Reconstructive surgery for the resolution of defects in posterior cervical and occipital region can often be a challenge for plastic surgeons. The trapezius myocutaneous flap is one of the most used alternatives. This article describes a technical variation of the trapezius myocutaneous flap based on a bilateral cutaneous VY design to reconstruct the defect caused by wound dehiscence with cerebrospinal fluid fistula in the posterior cervical region of 52 and 72 years old patients. Total coverage was achieved with a successful defect biological isolation given by the major surface and volume provided by the middle third of the two trapezoids. There was no suffering of the flaps and no problems with the functions. The closure of V-Y advance was without tension. No changes were manifested in the functionality of the shoulders. In conclusion, although there are different options to reconstruct the posterior cervical and occipital region, this new design trapezius myocutaneous flap is a secure, easy to perform, reproducible and functional conservation of the shoulder.

La cirugía reconstructiva para la resolución de defectos en la región cervical posterior y occipital muchas veces puede ser un verdadero desafío para los cirujanos plásticos. El colgajo miocutáneo de trapecio es una de las alternativas más utilizadas. En este artículo describimos una variante técnica del colgajo miocutáneo de trapecio basada en un diseño cutáneo bilateral en V-Y, para reconstruir defectos producidos por dehiscencia de heridas con fístula de líquido cefalorraquídeo en región cervical posterior de 2 pacientes de 52 y 72 años, intervenidos quirúrgicamente por hernia discal cervical. Logramos una cobertura total del defecto en ambos casos, con un exitoso aislamiento biológico proporcionado por la importante superficie y volumen brindados por el tercio medio de ambos músculos trapecios. No hubo sufrimiento de los colgajos ni se manifestaron alteraciones en la funcionalidad de los hombros en ambos casos. El cierre del avance en V-Y se hizo sin tensión. En conclusión, si bien existen distintas opciones para reconstruir la región posterior cervical y occipital, este nuevo diseño de colgajo miocutáneo de trapecio es una herramienta segura, de fácil ejecución, reproducible y que conserva la funcionalidad del hombro.

Poços de Caldas é um importante centro hidrotermomineral do Brasil, o qual apresenta depósitos de argilas não plásticas para as quais não há registros significativos a respeito da caracterização direcionada destes materiais, o que prejudica estudos de aplicação industrial. Estas argilas não plásticas, não aproveitadas, vêm sendo armazenadas em galpões ou a céu aberto, o que gera um elevado custo para a indústria, além de transformar-se em um passivo ambiental. No presente trabalho realizou-se o estudo químico-mineralógico de seis amostras de argilas de baixa plasticidade, além da caracterização preliminar destas amostras quanto à granulometria, plasticidade e propriedades cerâmicas básicas, visando ampliar os horizontes das investigações destes materiais. Este estudo preliminar mostrou que, de maneira geral, as amostras são compostas por minerais refratários como caulinita e gibbsita, apresentando teores menos significativos de outras fases, como quartzo, vermiculita e illita. Juntamente às análises químicas, estes dados permitiram o agrupamento das matérias-primas em dois grupos em função de sua refratariedade, norteando assim, a caracterização posterior. Dentre as amostras, há material com potencial uso na formulação de massas de porcelanato, além de uma amostra turfosa, cuja aplicação está relacionada à correção de solos.

Poços de Caldas is an important "hydro-thermo-mineral" center in Brazil, where non-plastic clays deposits can be found with no significant records about their characterization, impeding the studies of industrial application. These non-plastic clays, not used, have been stored in sheds or open, which creates a high cost to the industry, and become an environmental liability. In the present work, the chemical-mineralogical study of six samples of non-plastic clays was realized, and also the preliminary characterization of these samples about the grain size, plasticity and basic ceramic properties, to expand the horizons of researches about such materials. This preliminary study showed that, overall, the samples are composed of refractory minerals such as kaolinite and gibbsite, with less significant amounts of other phases such as quartz, illite and vermiculite. The chemical analysis permitted the grouping of raw materials into two groups according to their refractory properties, guiding to the subsequent characterization. Among the samples, there is material with potential use in porcelain formulation, and also a peat sample, which implementation is related to soil correction.

Objective: to assess the social and working conditions and the needs of primary care pediatricians in the Autonomous Community of Galicia. Methods: a survey was carried out during the second half of 2007; the questionnaire was sent to 315 primary care paediatricians working for the Galician Health Service. It included questions about their social and working profile and conditions, health centre, number of patients assigned, daily work organization, nurse support, research and teaching activities, professional relationships and future expectations. Results: one hundred and eighty pediatricians (57.9%) answered the survey. There was a majority of women, age range 40-55 years, with two children on average, who have obtained their pediatric specialization through the hospital resident training programme (MIR). They mostly work in primary care health centres (EAP), in rural or semi urban towns of less than 50.000 inhabitants, with a morning only clinics schedule, which is the preferred schedule by almost all the respondents. The number of patients assigned to each paediatrician varies considerably. They usually work with a nurse, in half of the cases shared with other doctors, and who they consider highly motivated but often lacking specific training for their task. Conclusions: finally, generally speaking, we can say that Galician primary care pediatricians feel satisfied with their work. The wish more frequently expressed in the survey is to have easier access to continuing medical training and in a second, but close, position the claim for a higher salary.

Objetivos: averiguar las condiciones sociolaborales y las inquietudes de los pediatras que trabajan en la Atención Primaria de la Comunidad Autónoma de Galicia. Métodos: durante el segundo semestre del 2007, se envió una encuesta a 315 pediatras de nuestra comunidad que incluía preguntas sobre su perfil socio-profesional, centro de trabajo, magnitud del cupo adjudicado, consulta a demanda y programada, consulta de enfermería, investigación, docencia, relaciones con otros compañeros, y expectativas de futuro. Resultados: se recibieron 180 respuestas (57,9%). La mayoría son mujeres, de edad comprendida entre los 40-55 años, con dos hijos, que han obtenido el título de pediatra por la vía MIR (médico interno residente) y que trabajan en equipos de Atención Primaria en poblaciones rurales-semiurbanas de menos de 50.000 habitantes en turno de mañana, que es el preferido por casi la totalidad de los encuestados. Con cupos de magnitud muy dispar, trabajan con un profesional de Enfermería que, en la mitad de los casos, han de compartir con otros compañeros, profesional al que consideran motivado, pero muchas veces insuficientemente formado para la función específica que desarrollan. Conclusiones: finalmente, podemos decir que, en general, el pediatra de Atención Primaria de Galicia se siente razonablemente satisfecho con su trabajo, y que el deseo más veces formulado para mejorar las condiciones de trabajo y la satisfacción personal es una mayor facilidad para la formación continuada. La reivindicación salarial, aunque por escasa diferencia, se sitúa en segundo lugar.