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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Se entiende como úlcera de Marjolin cualquier tipo de neoplasia cutánea agresiva que surge en lesiones cicatriciales con inflamación crónica. El hallazgo histopatológico más frecuente es el carcinoma escamocelular, seguido del basocelular y otro tipo de células malignas. El diagnóstico debe realizarse de manera temprana para su correcto abordaje terapéutico; el método más implementado y con mayor sensibilidad es la biopsia del tejido comprometido. El tratamiento más utilizado es el quirúrgico por medio de la escisión temprana y el uso de injertos de piel, pero con el paso del tiempo se han presentado nuevas técnicas y enfoques que cuidan la progresión de la lesión y así darle un mejor pronóstico de vida al paciente.

O hidradenoma papilífero vulvar é uma neoplasia cutânea benigna e rara das glândulas sudoríparas apócrinas que comumente surge na região anogenital de mulheres em idade reprodutiva, entre 25 e 40 anos. Seu diagnóstico clínico pode ser difícil, sendo às vezes confundido com cistos da glândula de Bartholin, angioqueratomas de Fordyce, endometriose vulvar, dentre outras lesões vulvares malignas. O presente estudo relatou o quadro clínico, diagnóstico e tratamento de um caso de hidradenoma papilífero vulvar em paciente de 47 anos do sexo feminino. Nesse quadro, notou-se a importância dessa lesão como diagnóstico diferencial nas úlceras genitais crônicas.

Objetivo: analisar os fatores associados à prevalência de cicatrização em pacientes com feridas crônicas. Método: estudo transversal, em pacientes com feridas crônicas de uma Unidade de Saúde da Família, em Salvador, Bahia. Os dados foram coletados de fontes secundárias disponíveis na planilha de acompanhamento dos pacientes, analisando como desfecho os níveis de cicatrização das feridas crônicas. Resultados: foram verificadas diferenças estatisticamente significantes nas variáveis faixa etária e dor, em que a proporção de apresentar os piores índices de cicatrização foi 77,78% maior entre os pacientes adultos quando comparada aos idosos; e a proporção de apresentar os piores índices de cicatrização entre os pacientes com dor intensa/muito intensa foi 80% maior quando comparada aos pacientes sem dor. Conclusão: ficou evidente a importância de desenvolver estratégias voltadas ao estilo de vida, adesão ao tratamento, manejo da dor, bem como utilização de instrumentos qualitativos para avaliação dos fatores que possam interferir na cicatrização.

Las úlceras por presión, en especial las escaras sacras, han sido un desafío constante en la medicina desde hace décadas 1. Las complicaciones asociadas pueden ser graves, pasando de las infecciones locales, a la osteomielitis e incluso sepsis; su extensión al retroperitoneo es excepcional 2.

BACKGROUND: The World Health Organization (WHO) classifies leishmaniasis as an emerging and uncontrolled disease. It is caused by protozoa of the Leishmania genus and transmitted to animals and humans by vectors of the Psychodidae family. Its distribution is worldwide and it is estimated that about 2 million new cases occur each year. CLINICAL CASE: A 66-year-old male patient, resident of Cancun, Quintana Roo, Mexico, with cutaneous leishmaniasis who received amphotericin B deoxycholate, which is reserved to treat the disease in its most severe presentation. CONCLUSIONS: The use of an intravenous polyene antibiotic is an option for the management of leishmaniasis in endemic areas, when first-line treatments are limited. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: el linfoma nasal de células T/natural killer (LNT/NK) forma parte de un espectro de lesiones inmunoproliferativas de las células T postímicas. Consiste en un proceso necrótico que destruye en forma progresiva la nariz, senos paranasales, paladar y otras estructuras faciales. Dentro de su etiología se han descrito factores genéticos. El diagnóstico se basa en las características clínicas apoyadas en el estudio histopatológico con tinción de hematoxilina-eosina e inmunohistoquímica. Es conveniente la búsqueda de EBER (Epstein-Barr virus-encoded small RNAs) teniendo en cuenta la asociación entre estas dos patologías. Existen diferentes opciones de tratamiento que van a depender de la clasificación de la neoplasia en el paciente. Caso clínico: hombre de 58 años que presentó la aparición de una placa eritematoviólacea con posterior ulceración sobre el dorso nasal, de rápido crecimiento y destrucción de tejidos blandos adyacentes. Consultó al servicio de dermatología, donde consideró la toma de biopsia de piel con diagnóstico presuntivo de linfoma extranodal de células NK-T tipo nasal. Conclusión: el LNT/NK de tipo nasal es una entidad de rápida progresión que involucra un importante compromiso de órganos, por lo cual es de suma importancia hacer una identificación temprana para mejorar su pronóstico.

