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Surgical Complications in Breast Reconstruction: Assessment and Associations

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Journal of Biosciences and Medicines 2023年第6期11卷 171-181页

作者： Daniel De-Luna-Gallardo jaime aron garcía-espinoza Cuahútemoc Márquez-Espriella Blanca Yadira Arámbula-Sánchez Marco Antonio Cuervo-Vergara Rodrigo Dávila-Diaz Ricardo garcía-Corral Fernando Barbosa-Villarreal Fernando Isaac Recio-España Alberto Ignacio Cahuana-Quispe Plastic and Reconstructive Surgery Department Central South High Specialty Hospital of Petróleos Mexicanos Mexico City Mexico Plastic and Reconstructive Surgery Department Petróleos Mexicanos North Central Hospital Mexico City Mexico

Introduction: Breast cancer represents a pathology that generates catastrophic impact and has recently increased its incidence and survival due to timely diagnosis and treatment. Therefore, improving the quality of life of cancer survivors has become a priority, offering reconstructive procedures that reduce complications, costs, hospital stay, and optimize resources. Material and methods: 264 patients reconstructed with autologous tissue (TRAM flap and latissimus dorsi) and alloplastic (breast tissue expander—breast implant and direct breast implant) were included. Variables such as demographic, anthropometric, and histologic type were collected. Results: 62% were reconstructed through the use of alloplastics and 38% with autologous tissue. The risk factors related to a greater probability of immediate postoperative complications (surgical site infection, surgical wound dehiscence and reconstruction failure) were obesity (OR: 2.1, CI: 1.5 - 2.7), preoperative radiation (OR: 1.89, CI: 1.75 - 1.92), arterial hypertension (OR: 1.2), Diabetes Mellitus (OR: 1.78) and smoking (OR: 1.31). Conclusions: The reconstructive process is complex and influenced by patient factors, surgeon experience and the hospital center. However, when choosing the reconstructive strategy, risk factors present in each patient must be considered, since radiation and obesity present a greater probability of postoperative complications.

关键词： Breast Cancer Breast Reconstruction Obesity Radiotherapy TRAM

Upper Blepharoplasty Scar and Patient Satisfaction Evaluation in a Plastic Surgery Center in Mexico

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Journal of Biosciences and Medicines 2020年第6期8卷 77-88页

作者： Victor Hugo Avalos Gómez jaime aron garcía espinoza José Carlos Martínez López Carlos Illich Navarro Delgadillo Blanca Yadira Arámbula Sánchez Alejandro Costa Dulche Cuahutemoc Márquez Espriella Esteban Israel Campos Serna Division of Plastic and Reconstructive Surgery Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos Mexico City Mexico

Background: Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most common procedures performed in plastic surgery. Standardized tools allow for measurement of outcomes through patient satisfaction and surgeon experience. Objectives: Our objective was to measure the satisfaction index and scar quality of patients who underwent upper blepharoplasty using the Patient-reported Outcome Measure Questionnaire (PROM-Q) and Patient and Observer Scar Assessment Scale (POSAS). Methods: A retrospective review of patients that underwent upper blepharoplasty in our institution was performed. We included those with a preoperative anthropometric analysis, standardized incision markings (developed in our center), same operative technique and a 3-month postoperative evaluation with PROM-Q and POSAS. The sample for this study consists of 67 patients, all of them operated between January 1 2019 and June 30 2019 at the Department of Plastic Surgery, South Central High Specialty Hospital, Pemex, Mexico City, Mexico. Results: A total of 67 patients were included, 73% female and 27% male. The most frequent indication for surgery was functional visual symptoms. The index of PROM-Q at 3 months demonstrated an increased satisfaction above 90%, and the evaluation with POSAS reported an almost imperceptible scar. Conclusion: Evaluating outcomes with objective tools provides data useful to improve the surgical protocols of patients subjecting to aesthetic procedures.

