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1.
Rev. Odontol. Araçatuba (Impr.) ; 45(2): 15-23, maio-ago. 2024. tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-1553276

ABSTRACT

Introdução: Na medida em que envelhecemos os lábios estreitam-se, ocasionando perda de volume e contorno e como forma de minimizar este efeito fisiológico o preenchimento labial de escolha utilizado é o ácido hialurônico. É possível perceber efeitos adversos advindos do emprego deste material, e pelo fato da informação ao paciente ser assegurada pelo Código de Defesa do Consumidor e pelo fato da necessidade dos Cirurgiões-Dentistas terem de esclarecer seus pacientes, o Termo de Consentimento Livre e Esclarecido tornase necessário. Objetivo: identificar, por meio de aplicação de questionário, a percepção de profissionais que trabalham com Harmonização Orofacial em relação a necessidade do emprego do Termo de Consentimento Livre e Esclarecido (TCLE). O questionário apresentou 6 perguntas objetivas, que foram disponibilizadas na plataforma Google Forms®. Material e Método: os dados obtidos foram tabulados em uma planilha eletrônica do programa Microsoft Excel e após analisados descritivamente através de tabelas de frequência, porcentagens e gráficos estatísticos. Resultados: dentre os entrevistados foi constatado que a maioria, 87,5% dos especialistas em Harmonização Orofacial realizam o procedimento de preenchimento labial em sua rotina clínica, e 12,5% não. Conclusão: no presente estudo identificamos que os especialistas realizam o emprego do TCLE, em sua maioria, porém, alguns destes ainda negligenciam o seu uso(AU)


Introduction: As we age, the lips become thinner and to minimize this effect, the lip filler used is hyaluronic acid. It is possible to notice adverse effects arising from the use of this material, and it is extremely important that Dental Surgeons have to clarify their patients, the Free and Informed Consent Form becomes necessary. Objective: to identify, through the application of a questionnaire, the perception of professionals who work with Orofacial Harmonization in relation to the need to use the Free and Informed Consent Form (TCLE). The questionnaire presented 6 objective questions, which were made available on the Google Forms® platform. Materials and Methods: the data obtained were tabulated in a Microsoft Excel spreadsheet and then analyzed descriptively using frequency tables, percentages and graphs. Results: among those interviewed, it was found that the majority, 87.5% of specialists in Orofacial Harmonization perform the lip filling procedure in their clinical routine, and 12.5% do not. With the high percentage of 59.4%, it was possible to verify that the majority of professionals perform 1 to 3 procedures per month; 31.3% perform 4 to 9 procedures per month; and 9.4% of 10 or more monthly procedures. Conclusion: in the present study it was possible to identify that the majority of specialists in Orofacial Harmonization use the informed consent form, however, some of them still neglect its use(AU)


Subject(s)
Informed Consent , Consent Forms , Dermal Fillers
2.
Arq. bras. oftalmol ; 87(5): e2022, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1527850

ABSTRACT

ABSTRACT Purpose: Recently, hyaluronic acid (HA) was proposed as a promising option for the treatment of acquired lower eyelid cicatricial ectropion. However, this effect was not confirmed by quantitative assessments. This study aimed to assess the effect of hyaluronic acid on the treatment of acquired lower eyelid cicatricial ectropion. Methods: Eight patients with acquired lower eyelid cicatricial ectropion (13 eyelids) were treated with a single 1 mL injection of hyaluronic acid in the preseptal area of the lower eyelid. Evaluation of symptoms and biomicroscopic exam was performed before and 30 days after hyaluronic acid injection. Quantitative analysis of the lower eyelid position (with and without lid traction) was determined before and 30 days after hyaluronic acid injection through standard photographs analyzed using the ImageJ. Results: All patients experienced partial improvement of symptoms. The lower eyelid position was significantly lifted after hyaluronic acid injection with a significant reduction of medial and lateral angles, reduction of the margin reflex distance, and total and medial ocular fissure area. However, signs of lid margin inflammation and corneal punctate keratitis persisted. Conclusions: Hyaluronic acid injected in the pre-septal area of the lower eyelid improved acquired lower eyelid cicatricial ectropion symptoms and significantly lifted the position of the lower eyelid. Further studies, with a large number of participants and a long-term follow-up period, are needed to better determine the permanency of the effects of hyaluronic acid injections on the treatment of acquired lower eyelid cicatricial ectropion.


RESUMO Objetivo: Recentemente, o ácido hialurônico foi proposto como promissor no tratamento do ectrópio cicatricial adquirido da pálpebra inferior. No entanto, não foram feitas avaliações quantitativas para confirmar este efeito, motivo que levou a realização do presente estudo que visou avaliar o efeito do ácido hialurônico no tratamento do ectrópio cicatricial adquirido da pálpebra inferior. Métodos: Oito portadores de ectrópio cicatricial adquirido da pálpebra inferior (13 pálpebras) foram tratados com uma única dose de 1 mL de ácido hialurônico, injetada na área pré-septal da pálpebra inferior. Os sintomas e o exame biomicroscópico foram realizados antes e 30 dias após a injeção do ácido hialurônico. A análise quantitativa da posição palpebral inferior (com e sem tração palpebral) foi determinada antes e 30 dias após a injeção do ácido hialurônico por meio de fotografias que foram analisadas usando o programa ImageJ. Resultados: Todos os pacientes apresentaram melhora parcial dos sintomas. A posição da pálpebra inferior foi elevada significativamente após a injeção do ácido hialurônico, com redução significativa dos ângulos medial e lateral, da distância entre o reflexo pupilar e a margem da pálpebra inferior, da área de fissura palpebral total e da área medial. No entanto, sinais de inflamação da margem palpebral e ceratite puntata da córnea persistiram. Conclusões: O ácido hialurônico injetado na área pré-septal da pálpebra inferior, melhorou os sintomas do ectrópio cicatricial adquirido da pálpebra inferior e elevou significativamente a posição da pálpebra inferior. Estudos com maior número de participantes e período de acompanhamento mais longo são necessários para melhor determinar os efeitos das injeções de ácido hialurônico a longo prazo no tratamento do ectrópio cicatricial adquirido da pálpebra inferior.

