Background: In July 2009, an outbreak of influenza A H1N1 was reported in the pediatric units of Instituto Nacional de Salud del Nino, Lima, Peru. Objectives: To determine the clinical features and evolution of hospitalized patients who presented influenza A(H1N1) virus infection and who also suffered chronic co-morbidity. Design: Retrospective clinical study. Setting: Instituto Nacional de Salud del Niño, Lima, Peru. Patients: Pediatric patients hospitalized at Medicine ‘D’ Service. Methods: We revised medical records associated with chronic comorbidity in all cases of influenza A H1N1 from July 1 through August 31, 2009. We describe clinical characteristics and evolution of hospitalized patients. Main outcome measures: Evolution and prognosis of the viral infection. Results: In the period of study 18 cases of influenza A H1N1 were confirmed in hospitalized patients. Twelve patient...

Patient male of 10-year-old native of the city of Puno, arriving at the service of head and neck surgery from the National Institute of health of the child to present an expansive left mandibular tumor of 2 years of evolution of insidious onset and progressive course. Compatible with Desmoplastic fibroma diagnosis. Resection of mandibular tumor, up to 10 cm in length, was practiced the hemimandibulectomy since the region right up to the preangular area of the jaw. During this surgical procedure the flap of the fibula, was conducted on the same side as the hemimandibulectomy. Once the fibula osteotomy was performed to rebuild the receptor bed with unilock reconstruction plates and was fixed with screws. Finally the anastomosis was carried out. One of the greatest challenges of the reconstructor surgeon is the coverage of complex defects in extremities, with exhibition of deep tissues and ...