Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 41
Filtrar
1.
J Cosmet Dermatol ; 23(3): 830-838, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37877460

RESUMO

OBJECTIVES: Biological aspect and clinical research demonstrated that dual-frequency ultrasound (local dynamic micro-massage, LDM) waves of very high frequency can significantly modify cellular signaling providing anti-inflammatory and anti-fibrotic effects. During the recent past, these waves were successfully applied for the treatment of various inflammatory skin conditions, hypertrophic scars, and chronical wounds. Since the main complications after rhinoseptoplasty are caused by excessive inflammatory reactions and development of fibrosis along nasal implants which can lead to a revision rhinoseptoplasty, in this retrospective multicenter blinded study we have evaluated the efficacy of LDM ultrasound for the treatment of the postoperative perilesional ecchymosis and edema in patients after rhinoseptoplasty. METHODS: Twenty-four patients received daily LDM treatment (study group) for 5 days starting from the first day postoperative, whereas 24 patients (control group) were treated with conventional ice packs. Dynamic reduction of the postoperative perilesional ecchymosis and edema was followed up, and the total duration of these side effects was determined within specific paranasal anatomical areas. RESULTS: Post-rhinoseptoplasty ecchymosis and edema were observed in the areas of anterior cheek, lower eyelids, and upper eyelids. Duration of the postoperative perilesional edema was significantly reduced in the group treated with LDM (1.9 ± 0.9 days) compared with control group (4.5 ± 2.1 days). Duration of the ecchymosis was also significantly reduced in LDM group (2.8 ± 1.4 days) compared with controls (7.4 ± 2.8 days). Postoperative patient satisfaction in LDM-treated and control groups was 3.1 ± 1.3 and 1.5 ± 0.7, respectively, demonstrating significantly higher satisfaction in LDM-treated group. CONCLUSIONS: This study proved that the post-rhinoseptoplasty group treated with LDM ultrasound showed a significantly shorter duration of the postsurgical perilesional ecchymosis and edema, with no substantial adverse effects other than those observed in the control group. It can be suggested that ultrasound treatment can serve as an alternative option for the noninvasive management of postoperative perilesional ecchymosis and edema.


Assuntos
Equimose , Rinoplastia , Humanos , Equimose/etiologia , Equimose/terapia , Edema/terapia , Edema/tratamento farmacológico , Nariz/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/tratamento farmacológico , Rinoplastia/métodos
2.
Physiother Theory Pract ; 39(5): 1061-1070, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-35086430

RESUMO

BACKGROUND: Previous studies have reported success of edema management with manual lymphatic drainage (MLD) or Kinesio® taping. However, there is limited evidence investigating the use of a combination of the two postoperatively and evidence is conflicting due to limitations of published trials. The purpose of this case report was to describe the utilization of MLD and Kinesio® taping in the physical therapy (PT) management of edema and ecchymosis post-arthroscopic meniscectomy. CASE DESCRIPTION: A 51 year-old male was referred to PT 10 days after meniscectomy. He presented with increased edema that was not atypical secondary to a suspected saphenous vein injury. Severe edema and ecchymosis began 24 hours after surgery, which led to pain and decreases in range of motion (ROM) and difficulty with gait. Interventions for edema management consisted of MLD, Kinesio® taping and therapeutic exercise. OUTCOMES: The patient was seen for five visits over 10 days for edema management that resulted in decreases in girth and pain and increases in ROM and the Lower Extremity Functional Scale, and Patient Specific Functional Scale. He was able to sleep, return to the gym, and squat without pain. DISCUSSION: Following MLD and Kinesio® taping in conjunction with therapeutic exercises, edema and ecchymosis were reduced allowing for improved function acutely. Early and aggressive edema management postoperatively should be considered to optimize patient outcomes. This case demonstrated early management of edema facilitated increases in ROM and ease of patient-specific activities and decreased pain in five visits.