3.
J. appl. oral sci ; 32: e20230294, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1558234

ABSTRACT

Abstract Objective This study aims to develop a compound biomaterial to achieve effective soft tissue regeneration. Methodology Compound hyaluronic acid (CHA) and liquid horizontal-platelet-rich fibrin (H-PRF) were mixed at a ratio of 1:1 to form a CHA-PRF gel. Human gingival fibroblasts (HGFs) were used in this study. The effect of CHA, H-PRF, and the CHA-PRF gel on cell viability was evaluated by CCK-8 assays. Then, the effect of CHA, H-PRF, and the CHA-PRF gel on collagen formation and deposition was evaluated by qRT‒PCR and immunofluorescence analysis. Finally, qRT‒PCR, immunofluorescence analysis, Transwell assays, and scratch wound-healing assays were performed to determine how CHA, H-PRF, and the CHA-PRF gel affect the migration of HGFs. Results The combination of CHA and H-PRF shortened the coagulation time of liquid H-PRF. Compared to the pure CHA and H-PRF group, the CHA-PRF group exhibited the highest cell proliferation at all time points, as shown by the CCK-8 assay. Col1a and FAK were expressed at the highest levels in the CHA-PRF group, as shown by qRT‒PCR. CHA and PRF could stimulate collagen formation and HGF migration, as observed by fluorescence microscopy analysis of COL1 and F-actin and Transwell and scratch healing assays. Conclusion The CHA-PRF group exhibited greater potential to promote soft tissue regeneration by inducing cell proliferation, collagen synthesis, and migration in HGFs than the pure CHA or H-PRF group. CHA-PRF can serve as a great candidate for use alone or in combination with autografts in periodontal or peri-implant soft tissue regeneration.

4.
Dental press j. orthod. (Impr.) ; 29(1): e2423115, 2024. tab, graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1550225

ABSTRACT

ABSTRACT Objective: The objective of the present prospective case control study was to evaluate the facial pleasantness of patients with complete and unilateral cleft lip and palate at the end of interdisciplinary rehabilitation, submitted to facial fillers based on hyaluronic acid. Methods: The study group consisted of 18 individuals with complete unilateral cleft lip and palate, aged between 18 and 40 years (mean age 29 years) of both sexes. The patients presented a concave profile with mild to moderate maxillary deficiency, with completed orthodontic treatment and conducted by means of dentoalveolar compensations without orthognathic surgery. Participants underwent facial filling procedures with hyaluronic acid (HA) in the midface, inserted by a single operator. Standard photographs in frontal norm at rest, right profile at rest, and left profile at rest were obtained from each patient at the following operative times: (T1) pre-filler and (T2) and one-month post-filler. The photographs in T1 and T2 were randomly placed on a page of a virtual album. A 5-point Likert scale was used to assess facial pleasantness. The photographs were evaluated by two groups of evaluators consisting of 18 individuals with cleft lip and palate (CLPG=18) and 18 orthodontists with experience in the treatment of clefts (OG=18). For comparison between phases T1 and T2, and between evaluators with orofacial clefts and orthodontists, the Wilcoxon test was used (p<0,05). Results: People with cleft lip and palate rated their face as more pleasant after the midface filling procedure. In the perception of the orthodontists, on the other hand, the facial pleasantness remained similar after the facial filling procedure. Conclusions: The filling of the middle third of the face in patients with cleft lip and palate treated without orthognathic surgery increased the pleasantness of the face in the opinion of laypeople with cleft lip and palate.


RESUMO Objetivo: O objetivo do presente estudo caso-controle prospectivo foi avaliar a agradabilidade facial de pacientes com fissura labiopalatina completa e unilateral ao final da reabilitação interdisciplinar, submetidos a preenchimentos faciais à base de ácido hialurônico. Métodos: O grupo de estudo foi composto por 18 indivíduos com fissura labiopalatina unilateral completa, com idade entre 18 e 40 anos (média de 29 anos), de ambos os sexos. Os pacientes apresentavam perfil côncavo com deficiência maxilar leve a moderada, com tratamento ortodôntico concluído e realizado por meio de compensações dentoalveolares sem cirurgia ortognática. Os participantes foram submetidos a procedimentos de preenchimento facial com ácido hialurônico (AH) no terço médio da face, implantado por um único operador. Fotografias padrão em norma frontal em repouso, perfil direito em repouso e perfil esquerdo em repouso foram obtidas de cada paciente nos seguintes tempos operatórios: (T1) pré-preenchimento e (T2) um mês pós-preenchimento. As fotografias em T1 e T2 foram inseridas aleatoriamente em uma página de um álbum virtual. Uma escala Likert de 5 pontos foi utilizada para avaliar a agradabilidade facial. As fotografias foram avaliadas por dois grupos de avaliadores formados por 18 indivíduos com fissura labiopalatina (GFLP=18) e 18 ortodontistas com experiência no tratamento de fissuras (GO=18). Para comparação entre as fases T1 e T2, e entre avaliadores com fissura labiopalatina e ortodontistas, foi utilizado o teste de Wilcoxon (p<0,05). Resultados: As pessoas com fissura labiopalatina avaliaram seu rosto como mais agradável após o preenchimento do terço médio da face. Já na percepção do ortodontista, a agradabilidade facial permaneceu semelhante após o procedimento de preenchimento facial. Conclusões: O preenchimento do terço médio da face em pacientes com fissura labiopalatina tratados sem cirurgia ortognática aumentou a agradabilidade da face na opinião dos leigos com fissura labiopalatina.

5.
Article in English | LILACS-Express | LILACS | ID: biblio-1528859

ABSTRACT

Hyaluronic acid (HA) dermal fillers are widely used in aesthetic treatments for facial and lip modeling. Despite HA fillers has largely known to be use in procedures for augmentation the lip volume, their application to management lip abnormalities is not widespread. This study reviewed the use of HA fillers for reconstruction of congenital and acquired li p asymmetries and deformities, searching to expand knowledge about this treatment modality. To undertake this narrative review, the Medline-Pubmed, Web of Science, Scopus, Embase, Google Schoolar e Lillacs databases were searched. Several studies have reported positive results in the use of HA fillers for the treatment of lip deformities caused by different factors such as: Insatisfactory dermal fillers, permanent lip implants, excision of lip carcinoma, post-operative scars and electrical burns. HA fillers are also an alternative for the management of lip asymmetries and residual surgical scars in patients with cleft lip. Moreover, injection of HA fillers in individuals with facial paralysis and facioscapulohumeral muscular dystrophy can also improve lip incompetence. Additionally, HA fillers can be used as a complementary treatment in cases of severe malocclusion associated with skeletal changes, helping to maintain the seal and refine the lip appearance. Therefore, HA fillers can be used as alternative treatment for several types of congenital and acquired lip deformities and asymmetries. However, it is necessary to carry out randomized clinical trials with a greater number of patients and follow-up time, in order to investigate the benefits of the HA fillers for carriers patients of lip abnormalities.


