Respiratory viruses are responsible for at least 47.2% of LRTI requiring hospitalization at our hospital. Respiratory syncytial virus was the most important respiratory agent identified.

ResumenAntecedentes: Las heridas por mordedura de perro constituyen un problema de salud pública creciente que involucra a todos los niveles de atención. Pueden variar en gravedad, desde heridas superficiales (piel y tejido subcutáneo) hasta desvitalización y pérdida de tejidos, con presencia de infecciones, complicaciones y secuelas estéticas y funcionales que requieren tratamiento especializado. Objetivo: Describir la experiencia de 7 años en el manejo de heridas por mordedura de perro y proponer un algoritmo de manejo en un centro de referencia en cirugía plástica y reconstructiva en México. Método: Se realizó un estudio retrospectivo en el que se incluyeron todos los registros de pacientes con heridas por mordedura de perro entre julio de 2010 y agosto de 2017. Las variables recabadas fueron edad, sexo, localización anatómica, características de la herida y manejo terapéutico. Resultados: Se obtuvo un total de 416 pacientes. El 63% de las lesiones ocurrieron en menores de 18 años. La mayoría de las heridas (88.2%) fueron aisladas en una región anatómica. La localización más frecuente fue la cara (61.3%). De todos los casos, el 74.3% se resolvieron solo con cierre primario, el 21.4% requirió además algún proceso reconstructivo, el 2.9% no requirió cierre y el 1.4% de los pacientes fueron hospitalizados. Todos los pacientes recibieron antibióticos profilácticos. El 2% reportaron infección posterior al manejo con cierre primario. Conclusiones: El correcto abordaje de las heridas por mordedura de perro en todos los niveles de atención mejora el pronóstico de los pacientes. Las heridas complejas deben ser manejadas inmediatamente en un centro de segundo o tercer nivel con cirugía plástica y reconstructiva. La mayoría de las heridas por mordedura de perro pueden ser reparadas con cierre primario y otras técnicas reconstructivas con seguridad.

Reconstruction of midfacial traumatic defects secondary to a gunshot wound (GSW) is one of the most challenging head surgeries. The high impact on the functional and aesthetic quality of life, and the small margin of error to achieve a successful outcome are significant hurdles in the surgical treatment of these cases. Here we report a 33-years old patient who suffered a GSW with an entrance wound penetrating between the soft and hard palate and an exit wound on the right malar region. A description of the case and a systematic review of the literature were conducted. The treatment depends on the type of weapon used, deforming characteristics of the bullet, kinetic energy, place of impact, and general conditions of the patient. GSW generate a particular injury due to their special trauma kinematics. In this case, our patient required extensive reconstructive surgery with interposition of costal cartilage to recover velopharyngeal structure and function, patients treated with this surgical strategy develop fewer complications such as infection, shrinkage, scarring. As demonstrated by this case report, the result can be satisfactory. In order to provide the most beneficial results for the patient, surgical techniques are evolving continuously, improving both structure and function, and increasing the quality of life of the patients. Free flaps are preferred because of the good results reported. Patients treated with this surgical strategy develop fewer complications such as infection, shrinkage, scarring. As demonstrated by this case report, the result can be satisfactory.

Background Craniofacial fibrous dysplasia (CFD) is an uncommon benign condition in which a bone is replaced by fibrous tissue. An adequate clinical characterization considering the number of affected bones and functional impairment is important to determine the most effective surgical intervention for its management. This study aims to present our institution's experience in the evaluation and management of CFD. Methods This was a retrospective study that included patients with CFD managed at our institution. Data included demographic characteristics, afflicted bones, surgical procedures performed, and recurrence. Results are presented as mean and percentages. Recurrence-free years and association between the type of surgery and recurrence was evaluated. Results Eighteen patients were included (11 females, 61%). The zygomatic, maxillary, and frontal bones were the most commonly affected with eight (18%) cases each. The most common procedure was bone burring, with 36 procedures. Recurrence was more prevalent after burring (58.3%) and occurred earlier than in the bone resection group (13 vs. 15 years, p > 0.05). Conclusion Surgery continues to be the cornerstone of CFD treatment. Bone burring is effective for debulking and contouring but increases the risk for recurrence. An individualized approach should be tailored according to the anatomical location of the disease, type of CFD, behavior of the lesion, and accompanying clinical complaints.