A 7-year Experience with Keloid Fillet Flap and Adjuvant Intralesional Corticosteroids.

CONTEXT: Keloids are fibroproliferative scars characterized by excessive collagen deposition beyond the margins of the original wound. Although many treatment modalities were described in the literature, no single first-line therapy is recommended, and its recurrence rate remains high. AIMS: The aim of this study was to investigate the efficacy rate in treating auricle keloids after fillet flap excision combined with adjuvant intralesional steroid injections. SETTINGS AND DESIGN: This was a retrospective study. MATERIALS AND METHODS: Between 2012 and 2019, a total of 16 auricle keloids were treated at our center with fillet flap excision and adjuvant steroid injections. Intralesional steroid injections were given at the end of the first week and then administered at 4-week intervals until the lesions were soft and flat. Postoperative efficacy, complications, recurrence, and patient satisfaction were analyzed. RESULTS: A high improvement of the keloid was observed in 13 (81.2%) lesions. No major complications and no recurrence of the keloid were detected during the follow-up period (mean, 35 months). Regarding patient satisfaction, nine (81.8%) considered their result as excellent. CONCLUSION: This study showed that this approach is effective regardless of the keloid location at the auricle.

Chaotic analysis of heart rate dynamics after an exercise with flexible pole / Análise caótica da dinâmica da frequência cardíaca após exercício com barra flexível

INTRODUCTION: Exercises with a flexible pole have been applied in clinical practice for upper limb rehabilitation. Nevertheless, its acute effects on cardiac autonomic regulation are unclear. OBJECTIVE: To evaluate the acute effects of exercise with flexible pole on complex behavior of heart rate variability (HRV). METHOD: We investigated 32 healthy female volunteers aged between 18 and 25 years who performed a session of exercise with a flexible pole. HRV was analyzed 10 minutes before and 10 minutes immediately after the exercise. RESULTS: Exercises with a flexible pole did not significantly change time and frequency domain indices of HRV. Non-linear analysis of HRV through the Higuchi Fractal Dimension was not significantly changed during recovery from exercise compared to the control reading at rest. CONCLUSION: Exercises with the flexible pole were unable to acutely change chaotic behavior of heart rate dynamics. This is advantageous for assessments of levels of rehabilitative treatment required in such patients; and their susceptibility to dynamical diseases.

INTRODUÇÃO: Exercícios com uma barra flexível têm sido usados na prática clínica para a reabilitação do membro superior. No entanto, os seus efeitos agudos sobre a regulação autonômica cardíaca não estão bem esclarecidas. OBJETIVO: Avaliar os efeitos agudos do exercício com barra flexível sobre o comportamento complexo da variabilidade da frequência cardíaca (VFC). MÉTODO: Foram investigadas 32 voluntárias saudáveis com idades entre 18 e 25 anos que realizaram uma sessão de exercício com barra flexível. A VFC foi analisada 10 minutos antes e 10 minutos imediatamente depois do exercício. RESULTADOS: Os exercícios com a barra flexível não alteraram significativamente os domínios de tempo e frequência de VFC. Análise não-linear da VFC através da Dimensão Fractal Higuchi mostra que a mesma não foi significativamente alterada durante a recuperação do exercício em relação ao controle pré-exercício. CONCLUSÃO: O exercício com a barra flexível não alterou profundamente o comportamento caótico da dinâmica da frequência cardíaca. Isto é vantajoso para a avaliação de níveis de tratamento de reabilitação necessário em tais pacientes; e sua suscetibilidade a doenças dinâmicas.

Acute effects of flexible pole exercise on heart rate dynamics.

INTRODUCTION: Exercise with flexible poles provides fast eccentric and concentric muscle contractions. Although the literature reports significant muscle chain activity during this exercise, it is not clear if a single bout of exercise induces cardiac changes. In this study we assessed the acute effects of flexible pole exercise on cardiac autonomic regulation. METHODS: The study was performed on 22 women between 18 and 26 years old. We assessed heart rate variability (HRV) in the time (SDNN, RMSSD and pNN50) and frequency (HF, LF and LF/HF ratio) domains and geometric indices of HRV (RRTri, TINN, SD1, SD2 and SD1/SD2 ratio). The subjects remained at rest for 10 min and then performed the exercises with the flexible poles. Immediately after the exercise protocol, the volunteers remained seated at rest for 60 min and HRV was analyzed. RESULTS: We observed no significant changes in time domain (SDNN: p=0.72; RMSSD: p=0.94 and pNN50: p=0.92) or frequency domain indices (LF [nu]: p=0.98; LF [ms(2)]: p=0.72; HF [nu]: p=0.98; HF [ms(2)]: p=0.82 and LF/HF ratio: p=0.7) or in geometric indices (RRTri: p=0.54; TINN: p=0.77; SD1: p=0.94; SD2: p=0.67 and SD/SD2: p=0.42) before and after a single bout of flexible pole exercise. CONCLUSION: A single bout of flexible pole exercise did not induce significant changes in cardiac autonomic regulation in healthy women.

Cardiac autonomic responses induced by mental tasks and the influence of musical auditory stimulation.

We investigated the acute effects of musical auditory stimulation on cardiac autonomic responses to a mental task in 28 healthy men (18-22 years old). In the control protocol (no music), the volunteers remained at seated rest for 10 min and the test was applied for five minutes. After the end of test the subjects remained seated for five more minutes. In the music protocol, the volunteers remained at seated rest for 10 min, then were exposed to music for 10 min; the test was then applied over five minutes, and the subjects remained seated for five more minutes after the test. In the control and music protocols the time domain and frequency domain indices of heart rate variability remained unchanged before, during and after the test. We found that musical auditory stimulation with baroque music did not influence cardiac autonomic responses to the mental task.