Los rellenos dérmicos de ácido hialurónico (AH) son muy utilizados en tratamientos estéticos para el modelado facial y de labios. A pesar de que se sabe en gran medida que los rellenos de HA se utilizan en procedimientos para aumentar el volumen de los labios, su aplicación para el tratamiento de anomalías labiales no está muy extendida. Este estudio revisó el uso de rellenos de HA para la reconstrucción de asimetrías y deformidades labiales congénitas y adquiridas, buscando ampliar el conocimiento sobre esta modalidad de tratamiento. Para realizar esta revisión narrativa, se realizaron búsquedas en las bases de datos Medline-Pubmed, Web of Science, Scopus, Embase, Google Schoolar y Lillacs. Varios estudios han reportado resultados positivos en el uso de rellenos de HA para el tratamiento de deformidades labiales causadas por diferentes factores tales como: rellenos dérmicos insatisfactorios, implantes labiales permanentes, escisión de carcinoma labial, cicatrices postoperatorias y quemaduras eléctricas. Los rellenos de HA también son una alternativa para el manejo de asimetrías labiales y cicatrices quirúrgicas residuales en pacientes con labio hendido. Además, la inyección de rellenos de HA en personas con parálisis facial y distrofia muscular facioescapulohumeral también puede mejorar la incompetencia de los labios. Además, los rellenos de HA se pueden usar como un tratamiento complementario en casos de maloclusión severa asociada con cambios esqueléticos, lo que ayuda a mantener el sellado y refinar la apariencia de los labios. Por lo tanto, los rellenos de HA se pueden utilizar como tratamiento alternativo para varios tipos de deformidades y asimetrías labiales congénitas y adquiridas. Sin embargo, es necesario realizar ensayos clínicos aleatorizados con mayor número de pacientes y tiempo de seguimiento, para investigar los beneficios de los rellenos HA para pacientes portadores de anomalías labiales.

6.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1533022

ABSTRACT

O ácido hialurônico (AH) composto empregado na especialidade de harmonização orofacial para fins de preenchimento facial confere obtenção de harmonia em casos de estética deficiente. O objetivo desse trabalho é verificar se existe alteração dos sulcos labiais após a aplicação de ácido hialurônico, por meio de um relato de prontuário e análise de fotografias periorais. O prontuário selecionado foi de um paciente do sexo feminino, que se submeteu a um procedimento de preenchimento labial com infiltração de um volume total de 0,7 mL de ácido hialurônico da marca comercial (Hialurox Soft® 8mg/mL São Carlos - Brasil) e apresentava documentação fotográfica completa, anterior ao procedimento e pós-operatório tardio de 108 dias. Foi realizada uma simulação de confronto queiloscópico comparando as imagens entre si com o auxílio da ferramenta de edição Paint Microsoft, os sulcos foram classificados de acordo com o método de Suzuki e Tsuchihashi (1971), e os dados foram registrados na ficha modificada de Stamm (2014). A técnica utilizada no presente estudo não promoveu alteração significativa nos sulcos labiais pré-existentes. No entanto, o período do pós-operatório tardio de 108 dias não foi suficiente para o reaparecimento de alguns sulcos encontrados na fase pré-procedimento


The compound hyaluronic acid (HA) used in the specialty of orofacial harmonization for the purpose of facial filling confers harmony in cases of poor aesthetics. The aim of this study was to find out whether there are any changes to the labial folds after the application of hyaluronic acid, by means of a medical record report and analysis of perioral photographs. The medical record selected was that of a female patient who underwent a lip filling procedure with infiltration of a total volume of 0.7 mL of hyaluronic acid commercial brand (Hialurox Soft® 8mg/mL São Carlos ­ Brazil) and had complete photographic documentation prior to the procedure and 108 days after the procedure. A cheiloscopic comparison simulation was carried out, comparing the images with each other using the Paint Microsoft editing tool, lip prints were classified according to the method of Suzuki and Tsuchihashi (1971), and the data was recorded on the modified form of Stamm (2014). The technique used in this study did not significantly alter the pre-existing labial traces. However, the late postoperative period of 108 days was not enough for some of the furrows found in the pre-procedure phase to reappear

7.
Rev. Bras. Odontol. Leg. RBOL ; 10(3): 107-115, 2023-12-30.
Article in English | LILACS-Express | LILACS | ID: biblio-1533024

ABSTRACT

A queiloscopia é uma técnica de identificação humana que consiste em estudar os lábios e suas características, como a espessura, a disposição da comissura labial, a posição dos sulcos e suas classificações, bem como o registro das impressões produzidas por eles em vários suportes. O aumento dos lábios com preenchedores de ácido hialurônico (AH) se tornou muito popular nos últimos anos, principalmente após inclusão da harmonização facial como especialidade odontológica. O objetivo deste estudo foi verificar se o preenchimento labial com AH tem implicações no estudo queiloscópico, por meio de um relato de caso clínico. Paciente do sexo feminino, 37 anos, leucoderma, participou do estudo. Foi realizado o registro fotográfico e tomadas as medidas de espessura labial, disposição da comissura labial e obtenção das impressões labiais com auxílio de batom, antes do preenchimento labial, 15 dias após aplicação de 1 ml de AH e 15 dias após completos 2 ml de preenchimento com AH. Os resultados do estudo sugerem que o preenchimento labial com AH pode interferir no método queiloscópico, pois houve alteração da arquitetura dos lábios, da disposição da comissura labial, melhorou contorno, arco do cupido e filtro, com mudança significativa na espessura dos lábios superior e inferior de aproximadamente 42% em relação ao volume anterior. Quanto ao padrão dos sulcos labiais, não houve alteração nos desenhos, no entanto, a qualidade da impressão labial foi afetada devido ao efeito produzido pelo AH


Cheiloscopy is a human identification technique that consists of studying the lips and their characteristics, such as their thickness, the arrangement of the labial commissure, the position of the grooves and their classifications, as well as recording the impressions produced by them on various supports. Lip augmentation with hyaluronic acid (HA) fillers has become very popular in recent years, especially since facial harmonization was included as a dental specialty. The aim of this study was to verify whether lip fillers with HA have implications for cheiloscopic studies, by means of a clinical case report. A 37-year-old female patient with leukoderma took part in the study. Photographs were taken and measurements of lip thickness, lip commissure layout and lipstick impressions were taken before the lip filler, 15 days after the application of 1 ml of HA and 15 days after the full 2 ml of HA filler. The results of the study suggest that lip filling with HA can interfere with the cheiloscopic method, as there was a change in the architecture of the lips, the layout of the labial commissure, improved contour, cupid's bow and filter, with a significant change in the thickness of the upper and lower lips of approximately 42% in relation to the previous volume. As for the pattern of the lip furrows, there was no change in the designs, however, the quality of the lip impression was affected due to the effect produced by the HA

