RESUMO
Introdução: A mamoplastia de aumento é uma das cirurgias plásticas mais realizadas no mundo. Tendo em vista sua alta aplicabilidade, é fundamental conhecer os fatores de risco relacionados à incidência de complicações pós-operatórias a fim de reduzilas nesse tipo de procedimento. Método: Este estudo é retrospectivo feito por meio da análise dos prontuários de 76 pacientes que realizaram mamoplastia de aumento primária com implantes de silicone durante os meses de janeiro de 2018 a dezembro de 2020. Resultados: Observou-se que a presença de comorbidades aumentou a incidência de complicações pós-operatórias precoces (p<0,001), mas não de complicações pósoperatórias tardias (p=0,8). O maior tempo cirúrgico também aumentou a incidência de complicações pós-operatórias (p=0,005). Conclusão: A presença de comorbidades influencia diretamente na incidência de complicações pós-operatórias da mastoplastia de aumento e por esta razão deve-se realizar uma adequada compensação pré-operatória antes de submeter as pacientes a este procedimento cirúrgico.
Introduction: Breast augmentation is one of the most performed plastic surgeries in the world. Given its high applicability, it is essential to know the risk factors related to the incidence of postoperative complications to reduce them in this type of procedure. Method: This retrospective study analyzed the medical records of 76 patients who underwent primary breast augmentation with silicone implants from January 2018 to December 2020. Results: It was observed that the presence of comorbidities increased the incidence of early postoperative complications (p<0.001) but not of late postoperative complications (p=0.8). Longer surgical time also increased the incidence of postoperative complications (p=0.005). Conclusion: The presence of comorbidities directly influences the incidence of postoperative complications after breast augmentation, and for this reason, adequate preoperative compensation must be carried out before submitting patients to this surgical procedure.
RESUMO
ABSTRACT Purpose: To evaluate the efficacy of soft HydroCone silicone hydrogel contact lenses in patients with posterior microphthalmos. Methods: The charts of 13 patients with posterior microphthalmos (26 eyes) who were fitted with soft HydroCone silicone hydrogel contact lenses were reviewed retrospectively. All the patients underwent assessments of uncorrected and best spectacle-corrected visual acuity and cycloplegic refraction. They were fitted with contact lenses according to the parameter values obtained from the topographical analysis and best contact lens-corrected visual acuity measurement. Results: The spherical equivalents of the right and left eyes ranged from 10.00 to 19.25 diopters and from 11.00 to 21.5 diopters, respectively. The mean axial and posterior chamber lengths were shorter than those of the age-matched population. However, the mean values of the anterior segment parameters such as horizontal visible iris diameter, central anterior chamber depth, lens thickness, and central corneal thickness were in the normal range. The mean keratometric measurements revealed increased corneal curvature compared with that in the normal population. The mean best contact lens-corrected visual acuity was significantly higher than the mean best spectacle-corrected visual acuity for both eyes (p=0.045). Conclusion: HydroCone silicon soft contact lenses provided better visual acuity than spectacles in the patients with posterior microphthalmos in this study.
RESUMO Objetivo: Avaliar a eficácia das lentes de contato gelatinosas HydroCone, de hidrogel com silicone, em pacientes com microftalmia posterior. Métodos: Foram revisados retrospectivamente 26 olhos com microftalmia posterior, a partir dos prontuários de 13 pacientes que receberam lentes de contato gelatinosas HydroCone, de hidrogel com silicone. Todos os pacientes foram submetidos ao exame de acuidade visual não corrigida e com melhor correção por óculos e com refração cicloplégica. Todos os pacientes receberam lentes de contato de acordo com os parâmetros obtidos na análise topográfica e foi obtida a melhor acuidade visual corrigida com lentes de contato. Resultados: O equivalente esférico do olho direito variou de 10,00 a 19,25 dioptrias, e o do olho esquerdo de 11,00 a 21,5 dioptrias. Os comprimentos médios axiais e das câmaras posteriores foram menores do que para a população de mesma idade. No entanto, os valores médios dos parâmetros do segmento anterior, como o diâmetro horizontal visível da íris, a profundidade da câmara anterior central, a espessura da lente e a espessura central da córnea estavam dentro da faixa normal. Os valores médios da ceratometria revelaram curvatura corneana aumentada em relação à população normal. A média da melhor acuidade visual corrigida com lentes de contato foi significativamente maior que a média da melhor acuidade visual corrigida com óculos em ambos os olhos (p=0,045). Conclusão: As lentes de contato gelatinosas de silicone HydroCone proporcionam melhor acuidade visual que óculos em pacientes com microftalmia posterior.
