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Ceramidas , Dermatitis Atópica , Parafina , Humanos , Dermatitis Atópica/tratamiento farmacológico , Niño , Ceramidas/administración & dosificación , Parafina/efectos adversos , Parafina/administración & dosificación , Método Doble Ciego , Emolientes/uso terapéutico , Emolientes/administración & dosificación , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
INTRODUCTION: Paraffin injections for breast augmentation once a popular form of mammoplasty are now considered obsolete. It had been abandoned by clinicians because of its associated serious complications. The practice is however still available and is being practiced by nonmedically qualified people. Paraffin injection results in the formation of multiple foreign-body granulomas known as breast paraffinoma. The clinical features of breast paraffinoma can mimic and be mistaken for breast carcinoma or inflammatory breast carcinoma. The use of fine-needle aspiration cytology (FNAC) in the evaluation of patients with breast paraffinoma has not been fully evaluated. METHODS: Retrospective review was performed on 30 patients who presented with breast paraffinoma between June 1, 2010, and June 30, 2020, who also had FNAC as part of their breast lump evaluation. RESULTS: FNAC of 73.3% patients showed multinucleated giant cells and macrophages or histiocytes containing engulfed clear, empty intracytoplasmic vacuoles of varying sizes. In 13.3% of the patients, macrophages or histiocytes with engulfed clear intracytoplasmic vacuoles of varying sizes were seen. In 6.7% of patients, multinucleated giant cells containing engulfed vacuoles of varying sizes were seen, and in 6.7% of patients, hypocellular smears with large amount of clear spaces were seen. Oily droplets were seen in the background of all the smears, and there were no malignant cells seen. These features were compatible with breast paraffinoma. CONCLUSION: Most patients with breast paraffinoma can be managed conservatively and they do not require further treatment; FNAC with its characteristic features can provide the reliable diagnosis of breast paraffinoma and therefore sparing these patients from more invasive diagnostic procedures.
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Enfermedades de la Mama/patología , Granuloma de Cuerpo Extraño/patología , Mamoplastia/efectos adversos , Parafina/efectos adversos , Adulto , Anciano , Biopsia con Aguja Fina , Enfermedades de la Mama/etiología , Enfermedades de la Mama/terapia , Neoplasias de la Mama/patología , Bases de Datos Factuales , Diagnóstico Diferencial , Femenino , Granuloma de Cuerpo Extraño/etiología , Granuloma de Cuerpo Extraño/terapia , Humanos , Inyecciones , Persona de Mediana Edad , Parafina/administración & dosificación , Valor Predictivo de las Pruebas , Pronóstico , Estudios RetrospectivosRESUMEN
Over the last decades, short-chain chlorinated paraffins (SCCPs), medium-chain chlorinated paraffins (MCCPs), and long-chain chlorinated paraffins (LCCPs) have become the most heavily produced monomeric organohalogen compound class of environmental concern. However, knowledge about their toxicology is still scarce, although SCCPs were shown to have effects on the thyroid hormone system. The lack of data in the case of MCCPs and LCCPs and the structural similarity with perfluoroalkyl substances (PFAS) prompted us to test CPs in the novel TTR-TR CALUX assay for their thyroid hormone transport disrupting potential. Four self-synthesized and additionally purified single chain length CP mixtures (C10-CPs, C11-CPs, C14-CPs and C16-CPs) and two each of industrial MCCP and LCCP products were tested in parallel with PFOA. All CP mixtures influenced the TTR binding of T4, giving activities of 1,300 to 17,000 µg/g PFOA equivalents and lowest observable effect concentrations (LOELs) of 0.95 to 0.029 mM/L incubate. Highest activities and lowest LOELs were observed for C16-CPs (48.3% Cl content, activity 17,000, LOEL 0.047 mM/L) and a LCCP mixture (71.7% Cl content; activity 10,000; LOEL 0.029 mM/L). A trend of higher activities and lower LOELs towards longer chains and higher chlorination degrees was implied, but could not be statistically confirmed. Irrespectively, the less well examined and current-use LCCPs showed the highest response in the TTR-TRß CALUX assay.