Assuntos
Fita Atlética , Meniscectomia , Masculino , Humanos , Pessoa de Meia-Idade , Meniscectomia/efeitos adversos , Drenagem Linfática Manual , Equimose/terapia , Equimose/complicações , Edema/etiologia , Edema/terapia , Dor , Amplitude de Movimento Articular
3.
Hematol Oncol Clin North Am ; 34(6): 1099-1113, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33099427

RESUMO

Clinical features of soft tissue amyloid light-chain (AL) amyloidosis include macroglossia, arthropathy, muscle pseudohypertrophy, skin plaques, and carpal tunnel syndrome. Vascular manifestations of AL amyloid include periorbital ecchymosis, jaw or limb claudication, and even myocardial infarction caused by occlusion of small vessel coronary arteries. Some of these features, such as macroglossia, periorbital ecchymosis, and the so-called shoulder-pad sign, are pathognomonic for AL amyloidosis. These findings may be the initial presenting features of the disease, and the recognition of these red flag symptoms is very important for the diagnosis and early intervention on the underlying plasma cell disease.


Assuntos
Anticorpos Monoclonais/metabolismo , Síndrome do Túnel Carpal , Doença da Artéria Coronariana , Equimose , Cadeias Leves de Imunoglobulina/metabolismo , Amiloidose de Cadeia Leve de Imunoglobulina , Macroglossia , Síndrome do Túnel Carpal/etiologia , Síndrome do Túnel Carpal/metabolismo , Síndrome do Túnel Carpal/patologia , Síndrome do Túnel Carpal/terapia , Doença da Artéria Coronariana/etiologia , Doença da Artéria Coronariana/metabolismo , Doença da Artéria Coronariana/patologia , Doença da Artéria Coronariana/terapia , Equimose/etiologia , Equimose/metabolismo , Equimose/patologia , Equimose/terapia , Humanos , Amiloidose de Cadeia Leve de Imunoglobulina/complicações , Amiloidose de Cadeia Leve de Imunoglobulina/metabolismo , Amiloidose de Cadeia Leve de Imunoglobulina/patologia , Amiloidose de Cadeia Leve de Imunoglobulina/terapia , Macroglossia/etiologia , Macroglossia/metabolismo , Macroglossia/patologia , Macroglossia/terapia
4.
Am J Clin Dermatol ; 21(6): 799-812, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32613545

RESUMO

The development of Bruton's tyrosine kinase (BTK) inhibitors represents a major breakthrough in the treatment of chronic lymphocytic leukemia and other B cell malignancies. The first-generation inhibitor ibrutinib works by covalent irreversible binding to BTK, a non-receptor tyrosine kinase of the TEC (transient erythroblastopenia of childhood) family that plays a critical role in the B-cell receptor signaling pathway. It also induces an 'off-target' inhibition of a range of other kinases including (but not limited to) epidermal growth factor receptor (EGFR), SRC, and other kinases of the TEC family (interleukin-2-inducible T-cell kinase [ITK], Tec, BMX). Dermatological toxicities are among the most common toxicities of ibrutinib, but remain of mild to moderate intensity in most cases and are readily manageable. Their incidence is highest during the first year of treatment and declines over time. In addition, it has been postulated that ibrutinib-related dermatologic adverse events are mediated by the direct binding to both BTK and other 'off-target' kinases. Bruising, ecchymoses, and petechiae represent the most characteristic dermatologic adverse events. Nail and hair changes are also common, as skin infections (opportunistic infections including herpes simplex and herpes zoster virus reactivations, and Staphylococcus aureus superinfection), folliculitis, and other types of rashes. Panniculitis, aphthous-like ulcerations with stomatitis, neutrophilic dermatosis, peripheral edema, and skin cracking can also occur. Next-generation BTK inhibitors, acalabrutinib and zanubrutinib, have been designed to optimize BTK inhibition and minimize off-target inhibition of alternative kinases (Tec, ITK, EGFR, SRC-family kinases). These drugs have been recently FDA-approved for relapsed or refractory mantle cell lymphoma. Although the overall incidence of their toxicities is expected to be more limited, acalubrutinib and zanubrutinib are associated with a range of dermatologic toxic effects that appear to be similar to those previously described with ibrutinib, including bruising and ecchymoses, panniculitis, human herpesvirus infections, cellulitis, and skin rash. In particular, both drugs induce skin bleeding events in more than 30% of patients treated. However, the available dermatological data are still rather limited and will have to be consolidated prospectively. This review article analyses the wide spectrum of dermatological toxicities that can be encountered with first- and second-generation BTK inhibitors. Finally, recommendations for appropriate treatment as well as a synthesis algorithm for management are also proposed.


