ABSTRACT
AIMS: The present study aimed to use a conventional and metagenomic approach to investigate the microbiological diversity of water bodies in a network of drainage channels and rivers located in the central area of the city of Belém, northern Brazil, which is considered one of the largest cities in the Brazilian Amazon. METHODS AND RESULTS: In eight of the analyzed points, both bacterial and viral microbiological indicators of environmental contamination-physical-chemical and metals-were assessed. The bacterial resistance genes, drug resistance mechanisms, and viral viability in the environment were also assessed. A total of 473 families of bacteria and 83 families of viruses were identified. Based on the analysis of metals, the levels of three metals (Cd, Fe, and Mn) were found to be above the recommended acceptable level by local legislation. The levels of the following three physicochemical parameters were also higher than recommended: biochemical oxygen demand, dissolved oxygen, and turbidity. Sixty-three bacterial resistance genes that conferred resistance to 13 different classes of antimicrobials were identified. Further, five mechanisms of antimicrobial resistance were identified and viral viability in the environment was confirmed. CONCLUSIONS: Intense human actions combined with a lack of public policies and poor environmental education of the population cause environmental degradation, especially in water bodies. Thus, urgent interventions are warranted to restore the quality of this precious and scarce asset worldwide.
Subject(s)
Bacteria , Metagenomics , Water Microbiology , Brazil , Bacteria/genetics , Bacteria/isolation & purification , Bacteria/classification , Bacteria/drug effects , Environmental Health , Rivers/microbiology , Rivers/virology , Viruses/genetics , Viruses/isolation & purification , Environmental Monitoring , Drug Resistance, Bacterial/genetics , Humans , Cities , Metals/pharmacologyABSTRACT
This study aimed to analyze the application of the Phytoplankton Community Index-PCI and Functional Groups-FG in determining the water quality of the Guamá River (Pará, Amazônia, Brazil). Samplings occurred monthly for analyses of phytoplankton and physical and chemical parameters, for two years, at the station where water was collected for human supply consumption. Seasonality influenced electrical conductivity, total suspended solids, dissolved oxygen, transparency, winds, true color, and N-ammoniacal. The ebb tide showed high turbidity and suspended solids. The density varied seasonally with the highest values occurring in September and December (61.1 ind mL-1 and 60.2 ind mL-1, respectively). Chlorophyll-a was more elevated in December (21.0 ± 4.7 µg L-1) and chlorophyll-c higher in relation to clorophyll- b indicated the dominance of diatoms. Functional Group P prevailed in the study months. Through the PCI índex the waters of Guamá River varied from reasonable to excellent and the TSI ranged from oligo to mesotrophic. The use of Functional Groups proved to be a promising tool in the determination of water quality since it covered the most abundant species in the Environment, but the PCI is not adequate to characterize Amazonian white-waters rivers, which have diatoms as the leading dominant group.
Subject(s)
Diatoms , Percutaneous Coronary Intervention , Humans , Phytoplankton , Rivers/chemistry , Brazil , Chlorophyll/analysis , Seasons , Environmental MonitoringABSTRACT
Neuropathic pain is caused by a lesion or disease of the somatosensory system and is one of the most incapacitating pain types, representing a significant non-met medical need. Due to the increase in research in the field and since innovative therapeutic strategies are required, namely in intractable neuropathic pain, neurostimulation has been used. Within this approach, transcranial magnetic stimulation (TMS) that uses a transient magnetic field to produce electrical currents over the cortex emerges as a popular method in the literature. Since this is an area in expansion and due to the putative role of TMS, we performed a bibliometric analysis in Scopus with the primary objective of identifying the scientific production related to the use of TMS to manage neuropathic pain. The research had no restrictions, and the analysis focused on the characteristics of the literature retrieved, scientific collaboration and main research topics from inception to 6 July 2023. A total of 474 articles were collected. A biggest co-occurrence between the terms "neuropathic pain" and "transcranial magnetic stimulation" was obtained. The journal "Clinical Neurophysiology" leads the Top 5 most productive sources. The United States is the most productive country, with 50% of US documents being "review articles", followed by France, with 56% of French documents being "original articles". Lefaucheur, JP and Saitoh, Y are the two most influential authors. The most frequent type of document was "original article". Most of the studies (34%) that identified the neuropathic pain type focused on traumatic neuropathic pain, although a large proportion (38%) did not report the neuropathic pain type. This study allows us to provide a general overview of the field of TMS application for neuropathic pain and is useful for establishing future directions of research in this field.
