Abstract This systematic review aims to assess the extent to which biomedical engineering has been applied in the rehabilitation of patients suffering from Guillain-Barré Syndrome (GBS), given the scarcity of information on this topic. We conducted a thorough analysis of research articles, conference abstracts, and case reports published between 2000 and 2023, specifically from ScienceDirect, PubMed, IEEE Xplore, Springer, and Dimensions. 19 articles were extensively discussed, complemented by an additional 40 information sources providing supplementary information. Each paper underwent a meticulous review process by the four authors, where each separately examined the title and abstract of the papers and subsequently provided a thorough examination of the full text; when conflicts arose, a clear consensus was reached through discussion. The analysis of the articles revealed a notable improvement in upper and lower limb function of GBS patients that was facilitated by both custom-made and commercial devices. Likewise, a small handful of other devices have been used (e.g., to improve urinary retention issues). There is a clear opportunity for new research, innovation and applications.

Resumen Esta revisión sistemática tiene como objetivo evaluar hasta qué punto se ha aplicado la ingeniería biomédica en la rehabilitación de pacientes que padecen el Síndrome de Guillain-Barré (SGB), dada la escasez de información sobre este tema. Realizamos un análisis exhaustivo de artículos de investigación, resúmenes de conferencias e informes de casos publicados entre 2000 y 2023, específicamente de ScienceDirect, PubMed, IEEE Xplore, Springer y Dimensions. Se discutieron ampliamente 19 artículos, complementados con 40 fuentes de información adicionales. Cada artículo pasó por un meticuloso proceso de revisión por parte de los cuatro autores, donde cada uno examinó por separado el título y el resumen de los artículos y posteriormente proporcionó un examen exhaustivo del texto completo; cuando surgieron conflictos, se alcanzó un consenso mediante la discusión. El análisis de los artículos reveló una mejora notable en la función de las extremidades superiores e inferiores de los pacientes con SGB que fue facilitada por dispositivos tanto hechos a medida como comerciales. Asimismo, se han creado un pequeño puñado de otros dispositivos, (por ejemplo, para mejorar los problemas de retención urinaria). Existe una clara oportunidad para nueva investigación, innovación y aplicaciones.

Abstract Introduction: Fenestrated and branched stent graft technology has come a long way over the past few years, enabling the treatment of complex juxtarenal aneurysms, thoracoabdominal aneurysms, and arch pathologies. Many innovations have been developed, namely device and delivery optimization and technical tricks. These concepts have proven to work well when there is sufficient time to plan and manufacture a custom-made device for the patient. However, this is different in urgent or emergent cases. Using parallel graft techniques or off-the-shelf stent grafts may be efficient in urgent situations, but it is also associated with selection limitations. Recent publications have demonstrated similar mid-term technical and clinical results between physician-modified endografts (PMEGs) and customized devices. The authors aim to describe their institutional series of PMEGs. Methods: The clinical files of all patients undergoing PMEGs were consulted, and demographic data as surgery outcomes were collected. Technical success: creating the intended number of fenestrations, target vessel catheterization, and patency. Procedural success: technical success with adequate aneurysm exclusion and without endoleak in the final angiography. 30-day complications and mortality were also evaluated. Technical and procedural success were assessed, as well as morbidity and mortality. Results: Between December 2020 and December 2022, 3 patients underwent PMEGs. The indications were a juxtarenal aortic aneurysm, a type V thoracoabdominal aneurysm and a persistent type 1a endoleak. All patients were symptomatic, with one stable rupture. All cases were performed with technical and procedural success and no morbidity and mortality at 30 days. Conclusion: Stent graft modification is a valuable and valid tool in emergencies and should be a vascular surgeon's trump card when dealing with complex aortic pathologies. Nevertheless, due to the absence of long-term evidence, it should be reserved for acute patients unfit for open repair and in aneurysms with unfavorable anatomy for an off-the-shelf device.