RESUMO
Adjuvant-induced autoimmune/inflammatory syndrome leads to capsular contracture and fibrosis from the oxidation that takes place in silicone. Anaplastic large cell lymphoma occurs through the development of a seroma, with the formation of a periprosthetic effusion, or through the infiltration of the condition itself. To analyze these conditions, a review of the literature was carried out on the symptoms and pathophysiology of the autoimmune/inflammatory syndrome induced by adjuvants and anaplastic large cell lymphoma, searched using the terms "ASIA breast silicone," "Lymphoma," "Adjuvants" "Immunologic" " Breast Implants" on the PubMed platform. Analyzing the data obtained, it was noted that the symptoms of the autoimmune/inflammatory syndrome induced by adjuvants are nonspecific, such as fatigue, myalgia, arthralgia, morning stiffness, and night sweats, and therefore need attention. Anaplastic large cell lymphoma presents with breast pain, periprosthetic effusion, and palpable mass, among other characteristics. Because of these aspects, it is concluded that a good investigation should be carried out when nonspecific symptoms appear, regardless of the time the surgery was performed since these complications can occur years later.
A síndrome autoimune/inflamatória induzida por adjuvantes leva à contratura capsular e fibrose pela oxidação que acontece no silicone. O linfoma anaplásico de grandes células ocorre através do desenvolvimento de um seroma, com a formação de derrame periprotético ou por uma infiltração da própria afecção. Para análise destes acometimentos, foi realizada uma revisão da literatura acerca da sintomatologia e fisiopatologia da síndrome autoimune/inflamatória induzida por adjuvantes e linfoma anaplásico de grandes células, pesquisada através dos termos "ASIA breast silicone" "Lymphoma" "Adjuvants" "Immunologic" "Breast Implants" na plataforma PubMed. Analisando os dados obtidos, notou-se que os sintomas da síndrome autoimune/inflamatória induzida por adjuvantes são inespecíficos, como fadiga, mialgia, artralgia, rigidez matinal e suores noturnos, e, portanto, necessitam de atenção. Já o linfoma anaplásico de grandes células se apresenta com dor mamária, derrame periprotético, massa palpável, dentre outras características. Em vista destes aspectos, conclui-se que uma boa investigação deve ser realizada ao surgirem sintomas inespecíficos, independentemente do tempo que a cirurgia foi realizada, uma vez que estas complicações podem ocorrer anos após a cirurgia.
RESUMO
Objetivo: Identificar sinais e sintomas experienciados por mulheres com síndrome autoimune induzida por adjuvantes (ASIA) devido ao uso de prótese mamária e os tratamentos realizados. Método: Estudo de campo de abordagem qualitativa realizado por meio de entrevistas online utilizan-do-se a técnica bola de neve. Incluíram-se 13 participantes. Resultados: A partir da análise dos dados, foram elencadas quatro categorias: conhecimento acerca da síndrome; sinais e sintomas; tratamento; e cuidados e implicações de Enfermagem. Identificaram-se mais de 120 sinais e sintomas, e o explante foi mencionado como tratamento definitivo por todas as entrevistadas. Os sinais e sintomas apresentados pelas participantes vão ao encontro do que é descrito pela literatura. Conclusão: Antes da descoberta da doença, as participantes realizaram tratamento com foco no alívio dos sintomas. Após o diag-nóstico, todas as mulheres procederam com o explante
Objective: To identify signs and symptoms experienced by women with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to the use of breast implants and the treatments performed. Method: Field study with a qualitative approach carried out through online interviews using the snowball technique. 13 participants were included. Results: Based on data analysis, four categories were listed: knowledge about the syndrome; signs and symptoms; treatment; and nursing care and implications. Over 120 signs and symptoms were identified, and the explant was mentioned as a defi-nitive treatment by all interviewees. The signs and symptoms presented by the participants are in line with what is described in the literature. Conclusion:Before discovering the disease, the participants underwent treatment focused on symptom relief. After diagnosis, all women proceeded with the explant.Keywords: Autoimmune diseases. Prothesis implantation. Breast implantation. Silicones. Perioperative nursing
Objetivo: Identificar los signos y síntomas experimentados por mujeres con síndrome autoinmune inducido por adyuvantes (ASIA) debido al uso de implantes mamarios y los tratamientos realizados. Método: Estudio de campo con enfoque cualitativo realizado a través de entrevistas en línea utilizando la técnica de bola de nieve. Se incluyeron 13 participantes. Resultados: Con base en el análisis de los datos, se enumeraron cuatro categorías: conocimiento sobre el síndrome; signos y síntomas; tratamiento; y cuidados e implicaciones de enfermería. Se identificaron más de 120 signos y sínto-mas, y todos los entrevistados mencionaron el explante como tratamiento definitivo. Los signos y síntomas presentados por los participantes están en línea con lo descrito en la literatura. Conclusión: Antes de descubrir la enfermedad, los participantes realizaban un tratamiento enfocado en el alivio de los síntomas. Después del diagnóstico, todas las mujeres procedieron al explante