关键词： Upper Blepharoplasty Satisfaction Index PROM-Q Quality of Life Scar

Anthropometric Analysis of the Upper Eyelid and Eyebrow in Patients Attended by the Plastic and Reconstructive Surgery Service of the Hospital Central Sur De Petróleos Mexicanos

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Journal of Biosciences and Medicines 2022年第8期10卷 47-56页

作者： Alejandro Costa-Dulché jaime garcía-espinoza Daniel De-Luna-Gallardo Cuahutemoc Márquez-Espriella Rodrigo Dávila-Díaz Blanca Arámbula-Sánchez Marco Cuervo-Vergara David Flores-Soto Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos Mexico City Mexico

Upper eyelid blepharoplasty is one of the most frequently performed surgeries by plastic surgeons worldwide. A prospective observational study was conducted to describe the anthropometric measurements of the upper eyelid and eyebrow in a Mexican population. The researcher measured the anthropometry of the eyelids and eyebrows to establish the diagnosis and surgical plan according to the checklist created and applied by the plastic and reconstructive surgery service. In anatomical position with a caliper instrument, the marginal reflex distance (MRD1), the tarsal thickness, the length of the vertical and horizontal slit, and finally the distance at which the external canthus is located with respect to the internal canthus were measured in millimeters. For the anthropometry of the eyebrows, the distance from the eyebrows to the hairline, the position in millimeters of the orbital rim with respect to the eyebrow, and the angle of its apex were measured. A sample of 210 patients was obtained, of which 65 were male and 145 females, divided by age groups. It was observed that in the three age groups, females presented a vertical palpebral fissure with a higher mean than males. Similar is the case of tarsal thickness, in which the difference was significantly greater in the female of the three age groups. On the other hand, it was observed that the horizontal slit in males was higher than that of females, while the MDR1 was similar in both sexes. Finally, it was identified that in the group of 41 to 50 years old significant decreases are observed both in the vertical cleft, tarsal thickness and the position of the external canthus compared to the group of 20 to 30 years old, this is due to the aging process. When evaluating the anthropometrics of the eyebrows, a greater distance from the trichion to the eyebrow was observed in males than in females, in contrast to the position of the eyebrow with respect to the supraorbital rim and its apex, in which it was shown that in f

关键词： Eyelid Upper-Eyelid Eyebrow Anthropometrics Facial-Analysis

Study of the Copper,Chromium,Manganese and Zinc Contents in the Species Azorella spinosa(Apiaceae),Collected in the Maule Region,Chile

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Journal of Environmental Protection 2019年第5期10卷 601-613页

作者： jaime Tapia Jorge Cornejo Margarita Gutierrez Patricio Penailillo Ricardo Baettig Luis Vargas-Chacoff Jessica espinoza Aurelio San Martin Institute of Natural Resources Chemistry University of TalcaTalcaChile Institute of Biological Sciences University of TalcaTalcaChile Faculty of Forestry Sciences University of TalcaTalcaChile Institute of Marine Science and Limnology University Austral of ChileValdiviaChile University of Magallanes Punta ArenasChile

The increase in prevalence of environmental pollution, especially soil contamination with toxic metals has led to their uptake in the human food chains through plant parts. Accumulation and magnification of heavy metals in human tissues through comsuption of herbal medicine can cause hazardous impacts on health. Therefore, chemical profiling of four heavy metals (Cu, Cr, Mn and Zn) was undertaken in samples of Azorella spinosa from coast and mountain of Maule Region in Chile. The Cu, Cr, Mn and Zn concentrations were determined in plants of the species Azorella spinosa and their soils of origin. For each plant, the metal contents in the stalk, leaves and soil were determined by flame atomic absorption spectroscopy. The methodology was validated using certified reference material: BIMEP-432 for the plant samples and MESS-1 for the soil samples. The concentration ranges found in the plant tissue were: Cu: 1.2 - 62.5;Cr: 0.2 - 3.2;Mn: 188.6 - 1345.1 and Zn: 7.5 - 55.9 mg·kg-1 (dry weight). For the soil samples, the ranges were: Cu: 6.4 - 81.5;Cr: 4.6 - 50.4;Mn: 335.6 - 1936.1 and Zn: 15.6 - 65.9 mg·kg-1 (dry weight). The results were evaluated statistically (two-way ANOVA) to correlate the Cu, Cr, Mn and Zn concentrations in Azorella spinosa plant tissues with those in the soil samples from the corresponding sampling areas.