ABSTRACT
Previously considered saprobe and non-pathogenic, the fungus Papiliotrema laurentii (formerly known as Cryptococcus laurentii), is rarely associated with human infection. Nevertheless, there has been an increase in reported infections by non-neoformans cryptococci. After a literature search on the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PMC (PubMed Central) databases, we conclude that this is the first case report of fungemia and probable meningitis caused by Papiliotrema laurentii in a previously immunocompetent host with associated COVID-19.
Subject(s)
Basidiomycota , COVID-19 , Cryptococcosis , Cryptococcus , Fungemia , Humans , Fungemia/complications , Fungemia/diagnosis , Fungemia/microbiology , Cryptococcosis/microbiology , COVID-19/complications , SARS-CoV-2ABSTRACT
ABSTRACT Previously considered saprobe and non-pathogenic, the fungus Papiliotrema laurentii (formerly known as Cryptococcus laurentii), is rarely associated with human infection. Nevertheless, there has been an increase in reported infections by non-neoformans cryptococci. After a literature search on the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PMC (PubMed Central) databases, we conclude that this is the first case report of fungemia and probable meningitis caused by Papiliotrema laurentii in a previously immunocompetent host with associated COVID-19.
ABSTRACT
Background: Listeriosis is a known cause of community acquired bacterial meningitis/meningoencephalitis. It occurs more frequently in neonates, older people and immunocompromised hosts. Rarely, brain abscesses can complicate the course of infection, which poses a difficulty in the management and elevates morbidity and mortality. Myasthenia gravis is an autoimmune disease that often requires immunosuppressive treatment, which increases the risk for invasive infections. Case description: A 75-year-old myasthenic patient, treated with prednisone and pyridostigmine, was diagnosed with invasive listeriosis. He presented with muscle weakness, dyspnea, hemiparesis and altered mental status. Brain imaging revealed multiple abscesses and blood cultures were positive for Listeria monocytogenes. Despite combination antibiotic therapy, he died 6 weeks after admission. Systematic review: Ninety-six cases of brain abscesses from 1968 to 2023 were reviewed; the majority of the patients were men, 54 years-old on average, and had at least one risk factor for invasive listeriosis. The mortality exceeded 22%. Blood cultures and CSF/abscess cultures were positive in only 79.2% and 54.6%, respectively. The most common therapeutic approach was a combination regimen that included amoxicillin or ampicillin. Only 8 patients underwent surgery, of which one died. Conclusion: This case highlights the importance of L. monocytogenes as a cause of brain abscesses in populations at risk, including myasthenic patients. The challenge of diagnosing and treating this condition is aggravated by the paucity of literature and the high mortality rate.
ABSTRACT
Mycetoma is a neglected tropical disease caused by fungi (eumycetoma) or bacteria (actinomycetoma), with high morbidity. Gordonia spp. are gram-positive bacteria that have previously been reported to cause mycetoma. Here, we report a case of Gordonia soli (initially misidentified as Nocardia spp.) as the etiological agent of actinomycetoma in a 64-year-old patient. After a literature search in the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PubMed Central databases, we concluded that this is the first case report of mycetoma caused by Gordonia soli. The current case highlights the importance of microbiological diagnosis of mycetoma and the challenges in its management.
Subject(s)
Actinobacteria , Mycetoma , Nocardia , Humans , Middle Aged , Mycetoma/diagnosis , Mycetoma/drug therapy , Mycetoma/microbiology , Fungi , Neglected DiseasesABSTRACT
The increase in competitive sports practice among children and lack of ionizing radiation have resulted in a higher demand for MRI examinations. MRI of the children skeleton has some particularities that can lead orthopedists, pediatricians, and radiologists to diagnostic errors. The foot and ankle have several bones with abundant radiolucent and high signal intensity cartilage in several ossification centers, apophysis and physis, that can make this interpretation even harder. The present revision aims to show, how to differentiate between normal developmental findings and anatomic variants from pathologic conditions, whether mechanical, inflammatory, infectious, or neoplastic.