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Doenças Autoimunes/etiologia , Adjuvantes Imunológicos/efeitos adversos , Implantes de Mama/efeitos adversos , Síndrome , Entrevistas como Assunto , Pesquisa QualitativaRESUMO
ABSTRACT Introduction: in videolaparoscopic surgery, movements are conducted from a twenty times magnified image of an indirect operative field. The video interface used assumes the need for depth perception using two dimensions instead of three. Objective: to evaluate the effectiveness of training to perform the laparoscopic knot in a silicone model, in 8-hour courses, and to analyze the correlation of learning outcomes with factors such as: sex, age, laterality, previous knowledge in endosuture and medical specialty. Material and Methods: in this prospective and randomized study, 56 students were evaluated, who took 8-hour courses, with groups of up to ten students. We used: a white box with camera, LCD screen and silicone piece. Four exercises were performed on the silicone mold: right hand, left hand, needle at 45° and back hand. Results: 56 students (mean age = 33.28 years). The female group, n=18, mean age 29.61 years, 17 right-handed and 1 left-handed. The male group, n=38, mean age 34.57 years, 35 right-handers, 1 left-handed and 2 ambidextrous. In both groups, no correlation was observed between the analyzes of well performed knots when correlated with the age or sex of the participants. Conclusion: laparoscopic knot training, in silicone molds, in 8 h courses, proved to be effective. Factors such as gender, age, laterality, previous knowledge in endosuture and medical specialty do not interfere with the learning results.
RESUMO Introdução: na cirurgia videolaparoscópica os movimentos são conduzidos a partir de uma imagem magnificada de vinte vezes de um campo operatório indireto. A interface de vídeo utilizada pressupõe a necessidade de percepção de profundidade utilizando duas dimensões ao invés de três. Objetivo: avaliar a eficácia do treinamento de execução do nó laparoscópico em modelo de silicone, em cursos de 8h, e analisar a correlação dos resultados de aprendizagem com fatores como: sexo, idade, lateralidade, conhecimentos prévios em endosutura e especialidade médica. Material e Métodos: Neste estudo, prospectivo e randomizado, foram avaliados 56 alunos, que realizaram cursos de 8h de duração, com turmas de até dez alunos. Foram utilizados: uma caixa branca com câmera, tela de LCD e peça de silicone. No molde de silicone foram executados quatro exercícios: mão direita, mão esquerda, agulha a 45° e back hand. Resultados: 56 alunos (média de idade = 33,28 anos). O grupo feminino, n=18, média de idade 29,61 anos, 17 destras e 1 canhota. O grupo masculino, n=38, média de idade 34,57 anos, 35 destros, 1 canhoto e 2 ambidestros. Em ambos grupos não foram observados nenhuma correlação entre as análises de nós bem executados quando correlacionados com a idade ou sexo dos participantes. Conclusão: o treinamento de nó laparoscópico, em moldes de silicone, em cursos de 8h de duração, mostrou-se eficaz. Fatores como sexo, idade, lateralidade, conhecimentos prévios em endosutura e especialidade médica, não interferem nos resultados do aprendizado.
RESUMO
O uso do silicone líquido industrial como material para modificação estética no contorno corporal é uma prática realizada de forma clandestina há cerca de 60 anos. Atualmente, a maioria dos relatos provém de países da Ásia e América do Sul e as vítimas são principalmente mulheres e transexuais. Devido ao grande número de casos com complicações, o uso do silicone industrial para fins estéticos nunca foi aprovado. Entretanto, continua a ser aplicado isoladamente ou associado a outros produtos, determinando graves complicações locais e sistêmicas. Relata-se um caso de óbito de paciente transexual após injeção de silicone industrial em coxas e glúteos.
The use of industrial liquid silicone as a material for aesthetic modification of body contour is a practice that has been carried out clandestine for about 60 years. Currently, most reports come from countries in Asia and South America, and the victims are mainly women and transsexuals. Due to the large number of cases with complications, the use of industrial silicone for aesthetic purposes has never been approved. However, it continues to be applied alone or associated with other products, determining severe local and systemic complications. We report a case of death of a transsexual patient after injecting industrial silicone in the thighs and buttocks.