8.
Rev. bras. cir. plást ; 38(3): 1-7, jul.set.2023. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1512609

ABSTRACT

Introdução: Tradicionalmente, o rebaixamento do dorso é o único método de correção da giba. Raras séries apontam a elevação do radix como possível solução. O que explica essa maciça predominância do procedimento redutor? Ineficácia dos métodos de aumento de radix e ponta? Percepção de nariz grande com os procedimentos de aumento? Nossos objetivos são descobrir se a percepção de redução ocorre na rinoplastia não cirúrgica (RNC), feita exclusivamente com adição de volume, e se a percepção de redução é importante na RNC. Método: Análise retrospectiva de 116 pacientes consecutivos submetidos a RNC. As imagens dos pacientes foram analisadas por 12 observadores independentes que avaliaram as mudanças percebidas no tamanho do nariz e a qualidade da correção, dando notas de 1 a 10 para os dois quesitos. Quanto ao tamanho, 1 representava muito menor que antes, 5 mesmo tamanho (neutralidade) e 10 muito maior que antes. A qualidade da correção foi classificada de 1 a 10. Resultados: 92 casos (79%) foram percebidos como redução do tamanho, enquanto 20 casos (17%) foram percebidos como aumento. Houve percepção de redução na média das pontuações de tamanho (4,71). A média da qualidade da correção foi de 8,28 na escala de 1 a 10. Ademais, nossos resultados sugerem que pode haver correlação indireta entre a percepção do tamanho e a qualidade da correção. Conclusão: O aumento proporcionado pela RNC pode causar percepção de redução do tamanho do nariz, e o grau da redução percebida pode estar diretamente relacionado ao grau de qualidade percebida da correção.


Introduction: Traditionally, lowering the dorsum is the only method of hump correction. Rare series point to raising the radix as a possible solution. What explains this massive predominance of the reduction procedure? Ineffectiveness of radix and tip augmentation methods? Big nose perception with augmentation procedures? Our objectives are to determine if the perception of reduction occurs in non-surgical rhinoplasty (NSR), performed exclusively with volume addition, and if the perception of reduction is important in NSR. Method: Retrospective analysis of 116 consecutive patients undergoing NSR. The patients' images were analyzed by 12 independent observers who evaluated the perceived changes in the nose's size and the correction's quality, giving scores from 1 to 10 for both questions. As for size, 1 represented much smaller than before, 5 same size (neutrality), and 10 much larger than before. The quality of correction was graded from 1 to 10. Results: 92 cases (79%) were considered size reduction, while 20 cases (17%) were considered enlargement. There was a perception of a reduction in the average size scores (4.71). The mean correction quality was 8.28 on a scale of 1 to 10. Furthermore, our results suggest that there may be an indirect correlation between perceived size and correction quality. Conclusion: The increase provided by the NSR can cause a perception of a reduction in the size of the nose, and the degree of perceived reduction can be directly related to the degree of perceived quality of the correction.

9.
Rev. cir. traumatol. buco-maxilo-fac ; 23(1): 22-25, jan.-mar. 2023. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1443751

ABSTRACT

Introdução: As Disfunções temporomandibulares (DTM) incluem desordens dos músculos da mastigação, das articulações temporomandibulares e da inervação local, frequentemente associadas a dor orofacial e que resultam em mioartropatias do Sistema Mastigatório. A tendência atual tende a começar com tratamento conservador e progredir a procedimentos mais invasivos na falha dos tratamentos iniciais. Relato de caso: O presente relato visa mostrar o resultado de uma técnica invasiva para o tratamento de uma DTM grave, com a aplicação do ácido hialurônico e de corticoide através de uma punção guiado por ultrassonografia. A paciente apresentava dor crônica e perda importante de peso devido a limitação da abertura da boca. A RM demonstrou disfunção das ATMs, com sinais de deslocamento parcial do disco direito anteromedialmente. Foi realizada a aplicação bilateral intra-articular de ácido hialurônico e de corticoide através de uma punção guiado por ultrassonografia. Considerações Finais: A associação destas classes na punção de ATMs ainda não está bem estabelecida havendo necessidade de estudos complementares para avaliar eficácia, como este relato de caso, que se mostrou favorável com grande melhora clínica da paciente... (AU)


Introduction: Temporomandibular dysfunctions (TMD) include disorders of the masticatory muscles, temporomandibular joints, and local innervation, often associated with orofacial pain and resulting in myoarthropathies of the masticatory system. The current trend tends to begin with conservative treatment and progress to more invasive procedures if the initial treatments fail. Case Report: The present report aims to show the result of an invasive technique for the treatment of a severe TMD, with the application of hyaluronic acid and corticoid through an ultrasound-guided puncture. The patient presented with chronic pain and significant weight loss due to limited mouth opening. MRI demonstrated TMJ dysfunction, with signs of partial anteromedial dislocation of the right disc. Bilateral intra-articular application of hyaluronic acid and corticoid was performed through an ultrasound guided puncture. Final considerations: The association of these classes in TMJ puncture is still not well established, and further studies are needed to evaluate efficacy, as in this case report, which proved favorable, with great clinical improvement for the patient... (AU)


Introducción: Los trastornos temporomandibulares (TTM) incluyen trastornos de los músculos masticatorios, de las articulaciones temporomandibulares y de la inervación local, a menudo asociados a dolor orofacial y que dan lugar a mioartropatías del sistema masticatorio. La tendencia actual es comenzar con un tratamiento conservador y progresar hacia procedimientos más invasivos al fracasar los tratamientos iniciales. Informe de un caso: El presente informe pretende mostrar el resultado de una técnica invasiva para el tratamiento de un TTM severo, con la aplicación de ácido hialurónico y corticoide a través de una punción guiada por ecografía. El paciente presentaba dolor crónico y una importante pérdida de peso debido a la limitación de la apertura bucal. La RMN demostró una disfunción de la ATM, con signos de dislocación parcial del disco derecho anteromedialmente. Se realizó la aplicación intraarticular bilateral de ácido hialurónico y corticoide mediante una punción guiada por ecografía. Consideraciones finales: La asociación de estas clases en la punción de la ATM aún no está bien establecida y se necesitan más estudios para evaluar la eficacia, como en el reporte de este caso, que resultó favorable con gran mejoría clínica del paciente... (AU)


Subject(s)
Humans , Female , Adult , Temporomandibular Joint Dysfunction Syndrome , Adrenal Cortex Hormones/therapeutic use , Conservative Treatment , Hyaluronic Acid/pharmacology
10.
Acta ortop. mex ; 37(1): 36-43, ene.-feb. 2023. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1556728