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Hidrocarburos Clorados/toxicidad , Parafina/toxicidad , Hormonas Tiroideas/metabolismo , Línea Celular , Relación Dosis-Respuesta a Droga , Humanos , Hidrocarburos Clorados/administración & dosificación , Hidrocarburos Clorados/química , Parafina/administración & dosificación , Parafina/química , Prealbúmina/metabolismo , Receptores beta de Hormona Tiroidea/metabolismoRESUMEN
A fifty-year-old healthy, Portuguese male, with prior history of paraffin injections into the penis 30 years ago, was referred for urological consultation because of a large, hardened ulcerated mass on the base of the penis causing deformity and pain. The patient underwent a biopsy that showed a benign granulomatous lesion, and then excision of the mass and penile plasty with a scrotum flap in the same surgical time. Histology confirmed the diagnosis of paraffinoma. Three months after surgery, the patient is satisfied with the functional (urinary function and erectile function) and aesthetic results. Penile paraffinoma is a rare disease (most common in Asia and Eastern Europe) and results from an inflammatory response to the subcutaneous injection of paraffin, Vaseline or other mineral oils. Treatment is usually surgery.
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Granuloma/inducido químicamente , Parafina/efectos adversos , Pene/cirugía , Procedimientos de Cirugía Plástica/métodos , Úlcera Cutánea/inducido químicamente , Granuloma/diagnóstico , Granuloma/etiología , Granuloma/cirugía , Humanos , Inyecciones Subcutáneas/efectos adversos , Masculino , Persona de Mediana Edad , Parafina/administración & dosificación , Enfermedades del Pene/diagnóstico , Enfermedades del Pene/etiología , Enfermedades del Pene/cirugía , Colgajos Quirúrgicos , Resultado del TratamientoRESUMEN
Choosing proper perfusates as contrast agents is an important aspect for postmortem magnetic resonance angiography (PMMRA). However, in this emerging field, the number of suitable kinds of liquid is still very limited. The objective of this research is to compare MR images of oleic acid (OA) with paraffin oil (PO) in vitro and in ex situ animal hearts, in order to evaluate the feasibility to use OA as a novel contrast agent for PMMRA. In vitro, OA, PO and water (control) were introduced into three tubes separately and T1weighted-spin echo (T1w-SE) and T2w-SE images were acquired on a 1.5T MR scanner. In the second experiment, OA and PO were injected into left coronary artery (LCA) and left ventricle (LV) of ex situ bovine hearts and their T1w-SE, T2w-SE, T1w-multipoint Dixon (T1w-mDixon) and 3DT2w-mDixon images were acquired. The overall results indicate that OA may have a potential to be used as a dual (T1 and T2 based) contrast agent for PMMRA when proper sequence parameters are utilized. However, as the pilot study was based on limited number of animal hearts, more researches using OA in cadavers are needed to validate our findings.
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Medios de Contraste/administración & dosificación , Vasos Coronarios/diagnóstico por imagen , Corazón/diagnóstico por imagen , Aceites/administración & dosificación , Ácido Oléico/administración & dosificación , Parafina/administración & dosificación , Animales , Autopsia , Bovinos , Estudios de Factibilidad , Angiografía por Resonancia Magnética , Proyectos Piloto , Interpretación de Imagen Radiográfica Asistida por ComputadorRESUMEN
BACKGROUND: Few head-to-head comparisons of the different classes of laxatives have been conducted. OBJECTIVE: The objective of this work is to compare the efficacy of lactulose plus paraffin vs polyethylene glycol in the treatment of functional constipation (non-inferiority study). METHODS: This randomised, parallel-group, multicentre phase 4 study recruited patients with functional constipation diagnosed according to Rome III criteria. Patients received lactulose plus paraffin or polyethylene glycol for 28 days. The primary end point was the change from baseline in the Patient Assessment of Constipation-Symptoms (PAC-SYM) score. RESULTS: A total of 363 patients were randomised to lactulose plus paraffin (n = 179) or polyethylene glycol (n = 184). On day 28, the mean PAC-SYM score decreased significantly vs baseline with both treatments (p < 0.001). The lower boundary of the 95% CI exceeded the pre-specified limit of -0.25, therefore establishing non-inferiority of lactulose plus paraffin vs polyethylene glycol. At least one adverse event occurred in 20 patients (11.2%) in the lactulose plus paraffin group and in 26 patients (14.2%) in the polyethylene glycol group, most of which were of mild or moderate severity and unrelated to study drugs. CONCLUSION: Lactulose plus paraffin may be used interchangeably with polyethylene glycol for the pharmacological treatment of functional constipation.Trial registration: EudraCT number 2015-003021-34.