Subject(s)
Ankle Joint , Ankle , Humans , Child , Ankle/diagnostic imaging , Ankle Joint/diagnostic imaging , Ankle Joint/pathology , Magnetic Resonance Imaging/methodsABSTRACT
Re-emerging arboviruses represent a serious health problem due to their rapid vector-mediated spread, mainly in urban tropical areas. The 2013-2015 Zika virus (ZIKV) outbreak in South and Central America has been associated with cases of microcephaly in newborns and Guillain-Barret syndrome. We previously showed that the conjugate gallic acid-Hecate (GA-FALALKALKKALKKLKKALKKAL-CONH2)-is an efficient inhibitor of the hepatitis C virus. Here, we show that the Hecate peptide is degraded in human blood serum into three major metabolites. These metabolites conjugated with gallic acid were synthesized and their effect on ZIKV replication in cultured cells was evaluated. The GA-metabolite 5 (GA-FALALKALKKALKKL-COOH) was the most efficient in inhibiting two ZIKV strains of African and Asian lineage at the stage of both virus entry (virucidal and protective) and replication (post-entry). We also demonstrate that GA-metabolite 5 does not affect cell growth after 7 days of continuous treatment. Thus, this study identifies a new synthetic antiviral compound targeting different steps of ZIKV replication in vitro and with the potential for broad reactivity against other flaviviruses. Our work highlights a promising strategy for the development of new antivirals based on peptide metabolism and bioconjugation.
Subject(s)
Dermatologic Agents , Zika Virus Infection , Zika Virus , Infant, Newborn , Humans , Antiviral Agents/chemistry , Virus Replication , Dermatologic Agents/pharmacology , Gallic Acid/pharmacologyABSTRACT
BACKGROUND: The continuous changes in the medical education to prepare medical doctors for the future requires updates in medical curriculum. However, the perspectives of the medical students are not frequently considered during the revision of the medical curriculum. In parallel with the process of defining and adjusting the medical curriculum, a large survey was performed to inquire the perspectives of the medical students at the Faculty of Medicine of the University of Porto (FMUP), Portugal, about the role of Histology and of Embryology. METHODS: Medical students at FMUP (Portugal) completed a structured and anonymous online questionnaire about the subjects Histology and Embryology. The questionnaire was prepared using questions of previous surveys performed in Europe, including another Portuguese medical school, and additional questions that were specifically prepared to this study. The questions referred to teaching methods, clinical relevance, use of virtual (digital) microscopes and association of Histology and Embryology with other subjects of the medical curriculum. RESULTS: Four hundred and sixty-two students participated in the study. The students in clinical years were more likely to recognise the clinical relevance of Histology (p = 0.016) and Embryology (p < 0.001). Students agree that teaching of these subjects would benefit from a clinical orientation (89% for Histology; 90% for Embryology). Students highlighted that Histology is crucial to understand Biopathology and agree (75%) that an integration of Histology with Biopathology could be considered in the medical curriculum. Most students (55%) agree that slide microscopes are more useful than virtual microscopes. CONCLUSIONS: Our study contributes to the debate about the evolution of medical curriculum. Gathering the medical students' perceptions using large surveys such as that performed in the present study may be useful to adapt the methods of teaching which may increase the motivation of the students. In the case of Histology and Embryology at the FMUP (Portugal) providing more clinically oriented teaching may be useful to motivate the students. Students of clinical years have strong clinical perspectives of Histology and Embryology and their enrolment in teaching of Histology and Embryology can also contribute to increase motivation of younger students. Consulting and involving medical students in the development of the medical curriculum can be positive and students should be more responsible and engaged in building their own education.
Subject(s)
Education, Medical, Undergraduate , Education, Medical , Histology , Students, Medical , Humans , Curriculum , Education, Medical/methods , Educational Status , Surveys and Questionnaires , Education, Medical, Undergraduate/methods , Histology/educationABSTRACT
ABSTRACT Mycetoma is a neglected tropical disease caused by fungi (eumycetoma) or bacteria (actinomycetoma), with high morbidity. Gordonia spp. are gram-positive bacteria that have previously been reported to cause mycetoma. Here, we report a case of Gordonia soli (initially misidentified as Nocardia spp.) as the etiological agent of actinomycetoma in a 64-year-old patient. After a literature search in the Cochrane Library, LILACS, SciELO, MEDLINE, PubMed, and PubMed Central databases, we concluded that this is the first case report of mycetoma caused by Gordonia soli. The current case highlights the importance of microbiological diagnosis of mycetoma and the challenges in its management.
ABSTRACT
BACKGROUND: Chronic nonbacterial osteomyelitis (CNO), also known as chronic recurrent multifocal osteomyelitis, is a noninfectious autoinflammatory disorder that occurs primarily in children and adolescents and is characterized by episodic musculoskeletal pain with a protracted course. MAIN BODY: Traditionally, the diagnosis of CNO is made by exclusion and commonly requires bone biopsy to rule out infection and malignancy. However, bone biopsy may be avoided when imaging and clinical characteristic features are present, such as multifocal bone lesions at typical sites, no constitutional symptoms and no signs of infection in laboratory test results. Whole-body magnetic resonance imaging (WB-MRI) can assess signs of acute and chronic inflammation and enables the detection of CNO typical patterns of lesion location and distribution, thereby helping to exclude differential diagnosis. The goal of the present study paper is to review the main clinical and imaging aspects of the disease with emphasis on the role of WB-MRI in the diagnosis, assessment of disease burden and follow-up monitoring. CONCLUSION: Radiologists need to be familiar with the imaging features to suggest the diagnosis as the early therapy may help to avoid irreversible secondary damage of skeletal system.