Assuntos
Tirosina Quinase da Agamaglobulinemia/antagonistas & inibidores , Toxidermias/epidemiologia , Equimose/epidemiologia , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Inibidores de Proteínas Quinases/efeitos adversos , Adenina/efeitos adversos , Adenina/análogos & derivados , Administração Cutânea , Tirosina Quinase da Agamaglobulinemia/metabolismo , Benzamidas/efeitos adversos , Biópsia , Toxidermias/diagnóstico , Toxidermias/imunologia , Toxidermias/terapia , Equimose/diagnóstico , Equimose/imunologia , Equimose/terapia , Emolientes/administração & dosagem , Humanos , Incidência , Necrose/diagnóstico , Necrose/epidemiologia , Necrose/imunologia , Necrose/terapia , Educação de Pacientes como Assunto , Piperidinas/efeitos adversos , Pirazinas/efeitos adversos , Pirazóis/efeitos adversos , Pirimidinas/efeitos adversos , Receptores de Antígenos de Linfócitos B/metabolismo , Índice de Gravidade de Doença , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/imunologia , Pele/efeitos dos fármacos , Pele/imunologia , Pele/patologia , Higiene da Pele/métodos
5.
Medicine (Baltimore) ; 99(11): e19040, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176031

RESUMO

Traditional high ligation and stripping (THLS) is a routine operation for varicose veins. However, THLS is accompanied with postoperative subcutaneous ecchymosis and pain. In this current study, we aimed to explore the effect of tumescence solution (TS) combined with negative pressure wound therapy (NPWT) on the relief of subcutaneous ecchymosis and pain after THLS of great saphenous vein.A total of 180 patients receiving THLS were enrolled in group A, and 120 patients undergoing THLS and TS combined with NPWT were assigned into group B. The occurrences of subcutaneous ecchymosis and pain were recorded. Moreover, the total area of subcutaneous ecchymosis was estimated by the grid method. Visual analogue scale (VAS) score was used to assess the pain level of both groups.Preoperative characteristics were not significantly different between 2 groups. Postoperative ecchymosis occurred in 112 cases (62.2%) of group A and 41 cases (34.2%) of group B. The area of ecchymosis in group A (66.6 ±â€Š44.5) cm was larger than that in group B (25.2 ±â€Š19.9) cm. The number of patients without obvious pain in group A (57, 31.7%) was significantly less than that in group B (77, 64.2%) after operation. In addition, VAS score in group A (3.1 ±â€Š2.6) was higher than that in group B (2.2 ±â€Š1.9).In conclusion, the application of TS combined with NPWT in THLS can not only alleviate subcutaneous ecchymosis and pain, but also prevent the occurrence of subcutaneous ecchymosis and pain after operation. Therefore, it is conducive to postoperative recovery and is suitable for clinical application.


Assuntos
Equimose/terapia , Epinefrina/uso terapêutico , Tratamento de Ferimentos com Pressão Negativa/métodos , Ropivacaina/uso terapêutico , Veia Safena/cirurgia , Varizes/cirurgia , Adulto , Epinefrina/administração & dosagem , Feminino , Humanos , Masculino , Dor Pós-Operatória/terapia , Complicações Pós-Operatórias/terapia , Estudos Retrospectivos , Ropivacaina/administração & dosagem
6.
Dermatol Surg ; 46(2): 203-212, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31592926

RESUMO

BACKGROUND: There are many intraoperative and postoperative techniques to aid hemostasis in dermatologic procedures. An updated understanding is critical for the surgeon. OBJECTIVE: To provide an updated review of methods for hemostasis and therapies for postprocedural purpura and ecchymosis applicable to dermatology. MATERIALS AND METHODS: A review of Ovid MEDLINE was performed to review the English-language medical literature of hemostatic options and their use in cutaneous surgery. All available publication years were included from 1946 to present. RESULTS: A comprehensive and current list of hemostatic options used in the intraoperative and postoperative period is provided along with traditional and emerging therapies for postprocedural purpura and ecchymosis. CONCLUSION: A myriad of options exist for minimizing and treating bleeding complications. The appropriate use and updated knowledge of hemostatic options is provided.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Procedimentos Cirúrgicos Dermatológicos/efeitos adversos , Técnicas Hemostáticas , Assistência Perioperatória/métodos , Complicações Pós-Operatórias/terapia , Equimose/etiologia , Equimose/terapia , Hematoma/etiologia , Hematoma/terapia , Humanos , Complicações Pós-Operatórias/etiologia , Púrpura/etiologia , Púrpura/terapia , Pele/irrigação sanguínea
7.
Dermatol Ther ; 32(3): e12861, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30758903