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Estreñimiento/tratamiento farmacológico , Lactulosa/administración & dosificación , Laxativos/administración & dosificación , Parafina/administración & dosificación , Polietilenglicoles/administración & dosificación , Administración Oral , Adulto , Anciano , Estreñimiento/diagnóstico , Combinación de Medicamentos , Femenino , Humanos , Lactulosa/efectos adversos , Laxativos/efectos adversos , Masculino , Persona de Mediana Edad , Parafina/efectos adversos , Polietilenglicoles/efectos adversos , Calidad de Vida , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
OBJECTIVE: To examine if range of motion of the shoulder treated with paraffin will be better than that of the shoulder treated with sustained stretch alone. DESIGN: Pilot randomized controlled trial. SETTING: Regional burn center. PARTICIPANTS: Patients (N=23) who sustained a burn injury, with a shoulder active abduction and/or flexion in the +70° to +150° degree range, who were 14 years or older, were receiving follow-up physical therapy after discharge from hospital, and provided a signed consent to participate. INTERVENTIONS: Group A received sustained stretch and paraffin, and group B received sustained stretch only. Both groups had 6 sessions of treatment over 2 weeks. MAIN OUTCOME MEASURES: Active range of motion (AROM) and active-assisted range of motion (AAROM) for shoulder flexion (SF) and shoulder abduction (SA) were measured before and after each treatment session. RESULTS: For pretreatment measurements, only the results for SF AAROM had significant time effects. For posttreatment measurements, SF AROM and SF AAROM had significant effects for time. Session 1 was significantly lower than sessions 2, 3, 4, and 6 for both measures, and additionally, session 1 was significantly lower than session 5 for SF AAROM. For SA AROM, a group-by-time interaction effect was significant, with scores for the paraffin group relatively stable across sessions, and the nonparaffin group had peaks at sessions 3 and 6. There were no significant effects for (1) within-session changes to examine improvement during a session or (2) presession scores across the 6 sessions showing maintenance of motion. Total change from the first session presession measurement to the sixth session postsession measurement for the 2 treatment groups were nonsignificantly different. CONCLUSIONS: As shown in this study, sustained stretching with paraffin may be a valuable adjunct to range of motion intervention for the shoulder after burn injury.
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Contractura/rehabilitación , Parafina/uso terapéutico , Modalidades de Fisioterapia , Articulación del Hombro/fisiopatología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ejercicios de Estiramiento Muscular , Dimensión del Dolor , Parafina/administración & dosificación , Proyectos Piloto , Rango del Movimiento Articular , Índices de Gravedad del TraumaRESUMEN
BACKGROUND: The stratum corneum plays an important protective physiological role in providing a barrier to preventing skin desiccation and penetration of external agents. Emollients are used commonly to improve barrier function and skin hydration. AIMS: The primary objective of this study was to evaluate the effect of an emollient, V0034CR cream, and its active ingredients, to restore the cutaneous barrier. Secondary objectives included assessment of the moisturizing activity of each product and tolerance. The study was not designed to evaluate therapeutic benefit. METHODS: In this randomized, double-blind, 4-arm crossover, clinical pharmacology study, the full emollient V0034CR, its vehicle formulation alone, or with glycerol, or petrolatum, was applied to the forearms of healthy volunteers (n = 51) with dry skin (Kligman score of 2 or 3). Cutaneous permeability by Trans Epidermal Water Loss (TEWL) and skin moisture content by corneometry were serially measured for 12 hours following application. An analysis of variance with repeated measures was performed on the evolution of TEWL and corneometry. RESULTS: V0034CR emollient significantly reduced mean TEWL compared to vehicle (P = .0018) and vehicle + glycerol (P = .0001) and significantly increased mean corneometry scores compared to vehicle (P < .0001) and vehicle + petrolatum (P < .0001). CONCLUSIONS: The emollient V0034CR presented combined effects, with the petrolatum component improving skin barrier function, with a reduction in TEWL, and the glycerol component improving skin hydration.