Background and objective. The pedicled DIEP flap offers a reproducible alternative in the management of ischial and trochanteric ulcers where healthy peripheral tissue is not available for the realization of a local flap. We describe the surgical technique and present 2 clinical cases in which this procedure has been used, offering a reproducible alternative in the treatment of these conditions. Methods. A doppler ultrasound scan of the periumbilical perforating arteries is carried out, tracing a 10 x 15 cm vertical skin island. The pedicle is dissected down to the junction with the deep inferior epigastric artery, which is dissected as proximal as possible. A subcutaneous tunnel is made to the area to be treated for the passage without tension of the vascular pedicle and the flap is placed in its receiving area, suturing it in two planes. Results. We present 2 clinical cases in which we obtained excellent functional results and low morbidity in the donor area. Conclusions. In our experience, the pedicled DIEP flap was an adequate reconstructive option in patients with ischial and trochanteric ulcers in whom peripheral tissues do not allow reconstruction with local flaps, since it has low morbidity in the donor area and a relatively long pedicle that allows it to reach the defect area. [ABSTRACT FROM AUTHOR]

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas is the property of Universidad de Santiago de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of INSPILIP. Revista Ecuatoriana de Ciencia, Tecnología e Innovacion en Salud Pública is the property of Instituto Nacional de Investigacion en Salud Publica (INSPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivo: apresentar a sistematização de um protocolo de scoping review para mapear e descrever os determinantes sociais da saúde, propostos pela Organização Mundial da Saúde, presentes em adultos com úlcera do pé diabético. Método: Será utilizada uma estratégia de busca em três etapas. As bases de dados utilizadas são LILACS (Portal BVS), IBECS (Portal BVS), BDENF (Portal BVS), ColecionaSUS (Portal BVS). MEDLINE (PUBMED), Pubmed Central (PMC). Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), CINAHL (EBSCO). As fontes de estudos não publicados e literatura cinzenta a serem pesquisadas incluem o portal de literatura cinzenta Scielo (Science.gov) e o banco de dados colaborativo e multilíngue Epistemonikos (Epistemonikos). Portal de Periódicos Capes nas bases de dados: Embase (Elsevier), Scopus (Elsevier), Web of Science (Clarivate Analytics), Cumulative Index to Nursing and Allied Health Literature – Cinahl, Academic Search Premier - ASP, Academic Source, Open Dissertations e SocINDEX com Texto Completo (EBSCO). Portal da revista Scientific Electronic Library Online (Scielo), Science. As listas de referência de estudos elegíveis serão pesquisadas. O portal de periódicos Scielo (Science.gov) e o banco de dados colaborativo e multilíngue Epistemonikos serão pesquisados por literatura inédita. Será extraído os dados de acordo com as características do estudo e da publicação e classificará os determinantes de acordo com os conceitos da Organização Mundial da Saúde.

Dermatomyositis positive anti-melanoma differentiation-associated gene 5 (anti-MDA5 DM) is a rare disease that represents less than 2%. The prevalence of anti-MDA5 DM ranges from 7 to 60%, with higher prevalence in Asian (11-60%) and women. The clinical picture may be variable and is accompanied by the typical features of dermatomyositis, such as periorbital heliotrope (blue-purple) rash with edema, erythematous rash on the face, or the anterior chest (in a V-sign), and back and shoulders (in a shawl sign), violaceous papules or plaques located on the dorsal part of the metacarpophalangeal or interphalangeal joints, which are pathognomonic by definition; yet, one of the most striking signs is the painful ulceration skin that is found in 82% of cases, which is deep and in punching holes or showing hyperkeratotic crusts. For diagnosis is necessary the typical DM rashes (Gottron's papules or Gottron's sign and heliotrope rash), along with either an "interface dermatitis" skin pathology or evidence of myositis or a MSA (myositis-specific autoantibodies). Immunopre-cipitation is the gold standard method to detect MSA. Combinations of glucocorticoids and immunosuppressants are used for treatment; besides, it is necessary the detection of rapidly progressive interstitial disease (RP-ILD) with a high-resolution CT because of its high association with fatal prognosis. [ABSTRACT FROM AUTHOR]