RESUMO

An increasing number of minimally invasive cosmetic procedures, such as filler or botulinum toxin injections, are performed annually. These procedures are associated with a high risk of post-procedure bruising or ecchymosis. Ecchymoses arise following hemorrhage and extravasation of red blood cells into the subcutaneous tissue, leading to local skin discoloration. Although ecchymoses generally resolve within 14 days, their appearance is cosmetically bothersome, and they may be painful and cause major distress to patients. Recent clinical evidence suggests that light/laser technology with pulsed dye laser (PDL) or intense pulsed light (IPL) can dramatically alleviate and minimize bruising when delivered within 24-72 hr of the injection. This article, will review reports of treatment of ecchymosis by lasers and IPL.


Assuntos
Equimose/terapia , Terapia a Laser/métodos , Fototerapia/métodos , Técnicas Cosméticas/efeitos adversos , Equimose/etiologia , Humanos , Injeções , Terapia de Luz Pulsada Intensa/métodos , Lasers de Corante/uso terapêutico , Fatores de Tempo
8.
J Drugs Dermatol ; 17(11): 1184 -1185, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30500137

RESUMO

Bruising after dermal filler and neuromodulator injections is a common side effect and can have durations of 1 to 2 weeks. While it ultimately resolves, faster resolution can produce better outcomes for patients and also make patients more likely to return for future treatments. We report the successful reduction in bruising following injections of fillers with an intense pulsed light source. We also documented the onset of action of bruising resolution with serial photographs. Resolution started within the first hour of treatment and continued rapidly over 48 hours. This is the first-time reported study of resolution of bruising from injectables with intense pulsed light. Patient satisfaction is improved when such adverse events are minimized.


Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Equimose/terapia , Terapia de Luz Pulsada Intensa/métodos , Rejuvenescimento , Preenchedores Dérmicos/administração & dosagem , Equimose/diagnóstico por imagem , Equimose/etiologia , Humanos , Injeções Subcutâneas/efeitos adversos , Terapia de Luz Pulsada Intensa/efeitos adversos , Terapia de Luz Pulsada Intensa/instrumentação , Lasers de Corante/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Terapia com Luz de Baixa Intensidade/instrumentação , Terapia com Luz de Baixa Intensidade/métodos , Satisfação do Paciente , Fotografação , Envelhecimento da Pele , Resultado do Tratamento
9.
J Fam Pract ; 66(9): E11-E13, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28863206

RESUMO

A 54-year-old man presented at our facility with a 3-month history of exertional breathlessness and purple blotches around his eyes. Examination revealed bilateral periorbital and perioral ecchymosis, purpuric spots along his waist, and waxy papules on his eyelids. In addition, the patient had macroglossia with nodular infiltration and irregular indentations at the lateral margin of his tongue. The patient also had a raised jugular venous pressure and prominent atrial and ventricular waves. Further examination revealed a fourth heart sound over the left ventricular apex, as well as bilateral basal rales. All other systems were normal except for mild hepatomegaly. Routine hematologic and biochemical lab work was unremarkable. X-rays of the spine and skull were normal, but a chest x-ray showed mild cardiomegaly. An electrocardiogram showed a QS complex from leads V1 to V4 (a pseudo-infarction pattern). An echocardiogram showed biatrial enlargement, left ventricular hypertrophy with a left ventricular ejection fraction of 48%, a speckled pattern on the myocardium, a thickened interatrial septum, and mild pericardial effusion. A color Doppler revealed mild mitral and tricuspid regurgitation with a restrictive pattern of mitral valve flow. Serum protein electrophoresis was normal. WHAT IS YOUR DIAGNOSIS? HOW WOULD YOU TREAT THIS PATIENT?