关键词： Azorella spinosa Toxic Metals Atomic Absorption Maule Region

Patient Satisfaction Index and Quality of Life Measurement with Breast-Q after Breast Reconstruction in a Plastic Surgery Center in Mexico

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Journal of Biosciences and Medicines 2021年第6期9卷 94-105页

作者： Jose C. Martinez-López jaime A. garcía-espinoza David Flores-Soto Carlos I. Navarro-Delgadillo Cuahutemoc Márquez-Espriella Rodrigo Dávila-Diaz Esteban I. Campos-Serna Víctor H. Avalos-Gómez Division of Plastic and Reconstructive Surgery Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos Mexico City Mexico

Introduction: Cancer is one of the most devastating pathologies to affect the breast. Mastectomy stigmas are associated with depression, body image dysmorphia, and decreasing quality of life. BREAST-Q is a PROM (Patient Reported Outcome Measures) that has proven useful in measuring satisfaction with breast reconstruction results from the patient’s point of view. Objectives: To measure the satisfaction index and improvement in quality of life after breast reconstruction for breast cancer sequelae in our hospital in the last 5 years. Materials and Methods: Descriptive Study that includes patients with Breast cancer diagnosis that underwent mastectomy and breast reconstruction (prosthesis or autologous tissue) in “Hospital Central Sur de Petroleos Mexicanos” (January 2015 to January 2020), whose satisfaction index was measured with BREAST-Q one year after reconstruction. Results: 153 patients were included in the analysis. Mean global satisfaction was 74 points. We observed a tendency towards higher psychosocial, sexual and appearance satisfaction in patients who underwent reconstruction with autologous tissue. The mean satisfaction with provided information was 64 points and with the medical team > 90 points. Conclusion: Breast reconstruction is associated to a high satisfaction index and quality of life improvement regardless of the technique. BREAST-Q proved to be useful in evaluating patient experience and it helped us identify areas of opportunity to improve our care.

关键词： BREAST-Q Breast Reconstruction PROM’s Satisfaction Index Quality of Life Mexico

Anthropometric Breast Measurements: Analysis of the Average Breast in the Mexican Female Population

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Journal of Biosciences and Medicines 2022年第3期10卷 124-135页

作者： David Flores-Soto Jose C. Martinez-López Fernando Barbosa-Villarreal Fernando I. Recio-Espana jaime A. garcía-espinoza Alfredo Chama-Naranjo Ana P. Campollo-Lopez D. Deluna-Gallardo Alejandro Costa-Dulche Cuahutemoc Márquez-Espriella Division of Plastic and Reconstructive Surgery Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos Mexico City Mexico

Introduction: The elements and perception of beauty vary between populations around the world. To obtain better results, surgical techniques should be planned based on anthropometric characteristics of the race, location, and body mass index (BMI). Objectives: To determine which are the standard measurements and anatomical proportions of the breast in a healthy Mexican women population. Materials and Methods: Female Mexican volunteers between 20 and 60 years of age, without any history of breast illness or breast surgery were studied. Demographic information and standard breast anthropometric measurements were collected manually by one of the authors. For the statistical analysis a Student-T test was performed, and the Pearson correlation coefficient was obtained using the latest version of SPSS software. Results: 78 volunteers were included in the analysis. Mean height, weight and BMI were 1.6 m, 68.9 Kg, and 26.6 Kg/m2 respectively. The mean anthropometric values found were: Supra Sternal notch to nipple distance (SSN:N) 22 cm, Breast volume (BV) 372.6 cm3, Upper breast pole length (UBPL) 11 cm, Lower Breast Pole length (LBPL) 7.7 cm, Midline to Nipple distance (ML:N) 10.2 cm, Transverse diameter of the Nipple areola complex (NAC-T) 4.1 cm, Height of the Nipple Areola Complex (NAC-H) 4.1 cm, Base of the breast (BB) 13.4 cm, Upper Pole to Lower Pole Ratio (UPP:LPP) 58.9:41.1. A statistically significant difference between Right and left breast was not found. The UPP/ LPP ratio in our population is far different from what is considered internationally aesthetic (45:55). A positive correlation was found between weight/ BMI and SSN:N, BV, BB, ML:N and LBPL. Also between age and SSN:N, LBPL, BV and BB. Conclusion: This study sets the Anthropometric grounds in Mexican population for an objective individual patient analysis and comparison with the female population of this and other nations.

关键词： Average Breast Anthropometric Measurements Mexico Breast Anthropometric Measurements Mexico

Some Aspects at the Formation in Engineering： The Curriculum by Competitions and the Curriculum Socio-Critic

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Psychology Research 2015年第11期5卷 655-659页

作者： jaime espinoza Oyarzun University of Santiago of Chile (USACH) Santiago Chile

Diversity and host assemblage of avian haemosporidians in different terrestrial ecoregions of Peru

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Current Zoology 2022年第1期68卷 27-40页