RESUMEN Introducción: La impresión tridimensional es una de las tecnologías que promueve el cambio a nivel económico y social, y uno de los elementos fundamentales de la industria 4.0. Asimismo, constituye un enorme potencial para el futuro de la medicina, estableciéndose como un nuevo paradigma. A pesar de sus ventajas, su explotación en nuestro medio es incipiente. Objetivos: Diseñar y desarrollar soluciones basadas en tecnologías tridimensionales para la enseñanza y la práctica de las ciencias biomédicas. Materiales y métodos: Se realizó una investigación colaborativa, de desarrollo tecnológico entre el Centro de Fabricación Asistida y Sostenible de la Universidad de Matanzas y la Universidad de Ciencias Médicas de Matanzas, entre septiembre de 2019 y julio de 2022. Los diseños y fabricaciones se realizaron a partir de la adquisición de imágenes de tomografía computarizada, o desde un escáner de superficie, las que luego se procesaron, se convirtieron en formato Standard Tessellation Language, se imprimieron y posprocesaron. Los diseños virtuales se desarrollaron empleando un software de diseño asistido por computadora. Resultados: Se desarrollaron varias soluciones que incluyen varios prototipos: biomodelos para reparación de craneosinostosis y figuras anatómicas, molde de prótesis craneal personalizada, prótesis de mano, divisores de líneas de O2, andamios tisulares, pistola portajeringas, protectores faciales, prótesis de mama, molde para restauración autóloga y expansor tisular. Conclusiones: En todas las áreas de aplicación de esta tecnología en medicina―salvo en la impresión de medicamentos, en el contexto actual―, es factible obtener soluciones en el territorio de Matanzas. Es un imperativo, pues, que directivos y la comunidad médica en general, comiencen a adquirir conciencia, conocimientos y experiencias para garantizar la utilización óptima de esta tecnología.

ABSTRACT Introduction: Three-dimensional printing is one of the technologies that promote change at an economic and social level, and one of the fundamental elements of industry 4.0. It has enormous potential for the future of medicine, establishing itself as a new paradigm. Despite its advantages, its use in our environment is incipient. Objective: To design and develop solutions based on three-dimensional technologies for the teaching and practice of biomedical sciences. Materials and methods: A technological development investigation was carried out between the Center for Assisted and Sustainable Manufacturing of the University of Matanzas and Matanzas University of Medical Sciences, between September 2019 and July 2022. The designs and fabrications were made from the acquisition of computed tomography images, or from a surface scanner, which were then processed, converted into Standard Tessellation Language format, printed, and post-processed. Virtual designs were developed using computer-aided design software. Results: Various solutions were developed including prototypes: biomodels for craniosynostosis repair and anatomical figures, custom cranial prosthesis mold, hand prosthesis, O2 line splitters, tissue scaffolds, syringe gun, face shields, breast prosthesis; autologous restoration mold and tissue expander. Conclusions: In all areas of application of this technology in medicine―except the printing of medicines, in the current context―, it is feasible to obtain solutions in the territory of Matanzas. It is therefore imperative that managers and the medical community in general, begin to acquire awareness, knowledge, and experience to ensure the optimal use of this technology.

Abstract This scoping review aimed to provide an overview of current advancements in virtual planning and custom-made 3D-printed bioresorbable scaffolds, and to evaluate their clinical outcomes in maxillofacial reconstructive surgeries. Electronic searches of PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library databases were conducted for publications up to June 2024. Included in the review were reports evaluating patients who underwent maxillofacial bone defect reconstruction using virtual planning and custom-made 3D-printed bioresorbable scaffolds. Data on postoperative complications, new bone formation, scaffold resorption, dental implant success/survival, and patient satisfaction were collected. The electronic search found 5799 results (3438 unique citations). A total of 54 studies were evaluated for full-text reading, of which 41 were excluded based on the inclusion criteria. Thirteen studies (6 case reports, 5 case series, one prospective clinical study and one randomized clinical trial) were included. These studies assessed the effectiveness of 3D-printed scaffolds in reconstructing maxillofacial defects, bone augmentation for dental implant placement, and regeneration of periosseous defects. Most of the 3D-printed scaffolds were biocompatible and did not cause local or systemic adverse events. However, some postoperative complications were reported, including graft exposure, wound dehiscence, and local infection. Overall, the 3D-printed scaffolds demonstrated favorable dimensional compatibility with deformities, provided durable support, promoted bone formation, achieved adequate bone union with host bone tissues, and supported dental implant placement without additional guided bone regeneration. In conclusion, custom-made 3D-printed bioresorbable scaffolds, guided by virtual planning, present a promising option for maxillofacial reconstruction due to their accuracy, osteoconductivity, and biocompatible properties. custommade custom made 3Dprinted Dprinted 3D printed D surgeries PubMed EMBASE Science Scopus 2024 formation resorption successsurvival success survival success/survival collected 579 3438 (343 citations. citations . citations) fulltext full text reading 4 criteria 6 ( series trial included defects events However reported exposure dehiscence infection Overall deformities support tissues conclusion accuracy osteoconductivity properties 202 57 343 (34 20 34 (3 2 3

