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Presentamos dos técnicas de relleno facial utilizando ácido hialurónico y los resultados obtenidos con este método desarrollado por nosotros en base a los principios físicos de sustentación, para optimizar y racionalizar el material de relleno y mejorar los resultados, especialmente la relación costo-beneficio. Hacemos también una presentación general de los principios básicos para conseguir remodelar el tejido cutáneo empleando técnicas de relleno facial. Señalamos la importancia de la evaluación clínica para llegar a un buen diagnóstico, haciendo hincapié en los límites de selección del paciente y enumeramos los puntos importantes y éticos en el uso de materiales de relleno.We present two techniques of facial injectable resorbable filling, using hyaluronic acid (HA), and the different results obtained with both methods, based on physical principles of sustentation, intending to demonstrate how theese techniques can optimize and rationalize the use of the filling substance, contributing to enhance the results and cost-benefit relation. We also make a general presentation of the basic principles that remodel the cutaneous tissue using facial filling methods, as well as the importance of the clinical evaluation to achieve a fine diagnostic, emphasizing the limits when selecting the patient, listing the important and ethical points related to the use of facial filling procedures.

Superficially at least, today’s refugee camps do not appear significantly different from those that existed 30 or 40 yearsago. But upon a closer look, it becomes apparent that thingsare changing…

Background: The production of carbapenem-hydrolyzing β-lactamases is one of the most concerning resistance mechanisms since it eliminates the last therapeutic option against multidrug resistant microorganisms., Aim: To determine the production of KPC and NDM-1 type carbapenemases, using phenotypic and genotypic methods, in isolated enterobacteria in a clinical laboratory in the city of Maracay, Venezuela., Methods: The production of carbapenemases was determined by phenotypic (according to the Malbrán algorithm) and genotypic methods (amplification of the blaNDM-1 and blaKPC genes by PCR) in clinical isolates of Enterobacteriaceae during the period March-August 2018., Results: 605 Enterobacteriaceae of different species were identified, being Escherichia coli the strain with the highest percentage of isolation (61.3%), followed by Klebsiella pneumoniae (14.9%). Sixteen strains (2.64%) were positive for carbapenemases production: 13 strains of K. pneumoniae and three of the Enterobacter cloacae complex. PCR showed that 14 strains (87.5%) carry the blaNDM-1 gene and two strains (12.5%) the blaKPC gene; 100% agreement was observed between phenotypic determination and PCR for both groups of enzymes., Conclusions: The results of this study showed a higher incidence of metallo-β-lactamase type NDM-1, which rapid dissemination and consequently difficult control has been cause of epidemiological alert. The identification of the type of enzyme would allow establishing more accurate management and control strategies in order to eradicate these pathogens.