Locoregional anesthesia for external ear surgery and postoperative analgesia

OBJECTIVES: To evaluate a change in the classical technique for local-regional anesthesia (periauricular "V" infiltration) for surgery on the outer ear, specifically adding a new infiltration of the osteocartilaginous juncture of the external acoustic meatus and the auditory foramen, as an alternative to general anesthesia in adults, including assessment of postoperative analgesia. PATIENTS AND METHODS: The new technique was used in 45 operations on 23 patients. We analyzed pain during and after surgery on a simple verbal scale. RESULTS: After modifying the technique it was possible to perform surgery on the outer ear without causing pain, patients reporting "0" pain on a scale of 0 to 10. Eight patients reported "0" for postoperative pain, while one assessed pain as "4" and one as "2". No signs of emesis or cardiac events were observed. CONCLUSIONS: The described local-regional blockade of the outer ear used as the only anesthetic method, is indicated for both cosmetic surgery and repair of outer ear injuries, given its excellent analgesia during and after surgery. The characteristics of this type of block of the pavilion make it ideal for major outpatient surgery and a valid alternative to general anesthesia in adults.     

Reduction of blood transfusion need with aprotinin in orthopedic surgery. Spanish Study Group on the Use of Aprotinin in Hip Arthroplasty (GEEEAAC)

Aprotinin is a protease inhibitor of interest for its antifibrinolytic effect of reducing perioperative bleeding in certain types of surgery, with wide use in heart surgery, liver transplantation and vascular surgery. The application of aprotinin during orthopedic surgery has recently been suggested. Such use is controversial, as there is lack of consensus as to the type of patient for whom aprotinin administration would be indicated, the surgical procedure during which it would be most effective (hip or knee arthroplasty, spinal arthrodesis, major tumor or septic surgery), the doses to administer, its safety and its real efficacy for conserving homologous blood. That is to say, there is no agreement as to the cost/benefit relation of aprotinin for the various types of orthopedic surgery. This critical review of the literature leads to the conclusion that aprotinin is a promising drug for use in orthopedic surgery, given that published studies have established the benefit in blood product savings and decreased blood loss during surgery.     

Descending necrotizing mediastinitis

Between 1990-1999, six patients (mean age, 41.5 years) with the diagnosis of descending necrotizing mediastinitis were surgically treated at our institution. All patients underwent cervical drainage plus an aggressive mediastinal debridement and drainage via posterolateral thoracotomy. The outcome was favorable in all cases. All patients received initially a high dose of broad-spectrum antibiotics. In four patients, a tracheostomy was necessary for respiratory management. We also review the literature.     

El plagio y las revistas depredadoras como amenaza a la integridad científica

This article presents an analysis of the concept of plagiarism in order to show the wide spectrum of manifestations that can be considered as such when committing a transgression of intellectual property, carried out with the intention of deceiving the authors’ true contribution and the originality and novelty of the information.The article describes the concurrent circumstances in intentional plagiarism, and the damage that this misconduct causes in the credibility of the scientific system, in which authorship credit is the foundation of the academic career, of the prestige of the author in the scientific community, and the basis for research funding.Some circumstances are favouring this fraud: the pressure exerted on researchers by the criteria used for promotion and reward that prioritise the quantity of works on their quality, the existence of a market for the purchase and sale of scientific articles, and the proliferation of predatory journals that operate without or minimal ethical standards.Finally, the paper highlights the convenience of the adoption of criteria that prioritise the intrinsic quality of the work versus its quantity, including the active involvement of the institutions in the development of active policies for the prevention, detection, and punishment of the cases of potential fraud, and emphasize that, in the end, the prevention of fraud relies on the individual adoption of an ethical and responsible behaviour.