Resumo Esta revisão de escopo teve como objetivo fornecer uma visão geral dos avanços atuais no planejamento virtual e no uso de enxertos bioabsorvíveis personalizados impressos em 3D, e avaliar seus resultados clínicos em cirurgias reconstrutivas maxilofaciais. Foram realizadas buscas eletrônicas nas bases de dados PubMed, EMBASE, Web of Science, Scopus e Cochrane Library para publicações até junho de 2024. Foram incluídos na revisão estudos que avaliaram pacientes submetidos à reconstrução de defeitos ósseos maxilofaciais usando planejamento virtual e enxertos bioabsorvíveis personalizados impressos em 3D. Foram coletados dados sobre complicações pós-operatórias, nova formação óssea, reabsorção do enxerto, sucesso/sobrevivência do implante dentário e satisfação do paciente. A busca eletrônica encontrou 5799 resultados (3438 citações únicas). Um total de 54 estudos foram incluídos para leitura completa do texto, dos quais 41 foram excluídos com base nos critérios de inclusão. Treze estudos (6 relatos de casos, 5 séries de casos, 1 estudo clínico prospectivo e 1 estudo clínico controlado randomizado) foram incluídos. Esses estudos avaliaram a eficácia de enxertos impressos em 3D na reconstrução de defeitos maxilo-faciais, aumento ósseo para colocação de implantes dentários e regeneração de defeitos ósseos periodontais. A maioria dos enxertos impressos em 3D foram considerados biocompatíveis e não causaram eventos adversos locais ou sistêmicos. Entretanto, algumas complicações pós-operatórias foram relatadas, incluindo exposição do enxerto, deiscência da ferida e infecção local. No geral, os andaimes impressos em 3D demonstraram compatibilidade dimensional favorável com deformidades, forneceram suporte durável, promoveram a formação óssea, alcançaram uma união óssea adequada com os tecidos ósseos hospedeiros e permitiram a instalação de implantes dentários sem a necessidade de regeneração óssea guiada adicional. Esta revisão pode concluir que os enxertos bioabsorvíveis personalizados impressos em 3D, guiados por planejamento virtual, apresentam uma opção promissora para reconstrução maxilo-facial devido à sua precisão, osteocondutividade e propriedades biocompatíveis. D PubMed EMBASE Science 2024 pósoperatórias, pósoperatórias pós operatórias, operatórias enxerto sucessosobrevivência sucesso sobrevivência paciente 579 3438 (343 únicas. únicas . únicas) texto 4 inclusão 6 ( casos randomizado maxilofaciais, maxilo faciais, faciais maxilo-faciais periodontais sistêmicos Entretanto relatadas local deformidades durável adicional maxilofacial facial precisão 202 57 343 (34 20 34 (3 2 3

ABSTRACT Objective: To present a novel, low-cost, and accessible methodology for capturing high-quality stereoscopic images and streaming it in real time to a standard three-dimensional television in a surgical setting, utilizing readily available smartphones. Methods: Two smartphones were attached to each eyepiece of the surgical microscope using a custom-made adapter. The smartphones recorded the surgical procedure and streamed the video via HDMI cables to a dual-input multi-viewer, which combined the feeds into a single image displayed on a conventional 3D television. Results: This setup allowed for the real-time viewing of surgical procedures in immersive 3D, providing a cost-effective and accessible alternative to traditional stereoscopic systems. Conclusion: Utilizing smartphones for capturing and streaming stereoscopic surgical videos can significantly enhance the accessibility of high-quality surgical training materials, making advanced surgical education more widely available. Objective novel lowcost, lowcost low cost, cost low-cost highquality high quality threedimensional three dimensional setting Methods custommade custom made adapter dualinput dual input multiviewer, multiviewer multi viewer, viewer multi-viewer D Results realtime costeffective effective systems Conclusion materials