ABSTRACT

Resumen: Introducción: la gonartrosis es una enfermedad degenerativa, cuya pérdida de cartílago origina cambios en el hueso adyacente y su respuesta produce deformaciones e intentos de regeneración. En 1934 Meyer y Palmer aislaron el humor vítreo bovino, polisacárido denominado ácido hialurónico, que tiene la propiedad de visco elasticidad. Hoy en día se conocen múltiples procedimientos realizados en ortopedia, con la finalidad de limitar el proceso degenerativo que este conlleva. Objetivo: conocer el uso y la eficacia del ácido hialurónico, en el paciente que requiere artroscopía de rodilla, valorando la evolución del paciente mediante escala de WOMAC; así como el tiempo ideal de aplicación del ácido hialurónico en este grupo de estudio. Material y métodos: ensayo clínico, no aleatorizado longitudinal, prospectivo, analítico. Se valoraron 48 pacientes de 45 a 60 años de edad, divididos en tres grupos con diagnóstico de gonartrosis grado II-III, en quienes se realizaron artroscopía con posterior aplicación ácido hialurónico; en el transquirúrgico (grupo 1), al mes del postquirúrgico (grupo 2) y sin aplicación (grupo 3) en un período de Septiembre de 2015 a Junio de 2016 en el Hospital del ISSSTE «Dr. Darío Fernández Fierro¼. Resultados: el tratamiento mostró diferencias en los pacientes en cuanto a reducción de dolor y rigidez; y mejoría en capacidad funcional. Conclusión: a pesar de que no es concluyente si algún tratamiento es mejor que otro, ciertos datos sugieren que el utilizar ácido hialurónico en el transquirúrgico mejora la rigidez y la función, sin embargo, no logró ser estadísticamente significativo.


Abstract: Introduction: gonarthrosis is a degenerative disease, whose loss of cartilage causes changes in the adjacent bone and its response produces deformations and attempts at regeneration. In 1934 Meyer and Palmer isolated bovine vitreous humor, a polysaccharide called hyaluronic acid, which has the property of visco-elasticity. Today, multiple procedures performed in orthopedics are known, in order to limit the degenerative process that this entails. Objective: to know the use and efficacy of hyaluronic acid in the patient requiring knee arthroscopy, evaluating the evolution of the patient using the WOMAC scale; as well as the ideal time of application of hyaluronic acid in this study group. Material and methods: clinical, non-randomized, prospective, analytical trial. 48 patients from 45 to 60 years of age, divided into 3 groups with a diagnosis of gonarthrosis grade II-III, who underwent arthroscopy with subsequent hyaluronic acid application, were evaluated; in the postoperative period (group 1), one month after the postoperative period (group 2) and without application (group 3) in a period from September 2015 to June 2016 at the ISSSTE Hospital «Dr. Darío Fernández Fierro¼. Results: the treatment showed differences in patients regarding reduction of pain and stiffness; and improvement in functional capacity. Conclusion: despite, there are no conclusive results if the treatment is better than the other, certain data suggests that using hyaluronic acid in the postoperative improves rigidity and function, however, it was not statistically significant.

11.
Article in English | WPRIM | ID: wpr-998914

ABSTRACT

@#Introduction: Hyaluronic acid (HA) has a long history and is widely used in cosmetics, medicine, and dermatology. This molecule is still considered relatively new in the field of dentistry. This study aimed to assess the application of HA in dental implant treatment. Method: Search in the multiple indexed databases such as Pubmed, COCHRANE, and Scopus was conducted up until August 2022 using the keywords “hyaluronic acid”, “hyaluronan,” and “dental implant.” Results: The literature search identified 816 articles, and 17 were selected in this study. Three domains of use of HA in dental implant treatment were identified: surface modification of implant surface, treatment after insertion of a dental implant, and bone graft/membrane material. There are eight randomized control trials and nine non-randomized control trials included in this study. Only six studies showed statistically significant results with HA groups. Conclusion: Overall, there are positive findings on the application of HA in dental implant treatment, showing it can be used in dental implantology, with multiple categories of uses.

12.
Article in Chinese | WPRIM | ID: wpr-981621

ABSTRACT

OBJECTIVE@#To study the preparation and properties of the hyaluronic acid (HA)/α-calcium sulfate hemihydrate (α-CSH)/β-tricalcium phosphate (β-TCP) material (hereinafter referred to as composite material).@*METHODS@#Firstly, the α-CSH was prepared from calcium sulfate dihydrate by hydrothermal method, and the β-TCP was prepared by wet reaction of soluble calcium salt and phosphate. Secondly, the α-CSH and β-TCP were mixed in different proportions (10∶0, 9∶1, 8∶2, 7∶3, 5∶5, and 3∶7), and then mixed with HA solutions with concentrations of 0.1%, 0.25%, 0.5%, 1.0%, and 2.0%, respectively, at a liquid-solid ratio of 0.30 and 0.35 respectively to prepare HA/α-CSH/ β-TCP composite material. The α-CSH/β-TCP composite material prepared with α-CSH, β-TCP, and deionized water was used as the control. The composite material was analyzed by scanning electron microscope, X-ray diffraction analysis, initial/final setting time, degradation, compressive strength, dispersion, injectability, and cytotoxicity.@*RESULTS@#The HA/α-CSH/β-TCP composite material was prepared successfully. The composite material has rough surface, densely packed irregular block particles and strip particles, and microporous structures, with the pore size mainly between 5 and 15 μm. When the content of β-TCP increased, the initial/final setting time of composite material increased, the degradation rate decreased, and the compressive strength showed a trend of first increasing and then weakening; there were significant differences between the composite materials with different α-CSH/β-TCP proportion ( P<0.05). Adding HA improved the injectable property of the composite material, and it showed an increasing trend with the increase of concentration ( P<0.05), but it has no obvious effect on the setting time of composite material ( P>0.05). The cytotoxicity level of HA/α-CSH/β-TCP composite material ranged from 0 to 1, without cytotoxicity.@*CONCLUSION@#The HA/α-CSH/β-TCP composite materials have good biocompatibility. Theoretically, it can meet the clinical needs of bone defect repairing, and may be a new artificial bone material with potential clinical application prospect.


Subject(s)
Calcium Phosphates , Bone and Bones , Phosphates
13.
Article in Chinese | WPRIM | ID: wpr-989805

ABSTRACT

Objective:To explore the role and preliminary mechanism of heparin-binding protein (HBP) in the development of acute pancreatitis (AP) through clinical analysis and animal models.Methods:(1) Clinical research: Blood samples were collected from AP patients admitted to the Second Affiliated Hospital of Anhui Medical University from January 1 to December 31, 2021 within 30 min of admission, including 20 patients with severe acute pancreatitis (SAP) and 20 patients with non-severe acute pancreatitis (NSAP). Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of HBP, syndecan-1 and hyaluronic acid (HA). Modified CT severity index (MCTSI), another 20 healthy volunteers were selected as controls (HC). Spearman correlation analysis was used to analyze the correlation between HBP and syndecan-1, HA and MCTSI. Receiver operating characteristic (ROC) curve was used to evaluate HBP to predict AP severity. (2)Animal experiment: The rat model of acute pancreatitis was prepared by intraperitoneal injection of L-arginine. In the normal control group (NC, n=8), the low molecular weight heparin (LMWH) intervention group ( n=8), and the acute pancreatitis group ( AP, n=8), the rats were euthanized 12 h later, and peripheral venous blood was collected to detect the levels of HBP, syndecan-1 and HA. Lung tissue and pancreas tissue were collected to observe the pathological damage, and the polysaccharide coating damage of vascular endothelial cells was observed under a fluoroscopy electron microscope. Results:The level of HBP at admission was significantly higher in the AP group than in the HC group, and the increase in the SAP group was more obvious. Correlation analysis showed that HBP was positively correlated with syndecan-1, HA and MCTSI. Animal studies found that the levels of HBP, syndecan-1 and HA in the AP group were significantly higher than those in the NC group. The pancreatic pathological score showed that the AP group was significantly increased, and the fluoroscopy electron microscope showed that the vascular polysaccharide coating was complete in the NC group, and the structure of the AP group was severely damaged. After LMWH intervention, the structure shedding and damage were significantly reduced, and the difference was statistically significant.Conclusions:HBP can promote the progression of AP, which is related to the destruction of the polysaccharide coating structure of endothelial cells and the increase of vascular permeability caused by HBP.