Currently, ulcerative sexually transmitted infections, including syphilis, herpes simplex virus (HSV), lymphogranuloma venereum (LGV), chancroid, donovanosis and, more recently, monkeypox (MPOX), represent a growing challenge for health care professionals. The incidence of syphilis and LGV has increased in recent years in Spain. Additionally, HSV, syphilis and chancroid can also increase the risk of HIV acquisition and transmission. The population groups most vulnerable to these infections are young people, men who have sex with men (MSM) and commercial sex workers. It is important to make a timely differential diagnosis since genital, anal, perianal, and oral ulcerative lesions may pose differential diagnosis with other infectious and non-infectious conditions such as candidiasis vulvovaginitis, traumatic lesions, carcinoma, aphthous ulcers, Behçet's disease, fixed drug eruption, or psoriasis. For this reason, the dermatologist plays a crucial role in the diagnosis and management of sexually transmitted infections. This chapter presents the main epidemiological, clinical and therapeutic features associated with these infections., (Copyright © 2024 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

La información sobre la presentación y los factores predisponentes del síndrome de úlcera gástrica en mulas (SUGM) es escasa en comparación con el síndrome de úlcera gástrica en equinos (SUGE) y asnales. Debido a la naturaleza multifactorial de este síndrome, la helicobacteriosis ha sido estudiada en otras especies. El objetivo de este trabajo fue establecer la presencia de Helicobacter spp. en mucosa gástrica de mulas a través de la prueba rápida de la ureasa (PRU) y de análisis histopatológico. Menos del 27% de las muestras reaccionaron a la PRU, con tiempos prolongados de reacción, y al Agar Urea (prueba de oro), con menor porcentaje de positividad. La histopatología reveló procesos inflamatorios crónicos, sin presencia de bacterias curvoespiraladas. Las PRU no fueron conclusivas en la determinación de Helicobacter spp., comportamiento similar reportado en equinos. Se requieren exámenes diagnósticos más específicos y procedimientos complementarios orientados a explorar por regiones del estómago en la consideración del número de muestras representativas.

Copyright of Journal of Negative & No Positive Results is the property of Research & Science S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hospital a Domicilio is the property of Centro Internacional Virtual de Investigacion en Nutricion and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La estomatitis aftosa recurrente es una enfermedad oral caracterizada por la aparición de úlceras dolorosas en la mucosa labial o yugal. Su etiología es desconocida; suele afectar a personas menores de 30 años; pudiendo repetir durante meses o años. Antinflamatorios, glucocorticoides, antibióticos, entre otros, son tradicionalmente indicados para el manejo de las lesiones. Debido a los efectos colaterales de estos tratamientos, se ha sugerido la terapia láser. El objetivo del reporte fue establecer si el láser diodo de alta potencia desenfocado es efectivo contra la estomatitis aftosa de una paciente de 30 años, que padecía de úlceras bucales desde los 10 años, sin éxito con los tratamientos tradicionales. Las lesiones se irradiaron con 1W de láser diodo, modo continuo con fibra de 400 µm seguido de onda plana y pieza disfocal angulada en lengua, labio interno y carrillos. Asimismo, se aplicó laserpuntura en zona extraoral, para un total de 10 sesiones. Se observó reducción completa del dolor al tercer día de irradiación. Después de 1 año de seguimiento no se evidenció recurrencia. Se concluye que el láser diodo mostró mejores resultados que los anteriores tratamientos al aliviar rápidamente el dolor, evitar la recidiva y mejorar la autoestima de la paciente.