RESUMO
The incidence of breast carcinoma is reportedly the second highest among all carcinomas in Indian women. Depending on the extent of resection, age, general health, and economic condition of the patient, various methods of breast reconstruction using surgery have been reported with success and a superior cosmesis. When the patient is unwilling to opt for surgical reconstruction due to various constraints, an alternative technique must be employed. In such cases, nonsurgical prosthetic reconstruction using maxillofacial silicones is considered the only viable option. This prevents the need for a second surgery and rehabilitates the patient during the decision-making phase for considering a delayed reconstructive surgery. The prosthesis mimics the natural texture, feel, weight, and appearance as its natural counterpart enabling the patient to go about her routine social activities. This case report illustrates an indigenous method of rehabilitation of a unilateral mastectomy case using hollow breast form/prosthesis
RESUMO
Tridimensional printing is becoming relevant in medicine, specially in surgical and interventional specialties. We review the technical aspects and clinical application of airway tridimensional printing. Using this technique, simulation models for bronchoscopy and models for diagnostic and therapeutic procedures such as stent design, tracheal reconstruction and airway models can be created.
Assuntos
Humanos , Sistema Respiratório , Impressão Tridimensional , Modelos Anatômicos , Próteses e Implantes , Desenho de Prótese , Traqueia , Stents , Treinamento por SimulaçãoRESUMO
Assuntos
Humanos , Cicatriz , Coinfecção , Eucalyptus , Seguimentos , Pigmentação , Maleabilidade , Prurido , Sensação , Silício , Silicones , Transplante de Pele , Pele , Coxa da Perna , Doadores de Tecidos , Sítio Doador de Transplante , Transplantes , CicatrizaçãoRESUMO
En prótesis fija la integridad marginal o perfección del margen es de suma importancia así como una impresión que copie perfectamente el terminado de la preparación ya que de esto depende la adaptabilidade de la prótesis que permita la supervivencia de la restauración y el mantenimiento de la salud periodontal en la boca del paciente. En este estudio se compara la capacidad de tres materiales de impresión (2 siliconas por adición y 1 poliéter) para copiar el margen cervical de la preparación mediante las técnicas de doble hilo y cofia de trasferencia. Se utilizaron 96 primeros molares inferiores izquierdos divididos en 6 grupos de 16 c/u se restauraron los dientes con ionómero de vidrio, resina o poste colado según fuera el caso, se prepararon los dientes con terminación en chamfer, el grupo 1: técnica de doble hilo con silicone por adición (Silicona 1), grupo 2: técnica de doble hilo con poliéter, grupo 3: técnica de cofia de transferência con silicona (Silicona 1), grupo 4: técnica de cofia de transferencia con poliéter, grupo 5: Técnica de doble hilo con silicona (Silicona 2), grupo 6: Técnica de cofia con silicona (Silicona 2). Posteriormente fueron observados en el estereomicroscopio para evaluar la cantidad de burbujas e irregularidades en el margen cervical según la escala de Jokstad. Donde la prueba estadística de Chi-cuadrada con un nivel de confianza de < 0.05 no mostró diferencia estadística significativa entre las técnicas de impresión de doble hilo y la de cofia de trasferencia, independientemente del material usado. Aunque numéricamente la técnica de doble hilo se comportó mejor que la técnica de cofia por lo que se sugiere su uso.
In fixed prosthesis, the integrity of perfection of the margin is of utmost importance, as well as an impression that perfectly copies the finish of the preparations, since the adaptability of the prosthesis that ensures survival of the restoration and periodontal health depends on this. This study compares the capacity of 3 different materials (2 silicones addition and 1 polyether) to copy the cervical margin of the preparation in the impression between the techniques of double cord and coping. We used 96 lower left molars divided into 6 groups of 16 each. The teeth were restored with glass ionomer, resin or cast post and core depending on the case, the margins were finished in a chamfer (group 1), double thread with addition silicone (group 2), double thread with polyether, (group 3), coping with PVS, (group 4), coping with polyether, (group5) double cord with PVS (group 6), coping With PVS. They were subsequently evaluated in a stereomicroscope to observe the number of bubbles and irregularities in the cervical margin according to the Jockstad scale, where the Chi-square test with a confidence level of <0.05 showed no statistically significant difference between impression techniques and coping regardless of material used. Although numerically the double-thread technique behaved better than coping technique, so it is suggested its use.
Assuntos
Silicones , Técnica de Moldagem Odontológica , Materiais para Moldagem OdontológicaRESUMO
SUMMARY Hypercalcemia associated with silicone-induced granuloma is a rare disease. Diagnosis can be tricky as it is established after ruling out other hypercalcemia-causing entities. In addition, management is customized depending on the patient's wishes and possible solutions. We present a male bodybuilder, in his thirties, with multiple silicone injections in his upper extremities, who developed hypercalcemia and urinary symptoms. Advanced laboratory tests ruled out various causes of hypercalcemia and CT imaging revealed nephrocalcinosis. A biopsy of the upper arm showed granulomatous tissue and inflammation. The patient necessitated two sessions of dialysis and corticosteroids were given to relieve symptoms and reverse laboratory abnormalities. Silicone-induced hypercalcemia should be on high alert because of the increasing trend of body contour enhancements with injections, implants and fillers. Treatment should be optimized depending on the patient's needs and condition.
