1,65 vezes maior no grupo B (riscorelativo = 1,6523; IC95% = 1,0240 a 2,6662).