Assuntos
Dispneia/diagnóstico , Dispneia/terapia , Equimose/diagnóstico , Equimose/terapia , Oftalmopatias/terapia , Cardiopatias/diagnóstico por imagem , Cardiopatias/terapia , Ecocardiografia , Eletrocardiografia , Oftalmopatias/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Resultado do Tratamento
10.
J La State Med Soc ; 169(4): 99-100, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28850556

RESUMO

A 72-year-old man presents with left knee pain and swelling over several days. The pain and swelling started after he felt a "pop" when bending to pick up an object off the floor. His past medical history is significant for type 2 diabetes mellitus. Physical exam revealed significant ecchymosis on the anterolateral aspect of the thigh. There was a minimal amount pain upon knee flexion.


Assuntos
Hematoma/diagnóstico por imagem , Traumatismos do Joelho/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Coxa da Perna/fisiopatologia , Idoso , Artralgia/diagnóstico , Artralgia/etiologia , Tratamento Conservador/métodos , Equimose/diagnóstico por imagem , Equimose/fisiopatologia , Equimose/terapia , Seguimentos , Hematoma/fisiopatologia , Hematoma/terapia , Humanos , Traumatismos do Joelho/fisiopatologia , Traumatismos do Joelho/terapia , Masculino , Medição da Dor , Exame Físico/métodos , Índice de Gravidade de Doença , Coxa da Perna/diagnóstico por imagem
11.
Eur Arch Otorhinolaryngol ; 274(7): 2685-2694, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28314960

RESUMO

Rhinoplasty is the most common facial plastic surgical procedure, and the occurrence of periorbital edema and ecchymosis is normal after rhinoplasty. The goal of this study was to perform a systematic review with meta-analysis of the efficacy of postoperative care of edema and ecchymosis following rhinoplasty. Two authors independently searched the databases (PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database) from inception to September 2016. We included studies that compared postoperative care methods (intervention groups) with no treatment (control group) where the outcomes of interest were edema, ecchymosis, and satisfaction rate of patients on postoperative days. Sufficient data for meta-analysis were retrieved for 11 trials with a total of 627 patients. Eyelid edema and ecchymosis during the first 7 days postoperatively were statistically decreased in the arnica administration groups versus the control group. Eyelid edema and ecchymosis during the first 24 h postoperatively were statistically decreased in the cold compression group versus the control group. The ratio of patient satisfaction was statistically higher in the tapping application group than in the control group. However, the analysis indicated that surgeons had a significant tendency to decrease intranasal packing. The administration of arnica, cold compression, and tape could reduce eyelid edema and ecchymosis. Intranasal packing was associated with more adverse effects in terms of postoperative ecchymosis compared to non-packing. However, additional trials with thorough research methodologies should be conducted to confirm the results of this study.


Assuntos
Arnica , Crioterapia , Equimose/terapia , Edema/terapia , Extratos Vegetais/uso terapêutico , Complicações Pós-Operatórias/terapia , Rinoplastia/efeitos adversos , Equimose/etiologia , Edema/etiologia , Humanos , Satisfação do Paciente , Cuidados Pós-Operatórios , Complicações Pós-Operatórias/etiologia
12.
Rev Med Interne ; 38(6): 416-419, 2017 Jun.
Artigo em Francês | MEDLINE | ID: mdl-27639912

RESUMO

INTRODUCTION: The presence of a psychiatric disorder during the course of an organic disease is a common cause of delayed diagnosis. CASE REPORT: We report a 16-year-old girl who was admitted with thrombocytopenia and had a two-year history of neuropsychiatric disorder which was attributed to a difficult family situation. Neurological examination showed a frontal lobe disorder and extrapyramidal manifestations. The thrombocytopenia was attributed to liver cirrhosis. These neurological and hepatic injuries were consistent with a metabolic disease, most likely Wilson disease. This was supported by the presence of a corneal Kayser-Fleischer ring and a decreased ceruloplasmin concentration. An urgent liver transplantation was required due to worsening neurological symptoms. CONCLUSION: Wilson disease is a rare genetic disease caused by copper toxicity. It is characterized by combined hepatic and neurologic damage to varying degrees and can develop at any age. Urgent treatment is required, but the diagnosis may be delayed by prevailing psychiatric symptoms.