ABSTRACT
Objectives: This study aims to summarize how child mortality-a Sustainable Development Goal stated by the United Nations-has been explicitly addressed in the context of innovations. Methods: A scoping review following the PRISMA-ScR Statement was performed analysing indexed and non-indexed literature. Results: Empirical and non-disruptive innovation in the context of process targeting under-five mortality rate was the main subset of literature included in this article. The increment of literature on innovation in the context of SDGs over the last years denotes its growing importance and even though innovation aiming to reduce child mortality is currently being done, a significant part of it is not published in indexed databases but as grey literature. Conclusion: Empirical, disruptive innovation under a structural approach and empirical, non-disruptive innovation under a project point of view are the main types of innovation addressed in the literature and would be of utmost potential to reduce child mortality rate. A systematic review of the methods used for the measures of evaluation of applied innovations, their quality and results would be of great importance in the future.
Subject(s)
Child Mortality , Sustainable Development , Child , Humans , United NationsABSTRACT
The sacroiliac joint (SIJ) is an amphiarthrosis composed of a posterior syndesmosis and an anterior cartilaginous portion, with limited yet present mobility. Its main function is to transmit the load from the axial skeleton to the lower limbs and vice-versa; it is susceptible to early mechanical and degenerative changes which are much more common than inflammatory sacroiliitis. Magnetic resonance imaging (MRI) has increasingly been used to evaluate these changes, and while subchondral bone marrow edema (BME) is a common finding related to both, care must be taken when applying the ASAS research MRI definition for sacroiliitis without considering lesion BME topography, size and depth, concomitant structural damage and, of course, the clinical picture. In this review, we will discuss the anatomy and biomechanics of the SIJ, the noninflammatory causes of SIJ subchondral BME, and how these concepts combined can be used to increase our diagnostic confidence.
Subject(s)
Bone Marrow Diseases , Sacroiliitis , Spondylarthritis , Bone Marrow Diseases/pathology , Edema/pathology , Humans , Magnetic Resonance Imaging/methods , Sacroiliac Joint/diagnostic imaging , Sacroiliac Joint/pathology , Sacroiliitis/diagnostic imaging , Sacroiliitis/pathology , Spondylarthritis/pathologyABSTRACT
Sexual transmission of Zika virus (ZIKV), an important arbovirus, and the virus persistence in semen raise several questions about how and where it circulates in the male reproductive system (MRS). Several studies reported detection of the virus in testes, epididymis, and prostate at 5 days post-infection (dpi) or more in animal models. In the present study, we investigated the interactions of ZIKV with mouse MRS using the AG129 strain, a ZIKV permissive immunodeficient mouse strain, at two dpi. Viral RNA was detected in blood, testes, epididymis, and prostatic complexes (prostate and seminal vesicles). Immunohistochemical (IHC) analyses, based on the envelope protein, showed an early infection in organs of MRS since ZIKV positive antigens were detected in cells within or surrounding blood vessels, Sertoli, and germ cells in testes and epithelial cells in epididymis and prostate. Positive antigens for NS5 protein, the virus RNA-dependent RNA polymerase, were also detected by IHC in these organs and circulating leukocytes, suggesting that the virus replicates in these sites as early as 2 days post-infection. Analysis of the early stages of ZIKV infection in MRS may improve the current knowledge about this issue and contribute to the development of therapies directed to the infection at this site.