14.
Article in Chinese | WPRIM | ID: wpr-989794

ABSTRACT

Objective:To investigate the application of endothelial glycocalyx degradation products in assessing the severity of pulmonary edema in patients with acute respiratory distress syndrome (ARDS).Methods:A prospective study was conducted to select patients diagnosed with ARDS at Wuxi People's Hospital from July 1, 2018 to December 31, 2019. The extravascular lung water index (EVLWI) was recorded within 2 h after admission by continuous cardiac output with pulse indicator. The indexes of glycocalyx degradation products syndecan-1 (SDC-1), heparan sulfate (HS), hyaluronic acid (HA) and the concentrations of inflammatory factors [blood tumor necrosis factor α (TNF-α), interleukin (IL)-6 and IL-10] were measured by enzyme-linked immunosorbent assay. Pearson correlation method was adopted to analyze the correlation of glycocalyx degradation products with EVLWI and inflammatory factors in ARDS patients. The patients were divided into the mild pulmonary edema group and severe pulmonary edema group according to EVLWI at the cut-off value of 10 mL/kg, and the differences of glycocalyx degradation products and inflammatory factors between the two groups were compared. Receiver operating characteristic (ROC) curve of the subjects were plotted to analyze the value of glycocalyx degradation products in determining the severity of pulmonary edema.Results:A total of 85 ARDS patients were enrolled. Pearson correlation analysis showed that SDC-1, HS, and HA were all positively correlated with IL-6, TNF-α, EVLWI (all P<0.05), but did not correlate with IL-10 (all P>0.05). Comparison of indicators between the mild pulmonary edema group (39 cases) and the severe pulmonary edema group (46 cases) showed that: IL-6[(33.63±3.43) ng/L vs. (39.99±4.64) ng/L], TNF-α[(43.38±6.05) ng/L vs. (50.79±7.35) ng/L], SDC-1[(494.13±47.23) ng/L vs. (563.50±56.36) ng/L], HS[(114.02±18.39) ng/mL vs. (138.93±17.02) ng/mL], and HA[(441.44±62.52) ng/mL vs. (546.23±85.24) ng/mL] were statistically different between the two groups(all P<0.05). Whereas, IL-10 [(24.37±10.11) ng/L vs. (28.75±11.98) ng/L] was not statistically different between the two groups ( P>0.05). ROC curve analysis showed that the combined prediction of SDC-1, HA and HS indicators was superior to the single indicator. The area under the ROC curve combining the three indicators was 0.928 (95% CI: 0.872-1.000), with a sensitivity and specificity of 87.5% and 86.7%, respectively. Conclusions:There is a positive correlation between glycocalyx degradation products SDC-1, HS, HA and EVLWI in ARDS patients. The application of these three glycocalyx degradation products can be used as a reliable indicators for judging the severity of pulmonary edema in ARDS patients.

15.
Journal of Medical Biomechanics ; (6): E220-E227, 2023.
Article in Chinese | WPRIM | ID: wpr-987939

ABSTRACT

Objective To explore how hyaluronic acid ( HA) in extracellular matrix regulates the adhesion ofCD44+tumor cells. Methods MDA-MB-231 cells or HL60 cells were perfused in a parallel plate chamber. Themovement of cells over immobilized HA was observed and analyzed to obtain the characteristics of cell adhesionand rolling. Results The adhesion number of MDA-MB-231 cells on HA substrate was positively regulated by HAconcentration, but not by HA molecular weight. Compared with physically adsorbed HA, immobilized HA byavidin-biotin could significantly improve the cell adhesion ratio. With the increase of shear stress in the range of30-50 mPa, the rolling velocity of cells increased and the adhesion ratio decreased, but the tether lifetime of cellswas not affected. In the same flow field, compared with MDA-MB-231 cells, HL60 cells with low expression ofCD44 rolled more quickly on immobilized HA, with shorter tether lifetime and much lower adhesion ratio(<1. 5% ). Conclusions Fluid shear stress might mediate the rolling velocity of MDA-MB-231 cells by regulatingthe CD44-HA association rate rather than their dissociation rate. The interaction between CD44 and HA is involved in the initial adhesion of HL60 cells, but it does not play a major role. This study will provide references for the design of anti-tumor drugs.

16.
Acta ortop. bras ; 31(6): e271857, 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1527642

ABSTRACT

ABSTRACT Objective: To describe the efficacy of using viscosupplementation in patients with hemophilic arthropathy (HA), on pain, limb functionality, and quality of life. Methods: A systematic review of the literature was performed following the PRISMA guidelines without limitations of language or year of publication. The search was performed on the following medical databases: PubMed, Cochrane Library, EMBASE, BVS/BIREME, Scopus, Web of Science, EBSCOhost, and PROQUEST in April 2020. The search used the following word: (hemophilia AND joint diseases) OR (haemophilic arthropathy OR hemophilic arthropathy) AND viscosupplementation. Results: The systematic review identified 127 articles, 10 of which were selected for data extraction and qualitative analysis. The 10 selected articles included 297 joints with HA in 177 hemophilic subjects. Our review showed positive results in alleviating pain and improving functional capacity, and quality of life. No major adverse effects were observed. Conclusion: There is a lack of scientific evidence regarding viscosupplementation with hyaluronic acid, but the results presented in this research suggest that it is an effective and safe therapeutic option to alleviate pain and improve functional capacity in patients with HA. Level of Evidence II, Systematic Review.