Copyright of Revista de la Facultad de Odontología. Universidad Nacional de Cuyo is the property of Universidad Nacional de Cuyo, Facultad de Odontologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Martorell's hypertensive leg ulcer was first described in 1945 as an extremely painful ulcer lesion and erythematous-violaceous edges on the lower limbs, initially associated with uncontrolled systemic arterial hypertension, later related to type 2 diabetes and obesity, in women between 50 and 70 years of age. CLINICAL CASE: A 33-year-old female patient with a history of poorly controlled hypertension and grade II obesity, who initially presented a spontaneous blister-like lesion at the left plantar level, progressing to a very painful left pretibial necrotic ulceration, denying trauma at that level. The ankle brachial index of the affected limb was 1.2 mmHg. Doppler ultrasound did not show an obstructive process; an incisional biopsy identified a characteristic arteriolosclerosis, hyalinosis and atrophy at the subcutaneous cellular tissue level; integrating the diagnosis of hypertensive ulcer of Martorell. Surgical debridement was performed with significant pain relief, she was a candidate for the application of local therapy with negative pressure continuously, favoring the appearance of granulation tissue. CONCLUSIONS: In Mexico, due to the high prevalence of systemic arterial hypertension, type 2 diabetes, and obesity, it is suggested to consider Martorell's hypertensive ulcer a possible cause when treating ulcerative lesions in this group of patients, with the aim of not delaying diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Introducción: los pacientes con heridas de difícil cicatrización son un reto clínico ya que la cicatrización se prolonga en el tiempo o muchas veces no se alcanza, pasando a ser una herida crónica. Presentamos el caso inusual de un tumor apendicular mucinoso tipo adenoma serrado del apéndice fistulizado a región inguinal derecha. Caso clínico: paciente femenina de 74 años de edad quien consulta al servicio de Urgencias con herida abscedada en región inguinal derecha que, mediante manejo interdisciplinario con técnicas avanzadas, se logra mejorar y cerrar. Reingresa después de diez meses, se realiza TAC abdominal que muestra lesión quística en fosa iliaca derecha adosada a la pared abdominal. Se explora quirúrgicamente, encontrando lesión tumoral incidental en el apéndice cecal, fistulizada. Se realiza apendicectomía con cierre primario de herida, el estudio histopatológico reporta tumor mucinoso del apéndice compatible con adenoma serrado con margen de resección libre de tumor. El seguimiento a un año no evidencia compromiso intraabdominal. Conclusiones: La herida crónica se define como una pérdida de continuidad de la superficie epitelial con pérdida de sustancia, con escasa o nula tendencia a la curación espontánea y que requiere periodos muy prolongados para su cicatrización por segunda intención. Las causas tumorales son infrecuentes, los casos como el reportado se convierten en un reto clínico que requieren una solución pronta.

Objetivo: analisar os perfis demográfico, clínico e terapêutico dos pacientes atendidos em uma Unidade de Tratamento Integral de Ferida. Método: estudo quantitativo, exploratório-descritivo, retrospectivo, que analisou relatórios gerenciais e prontuários de pacientes com feridas crônicas atendidos nas modalidades ambulatorial, hospitalar ou domiciliar. Resultados:dentre os 176 pacientes (100,0%), 50,6% eram do sexo feminino, com média de idade de 71,4 anos (DP±16,5). A assistência hospitalar foi predominante (52,8%); prevaleceram as doenças Hipertensão Arterial e Diabetes Mellitus. Houve associação estatística entre incontinência fecal e Lesão por pressão estágio dois (p=0,018); Diabetes Mellitus e Lesão por pressão estágio três (p

Objetivo: analizar los perfiles demográfico, clínico y terapéutico de los pacientes atendidos en una Unidad de Tratamiento Integral de Heridas. Método: estudio cuantitativo y retrospectivo, que analizó informes gerenciales e historias clínicas de pacientes con heridas crónicas atendidos en una Unidad de Tratamiento Integral de Heridas de Vitória da Conquista-Bahía, Brasil. Los datos, recolectados en febrero de 2020, fueron sometidos a análisis descriptivo e inferencial, y la prueba de chi-cuadrado con valor p