Assuntos
Equimose/diagnóstico , Degeneração Hepatolenticular/diagnóstico , Adolescente , Diagnóstico Tardio , Diagnóstico Diferencial , Equimose/etiologia , Equimose/terapia , Feminino , Degeneração Hepatolenticular/complicações , Degeneração Hepatolenticular/terapia , Humanos , Transplante de Fígado , Imageamento por Ressonância Magnética
13.
J Eur Acad Dermatol Venereol ; 31(3): 405-413, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27662522

RESUMO

Dermal fillers are increasingly used for soft tissue augmentation of the face and hands. The widespread use of dermal fillers for rejuvenation has led to a rise in reports of associated complications. Although the majority of complications are mild and transient, serious and long-lasting complications have been observed. This article discusses the key complications including pigmentary changes, hypersensitivity reactions, infections, nodule formation, granulomatous reactions, vascular occlusion and migration of filler material. A thorough literature review was performed in addition to the combined extensive authors' (GP and FA) experience. Complications from fillers are increasingly being recognized and highlighted in the literature partly reflecting the growth in the market. This article provides a comprehensive overview of the filler complications with mechanisms of prevention and treatment per complication. A thorough understanding of the preventative and management strategies for the associated dermal filler complications will help the physician to prepare the patient well, and deal with complications that may arise effectively.


Assuntos
Arteriopatias Oclusivas/induzido quimicamente , Preenchedores Dérmicos/efeitos adversos , Edema/induzido quimicamente , Reação a Corpo Estranho/induzido quimicamente , Pele/patologia , Arteriopatias Oclusivas/complicações , Arteriopatias Oclusivas/terapia , Hipersensibilidade a Drogas/etiologia , Hipersensibilidade a Drogas/terapia , Equimose/induzido quimicamente , Equimose/terapia , Edema/terapia , Eritema/induzido quimicamente , Eritema/terapia , Reação a Corpo Estranho/terapia , Humanos , Injeções Intradérmicas/efeitos adversos , Necrose/etiologia , Oclusão da Artéria Retiniana/induzido quimicamente , Oclusão da Artéria Retiniana/terapia
15.
Plast Reconstr Surg ; 137(5): 783e-789e, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27119940

RESUMO

BACKGROUND: The purpose of this study was to evaluate the efficacy of postoperative intense pulsed light therapy on patients who undergo bilateral eyelid surgery. METHODS: Patients presenting over a 3-month period for bilateral eyelid surgery were asked to participate in an institutional review board-approved study. Intense pulsed light therapy was administered three times to the same randomly assigned side on postoperative days 1 to 2, 5 to 7, and 10 to 12. Sham light therapy was administered to the contralateral side. Patient surveys and physician ratings were obtained based on photographic evaluation of ecchymosis, edema, and erythema. Three physicians, including the senior author (A.E.W.), submitted ratings, and these ratings were assessed for interobserver reliability. RESULTS: Twenty-eight patients who underwent bilateral eyelid surgery followed by intense pulsed light therapy were enrolled. The mean age of the patients was 66 years (range, 44 to 81 years). Eighty-six percent of patients were female. The change in ratings between postoperative days 1 to 2 and 10 to 12, in the treatment and control groups, was statistically significant for severity of bruising by both patient and physician assessment and for color of bruising only by patient assessment. The interobserver reliability reached the greatest agreement in the ecchymosis category at each time point for the treatment group. CONCLUSION: In a series of patients who underwent eyelid surgery, intense pulsed light therapy decreased the degree of ecchymosis compared with sham treatment in postoperative eyelid surgery patients. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.