RESUMO Objetivo: Descrever o uso da viscossuplementação com ácido hialurônico em pacientes com artropatia hemofílica (HA), sua eficácia na dor, a funcionalidade do membro e a qualidade de vida após sua aplicação. Métodos: Revisão sistemática da literatura (RSL) que seguiu as diretrizes PRISMA, sem limitação de idioma ou ano de publicação. A pesquisa foi realizada em abril de 2020 nas seguintes bases de dados médicas: PubMed, Cochrane Library, EMBASE, BVS/BIREME, Scopus, Web of Science, EBSCOhost e ProQuest. A estratégia de pesquisa foi: (hemofilia AND joint disease) OR (artropatia hemofílica OU artropatia hemofílica) E viscossuplementação. Resultados: A RSL identificou 127 artigos, dos quais 10 foram selecionados para extração de dados e análise qualitativa. Os 10 artigos selecionados incluíram 297 articulações com AH em 177 indivíduos hemofílicos. Nossa revisão mostrou resultados positivos na melhora da dor, na capacidade funcional e na qualidade de vida. Não foram observados efeitos adversos importantes. Conclusão: A evidência científica atual a respeito da viscossuplementação com ácido hialurônico é escassa, mas os resultados apresentados nesta pesquisa sugerem que é uma opção terapêutica eficaz e segura para diminuir a dor e melhorar a capacidade funcional em pacientes com AH. Nível de Evidência II, Revisão Sistemática.

17.
Braz. J. Pharm. Sci. (Online) ; 59: e22690, 2023. tab, graf
Article in English | LILACS | ID: biblio-1505850

ABSTRACT

Abstract Improving vaccine immunity and reducing antigen usage are major challenges in the clinical application of vaccines. Microneedles have been proven to be painless, minimally invasive, highly efficient, and have good patient compliance. Compared with traditional transdermal drug delivery, it can effectively deliver a large-molecular-weight drug into the skin, resulting in a corresponding immune response. However, few studies have examined the relationship between microneedle loading dose and immune effects. In this study, the hyaluronic acid (HA) conical and pyramidal dissolving microneedles were prepared by the two-step vacuum drying method, respectively. The model drug ovalbumin (OVA) was added to HA to prepare dissolving microneedles with different loading amounts. The mass ratios of HA to OVA were 5:1, 5:3, and 5:5. The mechanical properties of the dissolving microneedles were characterized using nanoindentation and in vitro puncture studies. The immune effects of the matrix and drug content were studied in Sprague-Dawley (SD) rats. Finally, the diffusion behavior of OVA and the binding mode of HA and OVA in the microneedles were simulated using Materials Studio and Autodocking software. The experimental results showed that the conical microneedles exhibited better mechanical properties. When the mass ratio of HA to OVA was 5:3, the immune effect can be improved by 37.01% compared to subcutaneous injection, and achieved a better immune effect with relatively fewer drugs. This conclusion is consistent with molecular simulations. This study provides theoretical and experimental support for the drug loading and efficacy of microneedles with different drug loadings


Subject(s)
Injections, Subcutaneous/adverse effects , Pharmaceutical Preparations/analysis , Vaccines/analysis , Immunization/classification , Mechanical Tests/instrumentation , Hyaluronic Acid/agonists , Antigens/adverse effects
18.
RGO (Porto Alegre) ; 71: e20230014, 2023. graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1449023

ABSTRACT

ABSTRACT The "RichBlend" protocol was designed for facial filling and collagen biostimulation, by means of a mixture of calcium hydroxyapatite (CaHA), hyaluronic acid (AH) and autologous platelet concentrates. This work reports the case of a 53-year-old patient with cutaneous photoaging, loss of facial volume, multiple rhythms in the frontal and periorbital regions, also marked skin flaccidity, especially the eyelid. The treatment was done with botulinum toxin (65 U) and the "RichBlend" protocol. Venipuncture was performed and the blood was centrifuged to obtain i-PRF (injectable platelet-rich fibrin) and plasma gel. After venipuncture and blood centrifugation, i-PRF and plasma gel were obtained. CaHA (Radiesse®) was diluted: a) in saline solution + i-PRF (hyperdilution) for biostimulationof the lower third of the face; and b) in AH (Juvederm Ultraplus XC®) + plasma gel, for hydrolifting on the forehead and dark circles, malar and temples. Plasma gel was applied to the nasogenian grooves and then the entire face was properly massaged. The "RichBlend" protocol rejuvenated the patient, as it promoted filling, volumizing, collagen formation (biostimulation), reduction of flaccidity, in addition to skin whitening. Since HA and CaHA are high-cost products, their mixture with autologous platelet concentrates, in liquid or gel form, allows the use of a greater amount of filled and biostimulator material on the face, at a more affordable cost.


RESUMO O protocolo "RichBlend" foi idealizado para preenchimento facial e bioestimulação de colágeno, por meio da mistura de hidroxiapatita de cálcio (CaHA), ácido hialurônico (AH) e concentrados plaquetários autólogos. Este trabalho relata o caso de um paciente de 53 anos, com fotoenvelhecimento cutâneo, perda de volume facial, múltiplas rítides nas regiões frontal e periorbital, apresentando também acentuada flacidez cutânea, especialmente palpebral. Foi feito o tratamento com toxina botulínica (65 U) e protocolo "RichBlend". Foi realizada a venopunção e o sangue foi centrifugado para obtenção da i-PRF (fibrina rica em plaquetas injetável) e do plasma gel. Após venopunção e centrifugação sanguínea, obtiveram-se a i-PRF e o plasma gel. A CaHA (Radiesse®) foi diluída: a) em soro + i-PRF (hiperdiluição) para bioestimulação do terço inferior da face; e b) em AH (Juvederm Ultraplus XC®) + plasma gel, para hidrolifting na fronte e preenchimentos de olheira, malar e têmporas. Plasma gel foi aplicado nos sulcos nasogenianos e, em seguida, toda a face foi devidamente massageada. O protocolo "RichBlend" rejuvenesceu o paciente, pois promoveu preenchimento, volumização, formação de colágeno (bioestimulação), redução da flacidez, além do clareamento cutâneo. Uma vez que o AH e a CaHA são produtos de alto custo, sua mistura com os concentrados plaquetários autólogos, na forma líquida ou gel, permite a utilização de uma maior quantidade de material preenchedor e bioestimulador na face, com custo mais acessível.

19.
Braz. dent. j ; 34(6): 50-66, 2023. tab, graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1528032

ABSTRACT

Abstract Mineral trioxide aggregate (MTA) has many clinical applications in dentistry; the main drawback is the long setting. The main objective is to investigate and compare the chemical effect of using two commercially available hyaluronic acid hydrogels (HA) instead of distilled water for mixing MTA as an accelerant of setting time. Materials and method: Test materials were divided into three groups; Group 1: (control) mixing MTA with distilled water supplied by the manufacturer; Group 2: mixing MTA with a hybrid cooperative complex of high and low molecular weight HA (Profhilo®); Group 3: mixing MTA with High molecular weight / non-cross-linked HA (Jalupro®). Mixing time, and setting time (initial and final) were determined, Fourier-transform infrared spectroscopy, Energy-dispersive X-ray spectroscopy, Field emission Scanning Electron Microscopy, and X-ray diffraction were performed. Results: mixing time, initial, and final setting time for (MTA + HA) groups were significantly different and lower in comparison to the control group (p < 0.05). This study revealed higher expression of calcium silicate hydrate and calcium hydroxide expression with higher Ca release in the MTA + HA group than the control group. Conclusion: commercially available HA demonstrated better chemical properties when used as a mixing medium for MTA. The Mixing and setting time for MTA + HA group were significantly shorter than those of the control group were. Thus, commercially available HA can be used as a mixing medium for MTA.