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Emolientes/administración & dosificación , Epidermis/efectos de los fármacos , Glicerol/administración & dosificación , Parafina/administración & dosificación , Crema para la Piel/administración & dosificación , Pérdida Insensible de Agua/efectos de los fármacos , Adulto , Estudios Cruzados , Método Doble Ciego , Combinación de Medicamentos , Emolientes/efectos adversos , Emolientes/química , Epidermis/fisiología , Femenino , Glicerol/efectos adversos , Voluntarios Sanos , Humanos , Masculino , Parafina/efectos adversos , Crema para la Piel/química , Resultado del TratamientoRESUMEN
The objective of this study was to compare the reproductive performance of cows affected by clinical endometritis (CE) following treatment with an intrauterine infusion of 50% dextrose solutions (DEX) and liquid paraffin (LP) as alternative therapies with routine treatments including PGF2α injection and intrauterine infusion of oxytetracycline (OTC). Moreover, the reproductive indices of cows treated with endometritis were compared with those of healthy ones. At postpartum reproductive tract examination (28-35 DIM) in one Iranian dairy farm, cows with CE without any selection were assigned to four groups: (a) OTC, a common treatment in Iran, was administered (5 g) to 396 cows, (b) PGF2 α (PG) was injected to 496 cows, (c) dextrose solution (DEX): intrauterine infusion of 50% dextrose solution (200 ml) was done in 427 cows, and (d) liquid paraffin (LP) was administered (100 ml) to 423 cows via intrauterine route. We further assigned 2,233 clinically healthy cows to the control group. The incidence of endometritis was 41.6% in this study. Based on the results of reproductive indices including median days to first AI, days open (DO), first service conception rate, conception rate in 2nd and 3rd services, conception rate in all three services, pregnancy rate < 100 days and pregnancy rate < 200 days, except for median days to first AI in other reproductive indexes, reproductive performance was significantly lower in LP group compared with the healthy cows and other treatment groups (p < 0.05). Except for the first service conception rate and proportion of cows pregnant before 100 days in milk (DIM), there existed no significant difference between the DEX group and the control as far as reproductive performance is concerned (p ≥ 0.05). The first service conception rate was recognizably lower in DEX group compared with OTC and PG (p < 0.05). In conclusion, the use of a non-antibiotic special solution of dextrose 50% is a good alternative to antibiotic agents concerning the treatment of CE in dairy cows.
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Enfermedades de los Bovinos/tratamiento farmacológico , Endometritis/veterinaria , Fertilización/efectos de los fármacos , Glucosa/administración & dosificación , Parafina/administración & dosificación , Animales , Bovinos , Dinoprost/administración & dosificación , Endometritis/tratamiento farmacológico , Femenino , Irán , Estimación de Kaplan-Meier , Modelos Logísticos , Oxitetraciclina/administración & dosificación , Embarazo , Índice de EmbarazoRESUMEN
Penile paraffinoma is a rare cause of penile mass that can occur following injection of liquid paraffin, performed illicitly for penile augmentation. Over the past 2 yr, we have observed an increasing number of cases presenting with the complications of penile paraffinoma; three patients of central European origin have required inpatient treatment at our institution and posed a significant management dilemma. This mini-review aims to review the literature on the aetiopathogenesis, clinical features, diagnosis, and management of penile paraffinoma. A systematic search of PubMed and Scopus was performed with 10 case series and 26 case reports identified between 1956 and 2017. A total of 124 cases, with a mean age of 36.29 yr, were identified. The majority originated in Korea, and the most common injected material was liquid paraffin (80.6%). Patients presented with pain/swelling, ulceration/fistulae, and penile deformity. The majority required surgical excision of paraffinoma followed by reconstruction with a variety of procedures including split skin grafting, scrotal skin flap reconstruction, and prepuce grafting. Mean duration of follow-up was 15.8 mo. Penile paraffinoma remains a rare presentation; however, it can present management difficulties. We have had an increase in cases, with three patients presenting with complications following injection of paraffin in our unit in the past 2 yr. Definitive management includes surgical excision and reconstruction as required with early involvement of plastic surgeons. There may be a role for conservative management; however, long-term outcomes are unclear. There may be a need for targeted preventative measures through public health agencies in communities where the practice is more prevalent. PATIENT SUMMARY: Penile paraffinoma can occur following injection of liquid paraffin or similar substances, generally used by non-healthcare personnel for the purpose of penile augmentations, and can cause significant pain, ulceration, and penile deformity. Definitive management includes surgical excision with reconstruction as required. Prevention of its use through awareness and education may be required in communities where the practice is more common.