Background: Despite the fact that Helicobacter spp. has been detected in equine gastric mucosa, no evidence exists about this infection in Colombian horses affected by equine ulcerative gastric syndrome (EGUS), nor in dental tartar. Objective: To detect Helicobacter spp. DNA in equine gastric mucosa and dental tartar and determine the relationship between the presence of Helicobacter spp. and gastric lesions. Methods: Samples of glandular gastric mucosa and dental tartar were collected from 30 equine slaughterhouses. Macroscopic lesions of the stomachs were classified and the total DNA in all samples was extracted using a commercial extraction kit. A final-point PCR was performed using primers for amplification of a segment of 251 bp of the gene encoding the 16s rRNA region; the amplified fragments were subjected to a second PCR to determine the presence of H. pylori, the VacA gene was typified. The resulting amplicons were sequenced. Results: It was possible to amplify 16s rRNA in several samples but there was no amplification of VacA. Fragments of the sequences were compatible with H. heilmannii. The 23.3 and 10% of gastric and tartar samples were positive for 16s rRNA of Helicobacter spp., respectively. Conclusion: Although genetic material of Helicobacter spp. was found in some animals, there was no relationship with gastric lesions. It is possible that helicobacteriosis has no bearing in EGUS etiology. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis is a neglected disease caused by an intracellular parasite of the genus Leishmania. The implementation of new techniques for its monitoring is increasing. This article presents a methodology based on photogrammetry for the follow-up and evaluation of skin ulcers caused by cutaneous leishmaniasis. Leishmaniasis was experimentally inoculated into golden hamsters, which were analyzed during and after treatment for four months. The follow-up of the evolution of the disease is carried out by taking clinical (manual) and computational measurements. The clinical data were obtained using a caliper, measuring directly on the ulcerated area and performing calculations of geometric approximations with sizes similar to the ulcerated area (square and elliptical). Computational data was obtained by Agisoft PhotoScan software using a photogrammetry-based 3D reconstruction technique to model and extract information from the surface. Validation is carried out on the size of the cutaneous ulcerative areas under study, comparing the square and elliptical approximation of the area with that calculated by the software (total area of the 3D surface generated from the point cloud). This validation is performed by graphically comparing the trend in the variation of the ulcer area of each hamster, and an area correlation calculation (clinical vs computational measurements). As a result, 60% of the study population presents a strong correlation with a value of 0.8. We found that the computational technique allows physicians to provide a more reliable concept during ulcer healing follow-up. [ABSTRACT FROM AUTHOR]

Se presentan 8 casos de enfermos portadores de úlcera gástrica, a los cuales se les practicó una resección de la úlcera y se les · asoció una vagotomía con operación de drenaje gástrico como tratamiento quirúrgico. Esta terapéutica se realizó como de necesidad y no de elección, motivada ya por la gravedad de los pacientes, por la ubicación del cráter ulceroso así como por la edad avanzada. La evolución postoperatoria fue buena. Creemos que es una conducta a tener presente en este tipo de pacientes.

El análisis de nuestra serie de operados demuestra algunos hechos que coinciden con los observados en grandes estadísticas existentes en la literatura. Destacaremos: 1) Ausencia de mortalidad en nuestra serie. 2) Mínima morbilidad de la vagotomía con drenaje gástrico, tanto en lo referente al número como en lo que respecta a la entidad de las complicaciones. 3) Baja incidencia y escasa jerarquía de las secuelas funcionales en el postopera torio alejado. 4) Eficacia para obtener una importante reducción de la secreción gástrica de HCl.

A úlcera refratária é caracterizada por uma lesão espontânea superficial da córnea, geralmente recidivante, e que não cicatriza dentro de um período habitual de tratamento. É ocasionada pela não aderência do epitélio ao estroma corneano. O diagnóstico é realizado pelo curso clínico e característica da lesão, observadas através de exame e testes oftalmológicos. Além do tratamento terapêutico adequado, deve ser removido o epitélio não aderente, a fim de facilitar o crescimento de novas células epiteliais, com complexos de adesão mais fortes. A broca de diamante (DB), destaca-se de forma promissora no tratamento para as úlceras refratárias, através da ceratectomia superficial. O procedimento com a DB é descrito em variadas espécies, contudo é raramente descrita em gatos. Dessa forma objetivou-se relatar o emprego da DB no tratamento de úlcera superficial não cicatrizante em um gato. O DB mostrou ser um dispositivo eficaz, de fácil aplicação, bem tolerado e seguro, na resolução de uma úlcera de córnea refratária num gato da raça Persa.