RESUMO Objetivo: Apresentar metodologia inovadora, de baixo custo e acessível para a captura de imagens estereoscópicas de alta qualidade e sua transmissão em tempo real para uma televisão tridimensional padrão em um ambiente cirúrgico, utilizando smartphones prontamente disponíveis. Métodos: Dois smartphones foram acoplados a cada ocular do microscópio cirúrgico usando um adaptador feito sob medida. Os smartphones gravaram o procedimento cirúrgico e transmitiram o vídeo via cabos HDMI para um multi-visualizador de entrada dupla, que combinou os vídeos em uma única imagem exibida em uma televisão 3D convencional. Resultados: Esta configuração permitiu a visualização em tempo real dos procedimentos cirúrgicos em 3D imersivo, oferecendo uma alternativa econômica e acessível aos sistemas estereoscópicos tradicionais. Conclusão: A utilização de smartphones para captura e transmissão de vídeos estereoscópicos cirúrgicos pode melhorar significativamente a acessibilidade a materiais de treinamento cirúrgico de alta qualidade, tornando a educação cirúrgica avançada mais amplamente disponível. Objetivo inovadora disponíveis Métodos medida multivisualizador multi visualizador dupla D convencional Resultados imersivo tradicionais Conclusão disponível

Abstract The following case report aims to demonstrate a total hip arthroplasty revision surgery (THARS) using a custom-made trabecular metal acetabular component for correction of a severe acetabular defect. Currently, in the literature, there are few complete descriptions of surgical planning and procedures involving customized prostheses. This is due to the inherent technical difficulty of the surgical procedure and the high costs related to the planning and materials. THARS (THARS custommade custom made defect Currently literature prostheses materials

Resumo O seguinte relato de caso tem como objetivo demonstrar uma cirurgia de revisão de artroplastia total do quadril (RATQ) com o uso de componente acetabular customizado de metal trabeculado para correção de defeito acetabular severo. Atualmente, na literatura existem poucas descrições completas do planejamento e procedimentos cirúrgicos envolvendo próteses customizadas, tanto pela dificuldade técnica, inerente ao ato cirúrgico, quanto devido aos altos custos relacionados ao planejamento e materiais. RATQ (RATQ severo Atualmente customizadas técnica cirúrgico materiais

Lithography-based ceramic manufacturing (LCM) is an additive manufacturing (AM) technology that builds custom-designed, three-dimensional ceramic parts layer by layer. The level of precision of the process allows for the printing of custom-made interconnected lattices and designs suitable for bone implants. This study investigated the LCM printability of various lattice structures with the hydroxyapatite (HA480) supplied by Lithoz. Different lattice structures were characterised. The microscopic structure, the composition, and the surface roughness of the test specimens were determined. To obtain the mechanical properties of the structures, compression tests were performed. The observed micropores of ±3 µm and the macropores of ±320 µm were suitable for bone cell growth. The measured microhardness of HA480 was 556±25 HV in the built direction and 559±27 HV perpendicular to the built direction. The compressive strength of the rhombic dodecahedron lattice structure was 4±0.5 MPa, and was superior to other tested lattices. From the results it was concluded that lattice structures produced through LCM have the potential to be used to produce customised bone-regenerating scaffolds.

Litografie-gebaseerde keramiekvervaardiging (LCM) is 'n laagvervaardigingstegnologie (LV) wat pasgemaakte, driedimensionele keramiekonderdele laag vir laag bou. Die vlak van akkuraatheid van die proses maak voorsiening vir die druk van pasgemaakte intern-aaneenlopende roosterstrukture en ontwerpe wat geskik is vir beenimplantate. Hierdie studie het die LCM-veraardigbaarheid van verskeie roosterstrukture ondersoek met die hidroksieapatiet (HA480) verskaf deur Lithoz. Verskillende roosterstrukture is gekarakteriseer. Die mikroskopiese struktuur, die samestelling en die oppervlakrofheid van die toetsmonsters is bepaal. Om die meganiese eienskappe van die strukture te verkry, is druktoetse uitgevoer. Die waargenome mikroporieë van ±3 µm en die makroporieë van ±320 µm was geskik vir beenselgroei. Die gemete mikrohardheid van HA480 was 556±25 HV in die bourigting en 559±27 HV loodreg op die bourigting. Die druksterkte van die rombiese dodekaëderroosterstruktuur was 4±0.5 MPa, en was beter as ander getoetste roosters. Uit die resultate is tot die gevolgtrekking gekom dat roosterstrukture wat deur LCM vervaardig word, die potensiaal het om gebruik te word vir vervaardiging van pasgemaakte beenregenererende steiers.