Assuntos
Equimose/terapia , Edema/terapia , Eritema/terapia , Pálpebras/cirurgia , Terapia de Luz Pulsada Intensa , Complicações Pós-Operatórias/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Equimose/etiologia , Equimose/prevenção & controle , Edema/etiologia , Edema/prevenção & controle , Eritema/etiologia , Eritema/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Método Simples-Cego , Resultado do Tratamento
17.
Dermatol Surg ; 39(10): 1459-64, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23899131

RESUMO

BACKGROUND: Several bruise reduction methods have been suggested to decrease postprocedure ecchymoses. Comparing the effectiveness of common bruise reduction therapies provides better evidence of the efficacy of bruise reduction techniques. OBJECTIVE: To compare the effectiveness of cold compresses, hydrogen peroxide, over-the-counter bruise serum, and pulsed dye laser (PDL) in minimizing the time required for bruise resolution. METHODS: Seventeen patients aged 22 to 51 (mean 28) with Fitzpatrick skin types I to IV underwent bruise induction with a PDL to produce five 2- by 2-cm zones of bruising on the lower abdomen. Excluding the control, bruises were randomly treated using a cold compress, bruise serum, 3% hydrogen peroxide-soaked gauze, or PDL. Subjects and two blinded physician evaluators evaluated bruise severity and graded it on a visual analog scale on days 0, 3, and 7. RESULTS: Treatment did not result in statistically significantly shorter bruise resolution time than in controls. PDL-treated bruises took a statistically significantly longer time to resolve than controls. CONCLUSION: Our study showed no significant difference in cold compress, hydrogen peroxide, and over-the-counter serum in reducing time to bruise resolution. PDL therapy resulted in greater bruise severity scores and increased time to bruise resolution when used soon after bruise induction.


Assuntos
Contusões/terapia , Equimose/terapia , Adulto , Contusões/etiologia , Crioterapia , Fármacos Dermatológicos/uso terapêutico , Combinação de Medicamentos , Equimose/etiologia , Feminino , Glicerol/uso terapêutico , Humanos , Peróxido de Hidrogênio/uso terapêutico , Lasers de Corante/efeitos adversos , Lasers de Corante/uso terapêutico , Ácidos Linoleicos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Oenothera biennis , Oxidantes/uso terapêutico , Óleos de Plantas/uso terapêutico , Método Simples-Cego , Fatores de Tempo , Índices de Gravidade do Trauma , Vitamina E/uso terapêutico , Adulto Jovem , Ácido gama-Linolênico/uso terapêutico
18.
Transfus Apher Sci ; 48(3): 311-2, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23628355

RESUMO

The treatment of refractory idiopathic thrombocytopenia in adult is a challenge. Here we report successful treatment of an adult ITP patient with immunoadsorption using tryptophan column who were refractory to steroids, splenectomy, eltrombopag and various immunosuppressive medications.


Assuntos
Adsorção , Remoção de Componentes Sanguíneos/métodos , Técnicas Imunológicas , Púrpura Trombocitopênica Idiopática/terapia , Adulto , Benzoatos/uso terapêutico , Equimose/terapia , Humanos , Hidrazinas/uso terapêutico , Imunossupressores/uso terapêutico , Masculino , Contagem de Plaquetas , Púrpura Trombocitopênica Idiopática/sangue , Pirazóis/uso terapêutico , Indução de Remissão , Esplenectomia , Esteroides/uso terapêutico , Resultado do Tratamento
20.
Niger Postgrad Med J ; 17(2): 172-4, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20539336

RESUMO

This is to illustrate the case of a 14 year old male student of a secondary school who fell off the top of an unguarded bunk bed in his hostel while sleeping and sustained a fracture of the left orbital margin, severe periorbital echymosis and conjunctivitis. He was managed conservatively. Two weeks post injury; the swelling resolved. At 2 months post injury, he improved tremendously and his visual acuity in the affected eye was 6/6. The swelling resolved and his anterior and posterior segments were normal. The patient was lucky to have had an intact eyeball. If it had been a penetrating eye injury, it could have been disastrous. Blinding eye injuries may be irreversible.Unguarded bunk beds may be dangerous to the eye. A recommendation of minimal standard for bunk-beds for children or no bunks at all in schools is suggested.


Assuntos
Leitos/efeitos adversos , Órbita/lesões , Acidentes por Quedas , Adolescente , Leitos/normas , Conjuntivite/etiologia , Conjuntivite/terapia , Equimose/etiologia , Equimose/terapia , Desenho de Equipamento , Traumatismos Oculares/fisiopatologia , Humanos , Masculino , Órbita/diagnóstico por imagem , Radiografia , Resultado do Tratamento , Acuidade Visual
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA