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Background:Preservation rhinoplasty is a widely used technique; however, its use on mestizo noses is poorly documented. Our objective was to assess the level of satisfaction of our mestizo patients 1 year after their preservation rhinoplasty. Methods:The Rhinoplasty Outcome Evaluation (ROE), a Likert-type questionnaire validated in Spanish, was used to assess the level of satisfaction of 14 mestizo patients who underwent preservation rhinoplasty from March to July 2021 at 1 year after their surgery at the Higuereta Clinic in Lima, Peru. Results:The study included 14 patients, three men and 11 women, who underwent preservation rhinoplasty. A presurgical ROE questionnaire was applied, presenting a minimum value of 6, a maximum value of 21, and a mean of 12. When applied 1 year after surgery, the same ROE questionnaire presented a minimum value of 28, a maximum value of 30, and a mean of 30. The variation had a minimum value of 9 and a maximum value of 23, with a mean of 17 (P < 0.001). Conclusions:Preservation rhinoplasty can be successfully implemented in mestizo noses with good aesthetic results.

Background: Communities that do not accommodate the needs and preferences of people with dementia can exacerbate disability and isolation. Although dementia-friendly communities (DFCs) were established to foster understanding and acceptance of dementia, the built environment remains underexplored. We identified the challenges and opportunities for fostering dementia-enabling environments among community planners. Method: This study is set in South-West Sydney, Australia, where a DFC is being established. The policies of seven local governments were analysed for actions that aligned with Dementia Australia’s 41 DFC recommendations: 13 for social, 14 for outdoor, and 14 for indoor environments. An online workshop was then held with 30 community planners to raise awareness for dementia-enabling environments. Participants were surveyed about their dementia beliefs and attitudes. Facilitated discussions identified challenges and opportunities for designing DFCs. Qualitative and quantitative data across all sources were triangulated. Result: Although none of the local government policies specifically mentioned dementia, up to 20/41 DFC actions were met. Most of these were in social engagement (with ≤10/13 recommendations met by each local government). Less action was taken on outdoor and indoor environments (with ≤9/14 outdoor and ≤4/14 indoor recommendations met by up to six local governments). Although beliefs and attitudes about dementia among planners were generally positive, only 48% indicated that they had a good understanding of it and nearly 80% noted they would feel anxious and depressed about a diagnosis. Key DFC challenges included a lack of awareness and conflicting priorities between government bodies. Opportunities included engaging with universities to conduct demographically relevant awareness raising, facilitate multisectoral collaboration, developing an evidence-base, and involving service providers to engage with the dementia community. Conclusion: This study triangulated data to identify gaps in community planning efforts, confirming that more action is required to design dementia-friendly communities. We are now leading a multisectoral collaboration to educate community planners and the public, and are advocating for the recognition of dementia-friendly environments in government plans. This study provides practical guidance to assist planners with DFC designs.

Resumen El osteoma de oído medio es un tumor poco común, de crecimiento lento y características benignas. Frecuentemente cursa de forma asintomática y su diagnóstico suele ser casual como en el caso que exponemos. Se presenta el caso de un varón de 26 años, que consultó por odinofagia y otalgia derecha en el contexto de una infección de vía aérea alta. Al explorarlo mediante otoscopia se visualizó en el oído izquierdo una lesión blanquecina y redondeada retrotimpánica compatible con osteoma de oído medio. El tratamiento de elección en pacientes con osteomas de oído medio sintomáticos es la cirugía. Sin embargo, en pacientes asintomáticos el seguimiento es la opción más recomendada.

Pregrado T?cnico en Registro M?dico y Estad?stica de Salud

Hereditary transthyretin amyloidosis (hATTR) is a disease caused by mutations in the transthyretin gene that frequently shows cardiac involvement due to amyloid deposition in the myocardium. Our objective was to identify cardiac involvement in a Spanish cohort.

INTRODUCTION: Spain is one of the countries with the lowest rates of revascularisation and highest ratio of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG). OBJECTIVES: To investigate the changes and trends in the two revascularisation procedures between 1998 and 2017 in Spain. DESIGN: Retrospective cohort study. Analysis of in-hospital outcomes. SETTING: Minimum basic data set from the Spanish National Department of Health: mandatory database collecting information of patients who are attended in the Spanish public National Health System. PARTICIPANTS: 603 976 patients who underwent isolated CABG or PCI in the Spanish National Health System. The study period was divided in four 5-year intervals. Patients with acute myocardial infarction on admission were excluded. PRIMARY AND SECONDARY OUTCOMES: We investigated the volume of procedures nationwide, the changes of the risk profile of patients and in-hospital mortality of both techniques. RESULTS: We observed a 2.2-fold increase in the rate of any type of myocardial revascularisation per million inhabitants-year: 357 (1998) to 776 (2017). 93 682 (15.5%) had a coronary surgery. PCI to CABG ratio rose from 2.2 (1998-2002) to 8.1 (2013-2017). Charlson's index increased by 0.8 for CABG and 1 for PCI. The median annual volume of PCI/hospital augmented from 136 to 232, while the volume of CABG was reduced from 137 to 74. In the two decades, we detected a significant reduction of CABG in-hospital mortality (6.5% vs 2.6%, p