More than 30 million persons worldwide take nonsteroidal anti-inflammatory drugs (NSAIDs) on a daily basis, and annual consumption is increasing. In addition to their analgesic and anti-inflammatory properties, NSAIDs also produce well-known gastrointestinal adverse events. There is no consensus in Mexico on the diagnosis, treatment, and prevention of NSAID-induced gastropathy and enteropathy, and so the Asociación Mexicana de Gastroenterología brought together a group of experts to establish useful recommendations for the medical community. Thirty-three recommendations were formulated in the present consensus, highlighting the fact that the risk for NSAID-induced gastrointestinal toxicity varies according to the drug employed and its pharmacokinetics, which should be taken into account at the time of prescription. The risk factors for gastroduodenal complications due to NSAIDs are: a history of peptic ulcer, age above 65 years, high doses of NSAIDs, Helicobacter pylori infection, and the presence of severe comorbidities. The symptoms and gastroduodenal damage induced by NSAIDs vary, ranging from an asymptomatic course to the presentation of iron-deficiency anemia, bleeding, stricture, and perforation. Capsule endoscopy and enteroscopy are direct diagnostic methods in NSAID enteropathy. Regarding prevention, the minimum dose of an NSAID needed to achieve the desired effect, administered for the shortest period of time, is the recommendation. Finally, proton pump inhibitors are the gold standard for the prophylaxis and treatment of gastroduodenal effects, but they are not useful in enteropathy. Resumen: Más de 30 millones de personas consumen diariamente antiinflamatorios no esteroideos (AINE) en el mundo, y este consumo se ve incrementado anualmente. Aunque los AINE poseen propiedades analgésicas y antiinflamatorias, sus eventos adversos gastrointestinales son bien reconocidos. En nuestro país no existía un consenso respecto al diagnóstico, tratamiento y prevención de la gastropatía y la enteropatía por AINE, por lo que la Asociación Mexicana de Gastroenterología reunió a un grupo de expertos para establecer recomendaciones de utilidad para la comunidad médica. En este consenso se emitieron 33 recomendaciones. El consenso destaca que el riesgo de toxicidad gastrointestinal de los AINE varía según el fármaco empleado y su farmacocinética, lo cual debe ser considerado al momento de su prescripción. Los factores de riesgo de complicación gastroduodenal por AINE son: antecedente de úlcera péptica, edad mayor a 65 años, dosis altas del AINE, infección por Helicobacter pylori (H.pylori), y presencia de comorbilidades graves. Los síntomas y el daño gastroduodenal inducido por AINE son variables ya que puede cursar asintomático o manifestarse como anemia por deficiencia de hierro, hemorragia, estenosis y perforación. La cápsula endoscópica y la enteroscopia son métodos diagnósticos directos en la enteropatía por AINE. Respecto a la prevención, se recomienda prescribir la dosis mínima necesaria de un AINE para obtener el efecto deseado y durante el menor tiempo. Finalmente, los inhibidores de la bomba de protones (IBP) representan el estándar de oro para la profilaxis y tratamiento de los efectos gastroduodenales, mas no son útiles en la enteropatía.

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Presentado en sesión de 13 de octubre 1954

Presentado en sesión de 24 de junio de 1953

Introduction: The radionecrosis ulcer have to be widely resected and repaired trough flaps with good blood supply who contibute with oxigen, nutrients and antibiotics.Thinking on this the more suitable flaps are the myocutaneous ones and in special conditions the fasciocutaneous. Aim: The objetive of this paper is to show the surgical treatment of radionecrosis ulcers with myocutaneous and fasciocutaneous flaps. Materials and Method: Casuistic is 31 patients with radionecrosis ulcers treated with, mainly, myocutaneous flaps and in special areas with fasciocutaneous ones. The majority were pedicle flaps and in less number microsurgical flaps. The age of patients were betwee30 and 75 years old. Results: 19 muscle or myocutaneous flaps and 12 fasciocutaneous flaps were made. Flaps were latissimus dorsi, temporal, escapular, para escapular, rectus abdominis, rectus femoris,gracilis, gatrocnemius, cone flap and local fasciocutaneous flaps. Complications were sutured operative wound dehiscence and cellulitis treated with antibiotics. There were no complete necrosis of any flap. Discusion: In this serie we used muscle or myocutaneous flaps because they give good blood supply, oxigen, nutrients and arrival of antibiotic with filling of the deep ulcers. When the ulcers were shallow we use fasciocutaneous flaps. The majority of our flaps were pedicles and microsurgical flaps were used when there was no near avialable tissue. Conclusion: The treatment have to be wide debridement of the ulcer. The surgical treatment is with myocutaneous and fasciocutaneous flaps sometimes pediculates and in others conditions microsurgicals. Keywords: ulcer; radionecrosis; myocutaneous flap; fasciocutaneous flap. [ABSTRACT FROM AUTHOR]

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