作者： Luz garcIA-LONGORIA jaime MURIEL Sergio MAGALLANES Zaira Hellen VILLA-GALARCE Leonila RICOPA Wilson Giancarlo INGA-DIAZ Esteban FONG Daniel VECCO Cesar GUERRA-SALDANA Teresa SALAS-RENGIFO Wendy FLORES-SAAVEDRA Kathya espinoza Carlos MENDOZA Blanca SALDANA Manuel GONZALEZ-BLAZQUEZ Henry GONZALES-PINEDO Charlene LUJAN-VEGA Carlos Alberto Del AGUILA Yessica VILCA-HERRERA Carlos Alberto PINEDA Carmen REATEGUI Jorge Manuel CARDENAS-CALLIRGOS JoseAlberto IANNACONE Jorge Luis MENDOZA Ravinder NMSEHGAL Alfonso MARZAL Departamento de Anatomia Biologia Celular y ZoologiaUniversidad de ExtremaduraBadajoz E-506071Spain Molecular Ecology and Evolution Lab Department of BiologyLund UniversitySolvegatan 37SE-22362 LundSweden Instituto Pirenaico de Ecologıa-IPE(CSIC) Avda.Nuestra Senora de la Victoria 16Jaca 22700Spain DIRESA Direccion Regional de SaludLoreto 16001Peru Departamento Academico de Microbiologia y Parasitologia.Facultad de Ciencias Biologicas Universidad Nacional de la Amazonia PeruanaIquitos 16001Peru Facultad de Ciencias Agropecuarias Universidad Alas PeruanasLima 15823Peru EverGreen Institute-San Rafael Distrito de IndianaLoreto 16200Peru Observatorio de Aves Loreto(LBO) Distrito de San JuanLoreto 16008Peru Centro Urku de Estudios Amazonicos Tarapoto 22200Peru Servicio Nacional de Areas Naturales Protegidas por el Estado 15036Peru Sanidad Animal-Facultad de Zootecnia Universidad Nacional Agraria La MolinaLima 15012Peru Laboratorio de Microbiologia Facultad de Medicina Veterinaria y ZootecniaUniversidad CientUfica del SurLima 15067Peru Laboratorio de Analisis Clinico Moraleslab SAC MoralesSan Martin 22201Peru Asociacion Ecosistemas Andinos(ECOAN) Cuzco 08002Peru Pharmacology and Toxicology Graduate Group University of CaliforniaDavisDA 95616USA Global Health Initiative Wabash CollegeCrawfordsvilleIN 47933USA Facultad de Ciencias Biologicas Universidad Nacional Mayor de San MarcosLima 15081Peru Facultad de Medicina Veterinaria Universidad Nacional Hermilio ValdizanHuanuco10160Peru Asociacion Peruana de Helmintologia e Invertebrados Afines Lima 15054Peru Laboratorio de Ecologia y Biodiversidad Animal Universidad Nacional Federico VillarrealEl AgustinoLima 15007Peru Laboratorio de Invertebrados Universidad Ricardo Palma-Santiago de SurcoLima 15537Peru Department of Biology San Francisco State UniversitySan FranciscoCA 94132USA

Characterizing the diversity and structure of host–parasite communities is crucial to understandingtheir eco-evolutionary *** and related haemosporidian parasites are responsible forfitness loss and mortality in bird species ***,despite exhibiting the greatest ornithologicalbiodiversity,avian haemosporidians from Neotropical regions are quite ***,we analyze the genetic diversity of bird haemosporidian parasites(Plasmodium andHaemoproteus)in 1,336 individuals belonging to 206 bird species to explore for differences in diversityof parasite lineages and bird species across 5 well-differentiated Peruvian *** 70 different haemosporidian lineages infecting 74 bird *** showed that 25 out ofthe 70 haplotypes had not been previously ***,we also identified 81 new host–parasite interactions representing new host records for these haemosporidian *** outcomesrevealed that the effective diversity(as well as the richness,abundance,and Shannon–Weaver index)for both birds and parasite lineages was higher in Amazon basin ***,we also showed that ecoregions with greater diversity of bird species also had highparasite richness,hence suggesting that host community is crucial in explaining parasite *** parasites were found in ecoregions with lower bird diversity,implying that the abundanceand richness of hosts may shape the exploitation strategy followed by haemosporidian *** outcomes reveal that Neotropical region is a major reservoir of unidentified *** studies analyzing host distribution and specificity of these parasites inthe tropics will provide important knowledge about phylogenetic relationships,phylogeography,and patterns of evolution and distribution of haemosporidian parasites.

关键词： Amazonia avian malaria generalist parasite habitat specificity Haemoproteus Plasmodium specialist parasite