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Hoyos A.,San Martin University Foundation | Perez M.,Calle 99 and 9A 80 Suite 908
Aesthetic Plastic Surgery | Year: 2012

Background: One of the most appealing characteristics of an athletic male body is a well-defined pectoral area. For decades, implants have been the gold standard method for the treatment of this area, but it is not suitable for every case. The goal was to design a mixed technique combining autologous fat extraction and grafting in an anatomically guided fashion to produce a highly athletic contour in the male pectoral. Methods: The patient criteria included a body mass index (BMI) lower than 30 kg/m2, adequate skin tone, and general good health. A three-phase procedure was performed, beginning with infiltration of tumescent solution and followed by fragmentation of extra fat in an anatomic fashion using internal third-generation ultrasound; extraction that blends deep, intermediate, and superficial fat removal; and multilayer fat grafting in the pectoral area. In the presence of gynecomastia, a selective pull-through technique was used in an anatomic manner. Results: In a series of 154 consecutive male patients, the minor complications (n = 15) included asymmetries (n = 10) and residual gynecomastia (n = 5). The major complications (n = 3) included unilateral hematoma (n = 2), and abscess that required sonographic-guided removal (n = 1). An appealing muscular contour was produced in most patients, and the satisfaction rate was very high. Conclusion: Implants are no longer the only option for defining and augmenting the male chest. Combining fat grafting in a multilayer fashion with precise anatomic fat and gland removal achieved a contoured and athletic male pectoral in a safe and reproducible manner. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2012. Source

Gonzalez-Marino M.A.,San Martin University Foundation
Revista de Salud Publica | Year: 2016

Objective To review the direct causes of death from breast cancer in Colombia according to data from death certificates in 2008. Material and Methods We reviewed the direct causes of death in patients whose code of underlying cause of death was malignant tumor of the breast according to the National Statistics Department of Colombia’s (DANE from Spanish initials) records of death in 2008. Distribution is evaluated by diagnostic code, age, educatio nal level, marital status, social security and place of death. Results In women, the main direct causes of death were respiratory insufficiency or failure, cardiac arrest, multiple or multisystem organ failure, breast cancer and metastatic breast cancer. Most of the death codes were C509 and they were issued for women over 50 years. In men, the most common cause was respiratory failure. Conclusions The main denominations listed on death records as a direct cause of death from breast cancer were respiratory failure and arrest and cardiopulmonary arrest. However, it is evident that this arises from problems in the registry that are the result of not following the International Classification of Diseases (ICD-10). Improving the quality of death records is required so that all the information given by the death certificates can be used more effectively. © 2016, Universidad Nacional de Colombia. All rights reserved. Source

Objective To determine the relation between bad self-rated health (SRH) and outcomes of physical and mental health and geriatric syndromes over one year. Methods A prospective study. A cohort of 231 adults over 60 years of age from commune 18 in Santiago de Cali, Colombia were classified into good and poor selfrated of health status according to results of a primary measurement carried out in 2009 and re-measured with the same instrument in 2010. The variables evaluated were physical and mental health, functional deterioration, geriatric syndromes, and use of health services. Parametric and non-parametric statistical tests were used through the module of complex samples of the statistical package SPSS version 17. Results After a year of monitoring, the incidence of mortality was higher among older adults with poor self-perceived health. Important differences were observed in: self-perception of recent weight loss (p=0.009); self-perception of undeliberate weight loss (p=0.065); self-report of suspension of any activity (p=0.001); selfreport of having done less things or activities than before (p=0.011); self-report of having felt their movements were slower (p=0.002); self-report of feeling without energy (0.001); weakened grab power and decreased of walking speed (p <0.05). Conclusion The elderly adults with poor self-perceived health status presented greater health deterioration, geriatric syndromes, and higher frequency of use of health services. © 2015, Universidad Nacional de Colombia. All rights reserved. Source

Hoyos A.,San Martin University Foundation | Perez M.,Private Practice
Aesthetic Surgery Journal | Year: 2012

Background: The contour of the arm is determined by muscular shape and volume. Liposuction in this area is challenging due to the difficulties of achieving symmetry and the high risk of contour irregularities due to fat structures in the region. Objective: The authors describe a new technique to achieve muscular definition in the arm. Methods: From January 2005 to December 2011, a total of 651 arm-sculpting procedures were performed in consecutive patients. Patients with body mass index (BMI) 30 kg/m2 and/or severe skin laxity were excluded. Fat grafting was performed in the deltoid area in selected cases. The areas of fat extraction and grafting were specific to gender: in men, an athletic, muscular look was preferred, whereas in women, a slimmer and less-defined shape was desired. Results: Of the 651 patients, 158 were men (24.3%) and 493 were women (75.7%). Most patients (98.3%) were satisfied with the results in arm dynamic definition. All patients underwent other body contouring procedures at the time of arm enhancement. Complications (n = 21) included 1 soft tissue abscess in the posterior arm, 2 unilateral hematomas, and 3 unilateral seromas that required puncture, along with 15 cases of minor asymmetry. Transitory hardening of the skin of the posterior arm was frequent (n = 104) due to superficial fat extraction, but all cases resolved within 6 months. Conclusion: The authors were able to achieve natural results with this new procedure in arm contouring. The technique is safe and effective with reproducible results when performed through multilayer fragmentation and liposuction with an anatomical extraction. Fat grafting can be performed for contouring with no additional complications. © 2012 The American Society for Aesthetic Plastic Surgery, Inc. Source

Vargas Upegui C.,San Martin University Foundation | Gomez J.,University of California at Los Angeles
Revista Colombiana de Psiquiatria | Year: 2015

Background Anorexia nervosa is an eating disorder in which cardiac arrhythmias and sudden death are frequent causes of mortality, which makes electrocardiographic monitoring indispensable in these patients. There are many suggestive findings but results are contradictory, making a critical review of the scientific literature is necessary. Methods The most relevant studies on electrocardiographic (EKG) changes in patients with AN, found in PubMed from 1974 to February 2014, were reviewed using the MeSH terms: eating disorders, nervosa anorexia, sinus bradycardia, QT prolongation, QT dispersion, electrocardiography, EKG, and electrocardiogram. Findings and discussion The two most common EKG findings reported in the literature are sinus bradycardia and changes in depolarization, as shown by prolongation and increased dispersion of the QT interval. Electrolyte disturbances seem to be the cause of these disturbances in some patients, but other reasons are also discussed in detail, such as QRS right axis deviation, disturbances of heart rate variability, low R wave voltage in V6, amplitude decrease of the QRS and T wave, and QRS prolongation. The majority of authors report that these changes are reversible after treatment of AN. Conclusions These findings support the need for initial and follow-up EKGs in patients with AN and for early diagnosis and treatment of cardiovascular disturbances that are associated with morbidity and mortality. They also support the need for the rational use of psychopharmacology, and that does not increase the risk of arrhythmias and sudden death in these patients. © 2014 Asociación Colombiana de Psiquiatría. Source

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