Abstract We present the case of a 73-year-old patient, previously treated with two hip prosthesis revisions due to a chronic infection caused by a multidrug-resistant microorganism, who consulted after the first surgical procedure. Radiographic and computed tomography studies revealed a Paprosky type IV femoral defect and a type IIIA acetabular defect. Following clinical and laboratory monitoring, it was decided to perform acetabular reconstruction using a custom-made implant and a tumor stem. Two years later, the patient shows a favorable evolution: he is able to walk with a cane and without pain. The implant is stable and properly positioned, with no recurrent infection.

Resumen Se presenta a un paciente de 73 años que había sido sometido a dos revisiones de prótesis de cadera debido a una infección crónica por un microorganismo multirresistente. Acude a nuestro centro tras un primer tiempo quirúrgico. En la radiografía simple y la tomografía computarizada, se observan un defecto femoral tipo IV y un defecto acetabular tipo IIIA de Paprosky. Tras un control clínico y análisis de laboratorio, se decide la reconstrucción acetabular mediante un implante “personalizado” y un vástago tumoral. A los 2 años, el paciente evoluciona favorablemente: deambula con bastón y sin dolor. El implante está estable y en posición normal, no hubo recidiva infecciosa.

Abstract Introduction: Acetabular revision is a particularly challenging surgery when there is loss of bone stock and extensive acetabular defects. 3D implants can make up for these defects and adapt to each circumstance. The objective of this study was to evaluate clinical and radiographic outcomes in patients with severe acetabular defects treated with 3D-printed implants and determine the appropriate cup constraint for each patient. Materials and Methods: A retrospective study was carried out on 10 patients with severe acetabular defects classified as Paprosky type IIIA-B and pelvic discontinuity who underwent surgery with a custom 3D-printed acetabular prosthesis, carried out by the same surgery team between 2016 and 2022. Results: The average follow-up was 40.5 months. The Harris hip score improved significantly from an average of 24.2 to 63.5 at the last follow-up. No signs of loosening or migration of the 3D cup in terms of inclination and anteversion were observed in any case, at the last control. Conclusion: Custom-made acetabular implants represent a valid solution to treat severe acetabular bone defects and pelvic discontinuity.

Resumen Introducción: La revisión acetabular es una cirugía particularmente desafiante cuando hay pérdida de stock óseo y defectos acetabulares extensos. Los implantes 3D pueden suplir estos defectos y adaptarse a cada circunstancia. El objetivo de este estudio fue evaluar los resultados clínicos y radiográficos en pacientes con defectos acetabulares severos tratados con implantes impresos en 3D y determinar la constricción adecuada del cotilo para cada paciente. Materiales y Métodos: Se realizó un estudio retrospectivo de 10 pacientes con defectos acetabulares severos clasificados como tipo IIIA-B de Paprosky y discontinuidad pélvica que se sometieron a una cirugía con prótesis acetabular a medida impresa en 3D, a cargo del mismo equipo quirúrgico, entre 2016 y 2022. Resultados: El seguimiento medio fue de 40.5 meses. El puntaje de cadera de Harris mejoró significativamente de un promedio de 24,2 a 63,5 en el último control. No se observaron signos de aflojamiento ni migración del cotilo 3D en cuanto a la inclinación y anteversión en ningún caso, en el último control. Conclusión: Los implantes acetabulares a medida representan una solución válida para tratar defectos óseos acetabulares severos y la discontinuidad pélvica.