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Modificación del Cuerpo no Terapéutica/efectos adversos , Cuerpos Extraños/etiología , Parafina/efectos adversos , Enfermedades del Pene/etiología , Humanos , Inyecciones , Masculino , Parafina/administración & dosificaciónRESUMEN
PURPOSE: The aim of the study was to compare different conservative treatments in patients with carpal tunnel syndrome (CTS). STUDY DESIGN: A single-blind randomized controlled study. METHODS: Patients (n = 169) diagnosed with mild or moderate CTS were screened; 110 met study requirements. The patients were randomized into 3 groups. The control (CON) comparison provided to all patients was a fabricated night orthotic which held the wrist in a neutral position. The second group received adjunctive kinesiotaping (KIN) and the third group received paraffin (PARA). All patients were evaluated clinically, electrophysiologically, and ultrasonographically before treatment and at 3 weeks, 3 months, and 6 months. RESULTS: There were 36 patients in CON, 37 in KIN, and 37 in PARA. Pain reduction in KIN was better than the other groups at 3 weeks (mean difference [MD] in CON 2.4 ± 2.5, KIN 3.7 ± 2.0, PARA 2.7 ± 2.3; P < .01) and 6 months (MD in CON 3.4 ± 3.0, KIN 4.9 ± 3.1, PARA 3.7 ± 2.9; P < .05). KIN pain reduction was better than CON at 3 months (MD in CON 3.8 ± 2.8, KIN 5.0 ± 2.5; P < .05). Reduction of the cross-sectional area of median nerve at the level of radioulnar joint was greater for KIN than CON at 3 weeks (MD in CON 0.0 ± 0.5, KIN 0.3 ± 0.7; P < .01) than PARA at 3 months (MD in KIN 0.3 ± 0.8, PARA 0.0 ± 0.8; P < .05) and both groups at 6 months (MD in CON 0.1 ± 0.8, KIN 0.5 ± 0.9, PARA 0.0 ± 1.0 P < .05). CONCLUSION: Adding KIN to night use of an orthotic was more effective in achieving symptomatic and structural improvements than either the orthotic alone or adjunctive use of paraffin in patients with mild and moderate CTS.
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Antiinflamatorios/administración & dosificación , Cinta Atlética , Síndrome del Túnel Carpiano/terapia , Inmersión , Aparatos Ortopédicos , Parafina/administración & dosificación , Adulto , Anciano , Femenino , Humanos , Nervio Mediano/diagnóstico por imagen , Persona de Mediana Edad , Conducción Nerviosa , Método Simple Ciego , Ultrasonografía , Escala Visual AnalógicaRESUMEN
Lipoid pneumonia is a rare pulmonary disease, classified in terms of the source of lipid exposure into two variants: exogenous and endogenous. We present a patient with exogenous lipoid pneumonia, acquired after chronic exposure to paraffin oil-containing nasal drops. The diagnosis was established by demonstration of lipid-laden macrophages in bronchoalveolar lavage, chest computed tomography results and a history of lipid exposure.