RESUMO A hipercalcemia associada ao granuloma induzido por silicone é uma doença rara. O diagnóstico pode ser complicado, pois é estabelecido depois de eliminadas outras entidades que causam hipercalcemia. Além disso, o gerenciamento é personalizado, dependendo dos desejos do paciente e das possíveis soluções. Apresentamos um fisiculturista masculino, com trinta e poucos anos, múltiplas injeções de silicone nas extremidades superiores, que desenvolveu hipercalcemia e sintomas urinários. Testes laboratoriais avançados descartaram várias causas de hipercalcemia e a imagem da TC revelou nefrocalcinoses. Uma biópsia da parte superior mostrou tecido granulomatoso e inflamação. O paciente exigiu duas sessões de diálise e foram administrados corticosteroides para aliviar os sintomas e reverter as anormalidades laboratoriais. A hipercalcemia induzida por silicone deve estar em alerta elevado devido à crescente tendência de aprimoramentos do contorno corporal com injeções, implantes e enchimentos. O tratamento deve ser otimizado de acordo com as necessidades e condições do paciente.
Assuntos
Humanos , Masculino , Adulto , Silicones/efeitos adversos , Granuloma de Corpo Estranho/complicações , Hipercalcemia/etiologia , Levantamento de Peso , Biópsia , Injeções Intradérmicas , Granuloma de Corpo Estranho/patologia , Hipercalcemia/patologiaRESUMO
ABSTRACT Objective: Evaluation of rheumatoid hand-associated metacarpophalangeal joint silicone arthroplasty most often relies on functional scores alone. This study aimed to understand the correlation between perceived and observed function, strength, and alignment. Methods: Cross-sectional study including all 11 women (15 hands) submitted to second to fifth metacarpophalangeal joint arthroplasty due to rheumatoid arthritis involvement for a time period of seven years. Measurements relied on the Michigan Hand Outcomes Questionnaire, Lafayette Purdue Pegboard, pinch and grip strength, and analysis of a lateral "OK-sign" X-ray view. Correlation analysis used Spearman's coefficient, assuming statistical significance for p-values < 0.05. Results: Objective function was strongly correlated with all other variables (p < 0.05), while perceived function failed to correlate with articular alignment in both measurements (p = 0.240 and p = 0.354). Strength and alignment were also strongly correlated (p < 0.05). Conclusions: Most measurements strongly correlate with each other, with emphasis on objective dexterity measurement.
RESUMO Objetivo: Na maioria das vezes, a avaliação da artroplastia da articulação metacarpofalangeana com implante de silicone é feita apenas por meio de escores funcionais. Este estudo teve como objetivo compreender a correlação entre função, força e alinhamento percebidos e observados. Métodos: Este estudo transversal incluiu todas as 11 mulheres (15 mãos) submetidas à artroplastia metacarpofalangeana no segundo ao quinto dedo devido a artrite reumatoide em um período de sete anos. As medições basearam-se no Michigan Hand Outcomes Questionnaire, no Lafayette Purdue Pegboard e nas forças de pinça e preensão, além da análise de radiografia da mão em leque. O coeficiente de Spearman foi usado para avaliar a correlação; valores de p < 0,05 foram considerados estatisticamente significantes. Resultados: A função objetiva foi fortemente correlacionada a todas as outras variáveis (p < 0,05). Por outro lado, a função percebida não foi correlacionada ao alinhamento articular em ambas as medições (p = 0,240 e p = 0,354). A força e o alinhamento também estiveram fortemente correlacionados (p < 0,05). Conclusões: A maioria das medições se correlacionou fortemente entre si, com ênfase na medição objetiva da destreza.
Assuntos
Humanos , Feminino , Artrite Reumatoide , Artroplastia , Força da Mão , Articulação Metacarpofalângica , SiliconesRESUMO
We evaluated the effect of silicone stent use during endoscopic dacryocystorhinostomy on postoperative morbidities in comparison with versus without a silicone stent. Two authors independently searched six databases (PubMed, Embase, Scopus, the Web of Science, the Cochrane library, and Google Scholar) from inception of article collection to July 2017. The analysis included prospective randomized studies that compared intraoperative silicone stent insertion (silicone group) with no application of a silicone stent (control group), in which the outcomes of interest were success rate (lacrimal passage patent check with syringing, symptom relief, or endoscopic confirmation of fluorescein dye from the opening of Hasner's valve) and morbidities (e.g., postoperative bleeding, rhinostomy closure, granulation tissue, synechia, and eyelid problems) after certain follow-up periods (over 10 weeks). Nine studies involving a total of 587 participants were included. Functional success rates tended to be higher in the silicone group than in the control, but there was no statistically significant difference in success rates (odds ratio, 1.45; 95% confidence interval, 0.77 to 2.73). According to the surgical type such as mucosal removal and mucosal flap surgery, the results from types didn't demonstrate any significant effect, but the mucosal flap technique seemed to be more beneficial. Regarding postoperative morbidities, although the outcomes of the groups did not present any statistically significant difference, eyelid problems and postoperative bleeding tended to occur more frequently in the silicone group, but rhinostomy closure tended to occur more frequently in the control group. Success and morbidity rates showed no difference between the silicone stent group and control group in the meta-analysis. However, additional analyses revealed that the success rate of endonasal dacryocystorhinostomy using silicone intubation with mucosal flap has shown an improving trend, and morbidities such as granulation and synechia showed decreasing trends compared with the group without silicone intubation.
Assuntos
Dacriocistorinostomia , Pálpebras , Fluoresceína , Seguimentos , Tecido de Granulação , Hemorragia , Intubação , Estudos Prospectivos , Silício , Silicones , Stents , Resultado do TratamentoRESUMO
BACKGROUND: Filler injection into the soft tissue of the nose is a useful technique for rhinoplasty. The individual characteristics of fillers determine which is best suited for a patient's specific circumstances. The objective of this study was to identify the characteristics of various fillers and to determine which fillers should be used for primary rhinoplasty in order to yield optimal long-term results. METHODS: Excluding patients treated with hyaluronic acid fillers, we reviewed 17 patients who underwent surgical rhinoplasty due to dissatisfaction with an injection using a different filler. After removing the previously injected filler, rhinoplasty was performed as part of the same procedure using a silicone or Surgiform® prosthesis. RESULTS: Various previous fillers were used in the cohort. During the process of filler removal, skin perforation occurred in 2 cases and infection was observed in 1 case. In the other cases, rhinoplasty using a prosthesis was performed at the time of filler removal and no complications were observed. CONCLUSIONS: We found that if surrounding tissue had been maintained stably, a simultaneous secondary operation using implants produced ideal results in most cases without any complications, despite the presence of residual remnant filler material.
Assuntos
Humanos , Estudos de Coortes , Ácido Hialurônico , Nariz , Próteses e Implantes , Rinoplastia , Silício , Silicones , PeleRESUMO
OBJECTIVES: Insertion of a silicone stent during endoscopic dacryocystorhinostomy (DCR) is the most common procedure to prevent rhinostomy closure. It has been claimed that silicone intubation improves the surgical outcomes of endoscopic DCR. However, many reports have documented an equally high success rate for surgery without silicone intubation. Accordingly, we conducted a systematic review and meta-analysis to clarify the outcomes of endoscopic DCR with and without silicone intubation and determine whether silicone intubation is actually beneficial for patients. METHODS: PubMed, Embase, and Cochrane Library databases were searched to identify relevant controlled trials evaluating endoscopic DCR with and without silicone intubation. The search was restricted to English articles published between January 2007 and December 2016. Relevant articles were reviewed to obtain information pertaining to interventions and outcomes. We also performed a meta-analysis of the relevant literature. RESULTS: In total, 1,216 patients included in 12 randomized controlled trials were pooled. A total of 1,239 endoscopic DCR procedures were performed, and silicone stents were used in 533 procedures. The overall success rate for endoscopic DCR was 91.9% (1,139/1,239), while the success rates with and without silicone intubation were 92.9% (495/533) and 91.2% (644/706), respectively. There was no statistically significant heterogeneity among the included studies. A meta-analysis using a fixed-effects models showed no significant difference in the success rate between endoscopic DCR with silicone intubation and that without silicone intubation (OR, 1.38; 95% CI, 0.89 to 2.12; P=0.148; z=1.45). Furthermore, there were no significant differences with regard to surgical complications such as synechia, granulation, and postoperative bleeding. CONCLUSION: The findings of our meta-analysis suggest that the success rate and postoperative complication rate for endoscopic DCR is not influenced by the use of silicone intubation during the procedure.
Assuntos
Humanos , Dacriocistorinostomia , Endoscopia , Hemorragia , Intubação , Características da População , Complicações Pós-Operatórias , Silício , Silicones , StentsRESUMO
PURPOSE: Accurate color matching of maxillofacial prostheses to skin is important for esthetics. A computerized color matching system specific to human skin has recently been developed. The purpose of this study was to evaluate the accuracy in color and translucency matching of the computerized color matching system across different skin colors. MATERIALS AND METHODS: The silicone was colored to simulate 28 different skin colors (n=5) to serve as “target skin colors”. Using a spectrocolorometer (e-skin), color codes were determined for “replicate skin color” fabrication. CIELAB Delta-E between target skin color-replicate skin color pairs and translucency parameter were calculated. CIELAB Delta-E values were compared with one-way ANOVA and Tukey multiple-comparison. The agreement between L*, a*, b* and translucency parameter of target skin colors and replicate skin color were calculated by a two-way mixed average measures intraclass correlation coefficient. Translucency parameter of target skin color-replicate skin color pairs were compared with Paired t-test (α=.05). RESULTS: The mean CIELAB Delta-E value was 3.83 and significant differences were found among colors. The intraclass correlation coefficient showed excellent reliability for L*, a*, b* and good reliability for translucency parameter (P < .001). The mean translucency parameter of replicate skin colors was significantly higher than that of translucency parameter. CONCLUSION: The computerized color matching system specific to human skin was found to be reliable in terms of color and translucency between target skin colors and replicate skin color.
Assuntos
Humanos , Estética , Técnicas In Vitro , Prótese Maxilofacial , Pigmentação , Reprodução , Silício , Silicones , Pele , Pigmentação da PeleRESUMO
ABSTRACT Objective: To analyze the quality and quantity of data in the questionnaires and in request forms for magnetic resonance imaging. Methods: This retrospective study was conducted with data from 300 medical records. The research used the following data from the questionnaires: patient age, reason for the magnetic resonance imaging, reason for placing the breast implant, report of any signs or symptoms, time elapsed since surgery to place the current breast implant, replacement implant surgery, chemotherapy, and/or radiation therapy treatments. From the magnetic resonance imaging request forms, information about the breast implant, the implant placement surgery, patient clinical information and ordering physician specialty were verified. Results: The mean age of patients was 48.8 years, and the mean time elapsed since breast implant surgery was 5 years. A total of 60% of women in the sample were submitted to aesthetic surgery, while 23.7% were submitted to chemotherapy and/or radiation therapy. In the request forms, 23.7% of physicians added some piece of information about the patient, whereas 2.3% of them informed the type of implant and 5.2% informed about the surgery. Conclusion: The amount of information in the magnetic resonance imaging request forms is very limited, and this may hinder quality of radiological reports. Institutional and technological measures should be implemented to encourage the requesting physicians and radiologists to share information.
RESUMO Objetivo: Analisar a qualidade e a quantidade de dados que constam nos questionários e nas requisições médicas de exame de ressonância magnética. Métodos: Estudo retrospectivo com 300 prontuários de pacientes. Dos questionários, foram utilizados os seguintes dados: idade, razão para a realização do exame, motivo para a colocação da prótese, referência a sinal ou sintoma, tempo decorrido desde a cirurgia de implante da prótese atual, se a cirurgia foi de troca da prótese, e se foi submetida à radioterapia ou à quimioterapia. Das requisições médicas do exame, foram utilizadas informações sobre prótese mamária, cirurgia de colocação do implante, dados clínico da paciente e especialidade do médico requisitante. Resultados: A média da idade das pacientes foi de 48,8 anos, e o tempo decorrido desde a colocação do implante foi de 5 anos, na média. Foram submetidas à cirurgia estética 60% das mulheres da amostra, e 23,7% tinham sido submetidas à quimioterapia e/ou radioterapia. Na requisição médica, 23,7% dos médicos inseriram algum dado, sendo que 2,3% informaram o tipo de implante e 5,2% sobre a cirurgia realizada. Conclusão: A quantidade de informações contidas nas requisições médicas foi baixa, o que pode comprometer a qualidade do laudo radiológico. Medidas institucionais e tecnológicas deveriam ser adotadas para estimular o intercâmbio de informações entre o médico solicitante e o médico radiologista.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Encaminhamento e Consulta/estatística & dados numéricos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Inquéritos e Questionários , Implantes de Mama/efeitos adversos , Silicones/efeitos adversos , Fatores de Tempo , Prontuários Médicos/normas , Estudos Retrospectivos , Sistemas de Registro de Ordens Médicas , Pessoa de Meia-IdadeRESUMO
ABSTRACT CONTEXT: Lymphedema consists of extracellular fluid retention caused by lymphatic obstruction. In chronic forms, fat and fibrous tissue accumulation is observed. Genital lymphedema is a rare condition in developed countries and may have primary or acquired etiology. It generally leads to urinary, sexual and social impairment. Clinical treatment usually has low effectiveness, and surgical resection is frequently indicated. CASE REPORT: We report a case of a male-to-female transgender patient who was referred for treatment of chronic genital lymphedema. She had a history of pelvic radiotherapy to treat anal cancer and of liquid silicone injections to the buttock and thigh regions for esthetic purposes. Radiological examinations showed signs both of tissue infiltration by liquid silicone and of granulomas, lymphadenopathy and lymphedema. Surgical treatment was performed on the area affected, in which lymphedematous tissue was excised from the scrotum while preserving the penis and testicles, with satisfactory results. Histopathological examination showed alterations compatible with tissue infiltration by exogenous material, along with chronic lymphedema. CONCLUSION: Genital lymphedema may be caused by an association of lesions due to liquid silicone injections and radiotherapy in the pelvic region. Cancer treatment decisions for patients who previously underwent liquid silicone injection should take this information into account, since it may represent a risk factor for radiotherapy complications.