Resumo O pé é um local incomum para tumores ósseos, e compreende cerca de 3% de todos os tumores esqueléticos, em especial ao redor do calcâneo. A cirurgia radical cria um vazio no pé, o que afeta de forma negativa a capacidade de resgate do membro. As cirurgias de reconstrução do calcâneo não são comumente realizadas por causa da instabilidade da prótese, defeito de partes moles, e consequente possibilidade de insucesso pósoperatório. Assim, apresentamos aqui um caso raro de sarcoma sinovial originário da bainha do tendão tibial posterior com acometimento secundário do osso calcâneo. Considerando as experiências prévias de diferentes cirurgiões, projetamos uma prótese sob medida com modificações relevantes. ósseos 3 esqueléticos membro moles pósoperatório Assim cirurgiões relevantes

Abstract The foot is an uncommon location for osseous tumors, comprising ~ 3% of all skeletal tumors, which occur particularly around the calcaneum. Radical surgery creates a void in the foot which adversely affects the ability to salvage it. Calcaneal replacement surgeries are not commonly performed due to factors involving instability of the prosthesis, soft-tissue defects, and resultant failure, which can occur in the postoperative period. Thus, we herein report a rare case of synovial sarcoma arising from the sheath of the tibialis posterior tendon, with secondary involvement of the calcaneus bone. Considering the previous experiences of different surgeons, a custom-made prosthesis was designed with relevant modifications. tumors 3 calcaneum it softtissue soft tissue defects failure period Thus tendon bone surgeons custommade custom made modifications

Abstract Introduction: the treatment of complex aneurysms using FEVAR includes among its objectives a reduced surgical time in order to achieve technical and clinical success. However, cannulation and implantation of bridging stents in multiple visceral arteries can be a limiting factor. To avoid a protracted scope time and radiation dose, there are some maneuvers that can help optimize catheterization time. Material and methods: a review of the last cases treated with custom made Zenith Cook® fenestrated endoprostheses during the year 2021 is performed in an angiology, vascular and endovascular surgery service. The objective is to show video clips recorded with the OneView system of these techniques that the surgeon can use with the usual material to optimize the treatment of complex aneurysms. Results: the first key step is the release of the fenestrated device. The Cook® endoprosthesis has one or more reduction ligatures that keep it puckered until it guarantees correct orientation and positioning, as well as the option of cannulating the visceral arteries between the arterial wall and the device. With proper planning and a systematic approach, the use of coaxial guides with single or reverse tip catheters and introducers are essential. The roof of the endoprosthesis allows the advancement of guides and introducers with sufficient support for their cannulation. The preloaded systems allow cannulation from the upper or lower limb. In the latter case, a 0.014” buddy guide is used to provide support for the introducer, bringing it even closer to fenestration in such a way as to enhance the torque and thrust of the catheter. In addition, we have the “swallowing” maneuver or emptying of a balloon catheter while advancing the introducer on a guide towards the target artery. We also have deflectable inserters that orient their tip with a more accentuated flexion if necessary. Conclusions: success in FEVAR includes optimization of surgical time, reduction of lower limb ischemia time, radiation dose and anesthetic time. This highlights the importance of having in-depth knowledge of the devices used in the operating room, the materials used, and the salvage options in visceral vessel cannulation.

Resumen Introducción: el tratamiento de aneurismas complejos mediante FEVAR incluye entre sus objetivos un tiempo quirúrgico reducido para poder alcanzar el éxito técnico y clínico. Sin embargo, la canulación y el implante de los stents puente en múltiples arterias viscerales pueden suponer un factor limitante. Para evitar un tiempo de escopia y una dosis de radiación prolongados existen algunas maniobras que pueden ayudar a optimizar el tiempo de cateterización. Material y métodos: se realiza una revisión de los últimos casos tratados mediante endoprótesis fenestradas custom made de Zenith Cook® durante el año 2021 en un servicio de angiología, cirugía vascular y endovascular. El objetivo es mostrar las técnicas que sirven para optimizar el tratamiento de aneurismas complejos y que el cirujano puede emplear con el material habitual. Para ello se muestran varios fragmentos de vídeos de estos procedimientos grabados con el sistema OneView. Resultados: el primer paso clave consiste en la liberación del dispositivo fenestrado. La endoprótesis de Cook® presenta una o varias ligaduras de reducción que la mantienen fruncida hasta garantizar una correcta orientación y un correcto posicionamiento. Asimismo, ofrece la opción de canular las arterias viscerales entre la pared arterial y el dispositivo. Con una planificación adecuada y un abordaje sistematizado, el uso de guías coaxiales, catéteres de punta simple o reversa e introductores es esencial. El techo de la endoprótesis permite el avance de guías y de introductores con el soporte suficiente para su canulación. Los sistemas precargados permiten la canulación desde el miembro superior o el inferior. En este último caso, se utiliza una guía buddy de 0,014” que ofrece soporte al introductor, ya que lo acerca más aún a la fenestración, de tal modo que potencia el momento de torsión (torque) y el empuje del catéter. Además, contamos con la maniobra de swallowing o vaciamiento de un catéter-balón mientras se avanza el introductor sobre una guía hacia la arteria diana. Disponemos además de los introductores deflectables, que orientan su punta con una flexión más acentuada en caso de ser necesario. Conclusiones: el éxito en FEVAR incluye la optimización del tiempo quirúrgico, la disminución del tiempo de isquemia de los miembros inferiores, la dosis de radiación y el tiempo anestésico. Esto realza la importancia de conocer en profundidad los dispositivos empleados en el quirófano, los materiales utilizados y las opciones de rescate en la canulación de los vasos viscerales.