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Aceites/efectos adversos , Parafina/efectos adversos , Neumonía Lipoidea/diagnóstico por imagen , Neumonía Lipoidea/etiología , Lavado Broncoalveolar , Líquido del Lavado Bronquioalveolar , Femenino , Humanos , Persona de Mediana Edad , Aceites/administración & dosificación , Parafina/administración & dosificación , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Atopic dermatitis (AD) is a chronic, recurrent, inflammatory skin disorder which may persist or directly start in adults. This is an open-label prospective study to clinically and instrumentally evaluate the effects of an emollient glycerin and paraffin-based cream and a gentle refatting cleanser in the management of mild to moderate adulthood AD. METHODS: Fifty adult patient with mild to moderate AD were recruited at the Professional Dermatology and Allergology Outpatient Clinic of the San Gallicano Dermatological Institute of Rome, between November 2016 and January 2018. The patients applied the emollient cream twice daily for 2 months. To assess the efficacy of the cream, two different areas of treatment were identified in each patient's limbs. The outcome was evaluated at 30 days (T1) and 60 days (T2) of treatment comparing to baseline (T0) by means of clinical evaluation, Dermatology Life Quality Index (DLQI) questionary, transepidermal waterloss (TEWL) and corneometry measurements. RESULTS: Clinical evaluation showed significative improvement of skin xerosis, fissuring, itching and erythema. Consistently, a significative reduction of TEWL and an improvement in skin hydration was also detected. A significative improvement of DLQI score was also detected. CONCLUSIONS: Study treatment was well tolerated and showed significative improvement of clinical and instrumental parameters evaluated. The topical daily use of an emollient glycerin and paraffin-based cream and a gentle refatting cleanser seems to be a useful tool in the treatment of mild to moderate adulthood AD improving quality of life.
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Dermatitis Atópica/tratamiento farmacológico , Fármacos Dermatológicos/administración & dosificación , Emolientes/administración & dosificación , Calidad de Vida , Administración Cutánea , Adolescente , Adulto , Dermatitis Atópica/patología , Femenino , Glicerol/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Parafina/administración & dosificación , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Crema para la Piel , Adulto JovenRESUMEN
Paraffin oil injections may cause severe hypercalcaemia, likely due to development of granulomas at injection sites, activating 1,25 dihydroxyvitamin D and increasing calcium uptake from gut, kidney and bone. This is a case report of a 39-year-old male with severe hypercalcaemia and renal failure due to paraffin oil injections. He was treated with prednisolone (25-50 mg daily), but the disease recurred the next two summers probably due to erroneous vitamin D supplement and sun exposure. The disease course and prognosis are unknown. Treatment options are discussed, and paraffin oil injections should be avoided.
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Hipercalcemia , Aceites , Parafina , Adulto , Granuloma , Humanos , Hipercalcemia/inducido químicamente , Masculino , Aceites/administración & dosificación , Aceites/efectos adversos , Parafina/administración & dosificación , Parafina/efectos adversosRESUMEN
The purpose of this study was to present our series of patients with disastrous consequences of failed penile self-augmentation and suggested surgical reconstruction. Ten patients with median age of 23 years and a variety of penile and scrotal deformities due to injections of several substances had undergone successful surgical reconstruction of external genitalia. The injections were self-performed in nine cases and the patients reported from 4 to 20 substance injections throughout the penile shaft. Three patients presented with fibrotic scirrhous masses in their scrotum, although they did not report any injections in scrotal area. All patients underwent extended penile-shaft skin excision, while all palpable scrotal lesions were removed in one-by-one fashion, as an attempt to destroy the less possible scrotal tissue. All patients were discharged on first post-operative day and reassessed at 2 months post-operatively. As a result, penile self-augmentation with injected substances may cause severe complications. Our proposed single-staged procedure seems safe and effective.