Resumo O agregado de trióxido mineral (MTA) tem muitas aplicações clínicas em odontologia, mas a principal desvantagem é a longa presa. O objetivo principal é investigar e comparar o efeito químico do uso de dois hidrogéis de ácido hialurônico (HA) disponíveis comercialmente em vez de água destilada para misturar o MTA como um acelerador do tempo de presa. Materiais e método: Os materiais de teste foram divididos em três grupos: Grupo 1: (controle) misturando o MTA com água destilada fornecida pelo fabricante; Grupo 2: misturando o MTA com um complexo cooperativo híbrido de HA de alto e baixo peso molecular (Profhilo®); Grupo 3: misturando o MTA com HA de alto peso molecular/não reticulado (Jalupro®). Foram determinados o tempo de mistura e o tempo de presa (inicial e final), a espectroscopia de infravermelho com transformada de Fourier, a espectroscopia de raios X com dispersão de energia, a microscopia eletrônica de varredura com emissão de campo e a difração de raios X. Resultados: o tempo de mistura, o tempo de presa inicial e final dos grupos (MTA + HA) foram significativamente diferentes e menores em comparação com o grupo de controle (p < 0,05). Esse estudo revelou maior expressão de silicato de cálcio hidratado e expressão de hidróxido de cálcio com maior liberação de Ca no grupo MTA + HA do que no grupo de controle. Conclusão: a HA disponível comercialmente demonstrou melhores propriedades químicas quando usada como meio de mistura para o MTA. O tempo de mistura e de presa do grupo MTA + HA foi significativamente menor do que o do grupo de controle. Portanto, a HA disponível comercialmente pode ser usada como meio de mistura para o MTA.

20.
Arq. ciências saúde UNIPAR ; 27(6): 2572-2584, 2023.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1436632

ABSTRACT

O edema tardio intermitente persistente (ETIP) é uma reação inflamatória imunomediada desencadeada pela aplicação de ácido hialurônico (AH). É classificado clinicamente como não depressível, difuso e de caráter tardio, por aparecer, no mínimo, 30 dias após a aplicação. Ademais, caracteriza-se como intermitente e recorrente, visto que a reação pode reaparecer enquanto a substância perdurar no tecido. O presente estudo tem como objetivo relatar um caso de ETIP desencadeado pelo medicamento Prolia, sua apresentação clínica e evolução do quadro, bem como o tratamento realizado. No presente relato de caso, foi observada essa reação após uso do medicamento Prolia (Denosumabe), um anticorpo monoclonal que reduz a reabsorção óssea, utilizado para o tratamento da osteoporose. A paciente em questão é uma mulher de 56 anos, procedente de Joaçaba (SC), a qual apresentou placas eritematosas infiltradas na região do lábio superior, inferior e sulconasomentual, após cinco meses da aplicação do AH. Após conhecimento das medicações de uso e posterior confirmação histopatológica, foi diagnosticada com ETIP e iniciou conduta médica. A ETIP geralmente apresenta uma progressão benigna, se diagnosticada e tratada corretamente. A paciente em questão apresentou completa melhora clínica e, apesar de ainda não existir um consenso na literatura sobre como manejar a ETIP, o tratamento que melhor se adaptou ao caso foi a administração de Prednisolona por 4 semanas. Por não haver sido descrito anteriormente, na literatura mundial, o aparecimento de ETIP desencadeado pelo Denosumabe, destaca-se a importância do presente estudo para elucidação desta possível inteiração entre os compostos.


Persistent intermittent delayed swelling (PIDS) is an inflammatory reaction immune-mediated by the application of hyaluronic acid (HA). It is clinically classified as non-depressible, diffuse, and delayed, as its onset is in at least 30 days following application. Moreover, it is characterized as intermittent and reocurring, as the reaction may reappear while the substance remains in the tissue. The present study aims to report a case of PIDS caused by the drug Prolia, including its clinical presentation and development, as well as the treatment performed. In this case report the reaction was observed after the use of Prolia (Denosumab), a monoclonal antibody that reduces bone reapsorption, indicated for the treatment of osteoporosis. The patient was 56 years-old woman from Joaçaba (SC) that presented erythematous plaques in the upper and lower lip regions and in the melomental folds five months after the application of HA. After acknowledging the medications under use and histopathological confirmation, the patient was dignosed with PIDS and started medical treatment. PIDS usually has a benign progression if correctly diagnosed and treated. The patient made a full clinical recovery and, despite the lack of consensus in the literature for the management of PIDS, the treatment with best responses for this case was the administration of Prednilosone for four weeks. As the emergence of PIDS triggered by Denosumab was not previously described in the global literature, the current study is important to elucidate the possible interaction between the compounds.


La hinchazón persistente intermitente retardada (PIDS) es una reacción inflamatoria inmunomediada por la aplicación de ácido hialurónico (AH). Clínicamente se clasifica como no depresible, difusa y retardada, ya que su aparición se produce en al menos 30 días tras la aplicación. Además, se caracteriza como intermitente y recidivante, ya que la reacción puede reaparecer mientras la sustancia permanece en el tejido. El presente estudio tiene como objetivo reportar un caso de PIDS causado por el medicamento Prolia, incluyendo su presentación clínica y desarrollo, así como el tratamiento realizado. En este caso clínico la reacción se observó tras el uso de Prolia (Denosumab), un anticuerpo monoclonal que reduce la reabsorción ósea, indicado para el tratamiento de la osteoporosis. La paciente era una mujer de 56 años de Joaçaba (SC) que presentó placas eritematosas en las regiones labial superior e inferior y en los pliegues melomentales cinco meses después de la aplicación del HA. Después del reconocimiento de los medicamentos en uso y de la confirmación histopatológica, la paciente fue dignosticada con PIDS e inició tratamiento médico. El PIDS suele tener una evolución benigna si se diagnostica y trata correctamente. La paciente tuvo una recuperación clínica completa y, a pesar de la falta de consenso en la literatura para el manejo de laIDS, el tratamiento con mejores respuestas para este caso fue la administración de Prednilosona durante cuatro semanas. Como la aparición de PIDS desencadenada por Denosumab no fue descrita anteriormente en la literatura mundial, el presente estudio es importante para dilucidar la posible interacción entre los compuestos.

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