Resumo A sociedade argelina do Saara é fundamentalmente concebida como uma sociedade tradicional, na qual a arquitetura surgiu de uma cristalização de valores sociais. Com referência ao passado, perpetua a memória e transmite conhecimentos. Esta contribuição pretende definir os fatores determinantes na conceção deste património edificado que tende a desaparecer. A partir de um estudo urbano, arquitetónico e antropológico, confirma a importância do material de construção (toub) na constituição do modelo cultural. O material dá forma à arquitetura popular feita à medida do homem, e para o homem, através da qual a cultura de um povo (de uma sociedade) é materialmente transcrita. Adaptado às exigências do clima, muitas vezes uma reprodução reduzida da ordem cósmica, o habitat tradicional do Saara estabelece o equilíbrio entre o homem, o meio ambiente e a sua cultura.

Résumé La société algérienne saharienne est conçue fondamentalement comme une société traditionnelle où l’architecture découle d’une cristallisation des valeurs sociales. En référence au passé, elle perpétue la mémoire et transmet des savoirs. Cette contribution a pour objet de définir les facteurs déterminants dans la conception de ce patrimoine bâti qui tend à disparaître. Basée sur une étude urbaine, architecturale et anthropologique, elle confirme l’importance du matériau de construction (toub) dans la constitution du modèle culturel. Le matériau donne forme à une architecture populaire faite à la mesure de l’homme, pour l’homme, à travers laquelle se transcrit matériellement la culture d’un peuple (d’une société). Adapté aux exigences du climat, souvent reproduction réduite de l’ordre cosmique, l’habitat traditionnel saharien établit l’équilibre entre l’homme, l’environnement et sa culture.

Abstract Algerian Saharan society is fundamentally conceived as a traditional society where architecture stems from a crystallization of social values. With reference to the past, it perpetuates memory and transmits knowledge. This contribution aims to define the determining factors in the design of this built heritage which tends to disappear. Based on an urban, architectural, and anthropological study, it confirms the importance of the building material (toub) in the constitution of the cultural model. The material gives shape to popular architecture custom made to man, for man, through which the culture of a people (of a society) is materially transcribed. Environmental built, often a reduced reproduction of the cosmic order, the traditional Saharan habitat establishes a balance between man, the environment, and his culture.

Abstract: The Mexican writer Rosario Castellanos reveals in her narrative her personal experience in the machismo of the mid-twentieth century in Mexico. In some of the stories, it is noted depth, intensity and descriptive thoroughness in the construction of the spaces. Thus, an approximation is made to the category of space in Los convidados de agosto, a tale of the book of the same name published in 1964, based on custom, eroticism and rumor, features present in the text and that have been little reviewed by literary studies.

Resumen: La escritora mexicana Rosario Castellanos revela en su narrativa corta su experiencia personal frente al machismo de mediados del siglo xx en México. En algunos de los relatos, se nota en la construcción de los espacios profundidad, intensidad y minuciosidad descriptiva. Así, se hace una aproximación a la categoría de espacio en el cuento «Los convidados de agosto», del libro homónimo publicado en 1964, a partir de la costumbre, el erotismo y el rumor, características presentes en el texto y que han sido poco revisadas por los estudios literarios.

Resumo Objetivo O presente estudo teve como objetivo analisar os resultados clínicos, radiológicos e funcionais da reconstrução do rádio distal após a ressecção do tumor com implante metálico personalizado de artrodese e compará-los com outros tipos de reconstrução do rádio distal, conforme apresentado na literatura. Pelo que conhecemos, este é o primeiro artigo descrevendo esse tipo particular de implante e funcionalidade no paciente. Métodos Os desfechos funcionais de reconstrução do rádio distal foram avaliados em uma série de 4 pacientes. Três dos pacientes tiveram ressecção de tumores de células gigantes (TCGs), sendo um paciente com ressecção de osteossarcoma. Resultados Não houve complicações relacionadas ao implante, como infecção, não sindicalidade ou afrouxamento. Dois pacientes tiveram que passar por uma nova cirurgia para a protusão da prótese metálica. A função geral foi boa de acordo com as pontuações da Musculoskeletal Tumor Society (MSTS) e Disabilities of the Arm, Shoulder, and Hand (DASH). Conclusão O estudo mostra que o implante metálico personalizado de artrodese se beneficia do fato de que pode ser usado como opção de salvamento quando outros tratamentos falharam, ou pode ser usado como opção primária nos casos em que há estoque ósseo limitado após a ressecção do tumor do rádio distal.

Abstract Objective The present study aimed at analyzing the clinical, radiological and functional results of the reconstruction of the distal radius after tumor resection with a custom-made metal arthrodesis implant and compare them with other types of distal radius reconstruction, as presented in the literature. To our best knowledge, this is the first article describing this particular type of implant and patient functionality. Methods Functional outcomes of reconstruction of the distal radius were assessed in a series of 4 patients. Three of the patients having had resection of giant cell tumors (GCTs), one patient having had resection of osteosarcoma. Results There were no major implant-related complications like infection, nonunion or loosening. Two patients had to undergo further surgery for protruding metalwork. Overall function was good according to the Musculoskeletal Tumor Society MSTS and Disabilities of the Arm, Shoulder, and Hand (DASH) scores. Conclusion The present study shows that custom-made metal arthrodesis implant benefits from the fact that it can be used as a salvage option when other treatments have failed, or it can be used as a primary option in cases in which there is limited bone stock after distal radius tumor resection.

Resumen Las quemaduras secundarias a agresión física con intención de desfigurar, torturar o incluso asesinar, se han convertido en un motivo de consulta común en el siglo XXI, siendo Bangladesh el país con la más alta incidencia en el mundo. Colombia es uno de los países con mayor incidencia a nivel de Latinoamérica. La mayoría de las lesiones ocurre en áreas expuestas como el rostro y se acompaña de graves secuelas físicas, estéticas y funcionales. Se realiza la presentación de caso de una paciente de 35 años con quemaduras de tercer grado en región frontal, periocular, malar bilateral, nasal, labial superior y pabellón auricular derecho, manejada con injertos de piel, quien posteriormente desarrolla cicatriz hipertrófica. Se describe el tratamiento con máscara termoplástica elaborada por los profesionales tratantes, con cubierta interna de silicona, fabricada sobre molde a medida y ajustada con bandas elásticas; integrando en un único dispositivo removible, cómodo y de bajo costo, diferentes alternativas terapéuticas que logran modular efectivamente el proceso de cicatrización y por su simplicidad favorecen la adherencia al tratamiento, la cual es indispensable para obtener resultados satisfactorios. MED.UIS.2020;33(3): 49-58

Abstract Burns secondary to physical aggression with the intention of disfiguring, torturing or even murdering, have become a common reason for consultation in the 21st century, with Bangladesh being the country with the highest incidence in the world. Colombia is one of the countries with the highest incidence in Latin America. Most injuries occur in exposed areas such as the face and are accompanied by serious physical, aesthetic and functional sequelae. We present the case of a 35-year-old patient with third degree burns in the frontal, periocular, bilateral malar, nasal, upper labial and right ear region, managed with skin grafts, who later developed a hypertrophic scar. The treatment with a thermoplastic mask made by the treating professionals is described, with an internal silicone cover, made on a custom mold and adjusted with elastic bands; integrating in a single removable, comfortable and low-cost device, different therapeutic alternatives that manage to effectively modulate the healing process and, due to their simplicity, favor adherence to treatment, which is essential to obtain satisfactory results. MED.UIS.2020;33(3): 49-58