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Disfunción Eréctil/cirugía , Granuloma de Cuerpo Extraño/cirugía , Enfermedades del Pene/cirugía , Procedimientos de Cirugía Plástica/métodos , Procedimientos Quirúrgicos Urológicos Masculinos/métodos , Adulto , Disfunción Eréctil/etiología , Granuloma de Cuerpo Extraño/etiología , Humanos , Inyecciones Subcutáneas/efectos adversos , Masculino , Aceites/administración & dosificación , Aceites/efectos adversos , Aceite de Oliva/administración & dosificación , Aceite de Oliva/efectos adversos , Tamaño de los Órganos , Parafina/administración & dosificación , Parafina/efectos adversos , Enfermedades del Pene/etiología , Pene/anatomía & histología , Pene/patología , Pene/cirugía , Vaselina/administración & dosificación , Vaselina/efectos adversos , Escroto/patología , Escroto/cirugía , Siliconas/administración & dosificación , Siliconas/efectos adversos , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: Injection of paraffin oil to augment muscles size is a troubling phenomenon known to cause a foreign body reaction with formation of granulomas. In a few case reports, long-term side effects have been reported in terms of hypercalcemia and renal failure. METHODS: We identified a case series of 12 male bodybuilders presenting with non-parathyroid hypercalcemia who previously had injected paraffin oil to increase muscles size. RESULTS: At admission, all patients had moderate-to-severe hypercalcemia with suppressed PTH levels and impaired renal function. Calcitriol levels were within the normal range or slightly elevated. Follow-up measurements showed marked hypercalciuria with nearly normal levels of bone turnover markers. A correlation was found between levels of peptidyl dipeptidase and calcitriol (R = 0.812, P = 0.050). Treatment with antiresorptive agents seemed less effective than glucocorticoids, which resulted in a significantly lowering of ionized calcium levels and improved renal function, although no patients were cured by this treatment. Immunosuppression with azathioprine or mycophenolate may have a glucocorticoid-saving effect. One patient had surgery with removal of affected muscle tissue, without any apparent effect on plasma calcium levels. CONCLUSION: The hypercalcemia and associated hypercalciuria seems to be due to an intestinal hyperabsorption of calcium. It remains to be elucidated, whether an increased calcitriol synthesis within granulomas is the only (main) mechanism by which intestinal calcium absorption is increased. Glucocorticoids seem most appropriate as the first choice for treatment. Bodybuilders should be warned against use of intramuscular oil injections (and other substances), as this may have severe adverse health consequences.
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Hipercalcemia/sangre , Hipercalcemia/inducido químicamente , Aceites/efectos adversos , Parafina/efectos adversos , Levantamiento de Peso/fisiología , Adulto , Humanos , Hipercalcemia/diagnóstico por imagen , Inyecciones Intramusculares , Absorción Intestinal/efectos de los fármacos , Absorción Intestinal/fisiología , Masculino , Aceites/administración & dosificación , Parafina/administración & dosificación , Hormona Paratiroidea/sangreRESUMEN
INTRODUCTION: Cosmetic injections with silicone and polymethylmethacrylate are not FDA approved for augmentation of body parts such as breast, buttock or legs, but they have been widely used for decades. Cosmetic injections can cause foreign body granulomas and occasionally severe and life-threatening hypercalcemia. We aimed to systematically analyze the published literature on cosmetic injection-associated hypercalcemia. METHODS: We searched relevant articles on hypercalcemia associated with various cosmetic injections and extracted relevant data on demographics, cosmetic injections used, severity of hypercalcemia, management and outcomes. RESULTS: We identified 23 eligible patients from 20 articles. Mean age was 49.83 ± 14.70 years with a female preponderance (78.26% including transgender females). Silicone was most commonly used, followed by polymethylmethacrylate and paraffin oil (43.48, 30.43, and 8.70% respectively). The buttock was the most common site followed by the breast (69.57% and 39.13% respectively). Hypercalcemia developed at mean duration of 7.96 ± 7.19 years from the initial procedure. Mean ionized calcium at presentation was 2.19 ± 0.61 mmol/L and mean corrected calcium at presentation was 3.43 ± 0.31 mmol/L. 1,25-Dihydroxyvitamin D (1,25(OH)2D or calcitriol) was elevated while 25-hydroxyvitamin D (25(OH)D) and PTH were low in majority of cases. Hypercalcemia was managed conservatively with hydration, corticosteroids and bisphosphonates in majority of cases. Surgery was attempted in 2 cases but was unsuccessful. Renal failure was the most common complication (82.35% cases) and 2 patients died. CONCLUSION: Hypercalcemia from cosmetic injections can be severe and life threatening and can present years after the initial procedure. Cosmetic injection-associated granuloma should be considered a cause of hypercalcemia, especially in middle-aged females presenting with non-PTH-mediated, non-malignant hypercalcemia, which is often associated with elevated calcitriol; however, it should be noted that calcitriol level may be normal as well.