RESUMO CONTEXTO: O linfedema consiste de retenção de fluido extracelular causada por obstrução linfática. Nas formas crônicas, observa-se acúmulo de tecido adiposo e fibrose. O linfedema genital é uma doença rara em países desenvolvidos e pode ter etiologia primária ou adquirida, em geral cursando com disfunções urinária e sexual, bem como com prejuízo do convívio social. O tratamento clínico é, em geral, pouco efetivo, indicando-se com frequência a abordagem cirúrgica, com excisão da área afetada. RELATO DE CASO: Relata-se o caso de paciente feminina transgênero, encaminhada para tratamento de linfedema genital crônico. Havia antecedente pessoal de tratamento de câncer de canal anal com radioterapia pélvica e de injeções de silicone líquido em glúteos e coxas com finalidade estética. Exames radiológicos mostraram tanto sinais de infiltração tecidual por silicone líquido como granulomas e linfadenopatia como de linfedema. Foi realizado o tratamento cirúrgico da área afetada, com excisão do tecido linfadenomatoso do escroto, preservando o pênis e testículos, com resultado satisfatório. A análise histopatológica mostrou achados compatíveis com infiltração tecidual por material exógeno, bem como com linfedema crônico. CONCLUSÃO: O linfedema genital pode ser causado pela associação de lesão por injeção de silicone líquido e radioterapia na região pélvica. As decisões no tratamento de neoplasias em pacientes previamente submetidos a injeção de silicone líquido devem levar em conta esse fato, já que pode representar fator de risco para complicações de tratamento radioterápico.
Assuntos
Humanos , Masculino , Feminino , Doenças do Pênis/etiologia , Silicones/efeitos adversos , Pessoas Transgênero , Linfedema/etiologia , Doenças do Pênis/cirurgia , Doenças do Pênis/diagnóstico por imagem , Retalhos Cirúrgicos , Espectroscopia de Ressonância Magnética , Linfedema/cirurgia , Linfedema/diagnóstico por imagemRESUMO
As the number of people who have undergone augmentation rhinoplasty has increased recently, nasal fractures are becoming more common after rhinoplasty. A silicone implant can affect the nasal fracture pattern, but there is no significant difference in treatment methods commonly. A 28-year-old female who had undergone augmentation visited our clinic with a nasal fracture. Computed tomography revealed that the silicone implant was sandwiched between the intact nasal bones with fractured bone fragments. In this case, open reduction was inevitable and a new silicone implant was inserted after reduction. Migration of the silicone implant beneath the nasal bone is a very rare phenomenon, but its accurate prevention and diagnosis is important because a closed reduction is impossible.
Assuntos
Adulto , Feminino , Humanos , Diagnóstico , Osso Nasal , Rinoplastia , Silício , SiliconesRESUMO
PURPOSE: The incidence of thyroid cancer is relatively high, especially in young women, and postoperative scarring after thyroidectomy is an important problem for both patients and clinicians. Currently, there is no available product that can be used for wound protection during thyroid surgery. We used the EASY-EYE_C, a new silicone-based wound protector. METHODS: We conducted a double-blind randomized controlled trial to assess the efficacy of the EASY-EYE_C with surgical scars. We studied 66 patients who underwent conventional total thyroidectomy or hemithyroidectomy performed by a single surgeon from August 2015 to June 2016. At 6-week follow-up, a single blinded physician observed the wounds to make clinical assessments using the Patient and Observer Scar Assessment Scale (POSAS), the Vancouver Scar Scale (VSS), and a modified Stony Brook Scar Evaluation Scale (SBSES). RESULTS: There were no significant differences by sex, age, type of surgery, body mass index, length of wound, incision site (from sternal notch), or thyroid weight, but the duration of operation was significantly shorter in the experimental group (E group). The e-group also had better POSAS scores than the control group (C group), with means of 43.2 (standard deviation [SD], ±15.9) versus 68.3 (SD, ±21.5), respectively (P < 0.05). The modified SBSES and VSS scores were similar to those from the POSAS. CONCLUSION: In this study, all scores for evaluating outcomes were higher in the E group than in the C group. In addition, the operation time was significantly shorter in the E group. Therefore, the EASY-EYE_C may be useful for improving the cosmetic outcomes of conventional thyroid surgery.