Asunto(s)
Técnicas Cosméticas/efectos adversos , Hipercalcemia/inducido químicamente , Hipercalcemia/diagnóstico , Humanos , Aceites/administración & dosificación , Aceites/efectos adversos , Parafina/administración & dosificación , Parafina/efectos adversos , Polimetil Metacrilato/administración & dosificación , Polimetil Metacrilato/efectos adversos , Siliconas/administración & dosificación , Siliconas/efectos adversosRESUMEN
OBJECTIVE: Retrograde infections often occur with excessive or incomplete drainage of exudate, or as a result of adherence of dressings to wounds. Dialkylcarbamoyl chloride (DACC) irreversibly binds to bacterial surfaces and physically removes bacteria when dressings are changed. Chlorhexidine acetate-soaked paraffin gauze provides a moist wound-healing environment. We hypothesise that when DACC is combined with chlorhexidine acetate-soaked paraffin gauze, wound healing times decrease. METHOD: From January 2013 to June 2015, medical records were retrospectively evaluated in 60 patients who underwent split-thickness skin grafts (STSG). Patients were divided into two groups: a 'thick skin group' and a 'thin skin group'. These two groups were further subdivided into a control group, where conventional foam dressings were applied to wounds, and an experimental group, where chlorhexidine acetate-soaked paraffin gauze with DACC was applied (DACC group). We compared the wound healing time between these subgroups. Differences in infected wound healing times were also compared. The Mann-Whitney test was applied to compare wound healing times between groups. RESULTS: Epithelialisation duration was significantly shorter in the DACC group. The control group had longer wound healing times, regardless of wound size. In the thick skin group, the median healing duration was 12 days in the control subgroup, compared with 9.5 days in the DACC subgroup (p=0.049). In the thin skin subgroup, the median healing duration in the control group was 18 days, compared with 10 days in the DACC subgroup (p=0.013). CONCLUSION: Application of DACC and chlorhexidine acetate-soaked paraffin gauze to skin graft donor sites can shorten healing times and is effective in treating infected wounds.
Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Clorhexidina/administración & dosificación , Parafina/administración & dosificación , Heridas y Lesiones/cirugía , Administración Cutánea , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Apósitos Oclusivos , Estudios Retrospectivos , Trasplante de Piel , Sitio Donante de Trasplante , Adulto JovenRESUMEN
BMI-specific differences in food choice and energy intake have been suggested to modulate taste perception. However, associations between body composition and fat taste sensitivity are controversial. The objective of this study was to examine the association between body composition, dietary intake and detection thresholds of four fatty stimuli (oleic acid, paraffin oil, canola oil, and canola oil spiked with oleic acid) that could be perceived via gustatory and/or textural cues. In 30 participants, fat detection thresholds were determined in a repeated measurements design over twelve days. Weight status was examined by measuring the participants' BMI, waist circumference and waist-to-hip ratio. The habitual food intake was assessed via several questionnaires and twelve, non-consecutive 24-hour food diaries. In this study, a negative correlation was found between fat detection thresholds and the intake of food rich in vitamins and fibre. Moreover, a positive correlation was identified between the intake of high-fat food and fat detection thresholds. No differences in fat detection thresholds were observed due to variations in BMI or waist-to-hip ratio. These findings indicate that a regular intake of fatty foods might decrease an individuals' perceptual response to fats which might lead to excess fat intake on the long term.