Subject(s)
Zika Virus Infection , Zika Virus , Animals , Genitalia, Male , Male , Mice , RNA, Viral/genetics , Semen , Zika Virus/geneticsABSTRACT
INTRODUCTION: The management of out-of-hospital traumatic cardiac arrest (TCA) for professional rescuers entails Advanced Life Support (ALS) with specific actions to treat the potential reversible causes of the arrest: hypovolemia, hypoxemia, tension pneumothorax (TPx), and tamponade. The aim of this study was to assess the impact of specific rescue measures on short-term outcomes in the context of resuscitating patients with a TCA. METHODS: This retrospective study concerns all TCA patients treated in two emergency medical units, which are part of the Northern French Alps Emergency Network (RENAU), from January 2004 through December 2017. Utstein variables and specific rescue measures in TCA were compiled: fluid expansion, pelvic stabilization, tourniquet application, bilateral thoracostomy, and thoracotomy procedures. The primary endpoint was survival rate at Day 30 with good neurological status (Cerebral Performance Category [CPC] score CPC 1 and CPC 2). RESULTS: In total, 287 resuscitation attempts in TCA were included and 279 specific interventions were identified: 262 fluid expansions, 41 pelvic stabilizations, five tourniquets, and 175 bilateral thoracostomies (including 44 with TPx). CONCLUSION: Among the standard resuscitation measures to treat the reversible causes of cardiac arrest, this study found that bilateral thoracostomy and tourniquet application on a limb hemorrhage improve survival in TCA. A larger sample for pelvic stabilization is needed.
Subject(s)
Cardiopulmonary Resuscitation , Emergency Medical Services , Out-of-Hospital Cardiac Arrest , Cardiopulmonary Resuscitation/adverse effects , Hospitals , Humans , Out-of-Hospital Cardiac Arrest/etiology , Out-of-Hospital Cardiac Arrest/therapy , Retrospective StudiesABSTRACT
OBJETIVO: Avaliar a eficácia do uso de realidade virtual para o manejo da dor durante procedimentos de cuidados com feridas em pacientes queimados. MÉTODO: Revisão sistemática com meta-análise incluindo ensaios clínicos randomizados que usaram aparelhos de realidade virtual para controle álgico durante o cuidado de feridas por queimaduras. As bases de dados utilizadas foram PubMed/MEDLINE, Cochrane CENTRAL, SciELO, Scopus, ScienceDirect e NIH Clinical Trials Registry. O risco de enviesamento dos estudos incluídos foi analisado com a ferramenta RoB2 da Cochrane. A análise estatística foi realizada por diferença de médias padronizada em modelo de efeitos aleatórios, com intervalo de confiança de 95%. RESULTADOS: Foram identificados 137 estudos, dos quais 13 alcançaram os critérios de elegibilidade. O uso de realidade virtual se mostrou efetivo para reduzir a intensidade da dor durante o procedimento de cuidado de feridas. A intervenção também se mostrou benéfica para desfechos adicionais, como a redução do tempo que o paciente permanece pensando na dor. A intervenção não se mostrou estatisticamente superior ao grupo de comparação na redução de sintomas ansiosos durante o procedimento. CONCLUSÕES: O presente estudo apresentou algumas limitações devido à heterogeneidade e risco de viés dos estudos originais, mas, ainda assim, as intervenções de realidade virtual se mostram como estratégia útil no manejo da dor procedimental em pacientes queimados.
OBJECTIVE: To evaluate the efficacy of virtual reality for pain management during wound care procedures in burn patients. METHODS: Systematic review with metanalysis including randomized clinical trials of virtual reality devices interventions for pain management during burn wound care. The databases used were PubMed/MEDLINE, Cochrane CENTRAL, SciELO, Scopus, ScienceDirect e NIH Clinical Trials Registry. The risk of bias of included studies was assessed with Cochrane's RoB2. Statistical analysis was performed by using the Standardized Mean Differences in a random effects model with a 95% confidence interval. RESULTS: 137 studies were identified, of which 13 achieved the eligibility criteria. The use of virtual reality was effective for reducing pain intensity during the wound care procedure. The intervention was also found to be beneficial for additional outcomes, such as reducing the time spent thinking about pain. The intervention was not superior to control for the reduction of anxiety during the procedure. CONCLUSIONS: This review had some limitations due to heterogeneity and risk of bias of the original studies, however, virtual reality interventions were found to be a useful strategy for pain management in burn patients.
ABSTRACT
Cancer is associated with immunodeficiency, while allergies result from immune system hyperactivity mediated by cytokines and immunoglobulins. The purpose of this study was to determine the relationship between immune environment of specific cancers and allergies, emphasizing cytokines related to Th1 and Th2 responses associated with IgE. 80 adults were distributed into two groups: control (n = 20) and cancer (n = 60), distributed in three subgroups (n = 20), head and neck, stomach, and prostate cancers. This study compared Th1 (IL-2) and Th2 (IL-4) parameters, anti-inflammatory, pro-inflammatory, or regulatory profile regarding both IgE levels and reported allergies, by means of clinical manifestations and IgE, IL-1ß, IL-2, IL-4, IL-17, and TGF-ß serum concentration. Clinically allergies were observed in 50% of the control group and in 20% of the cancer group (p = 0.009). IL-2 cytokine and TGF-ß concentrations were higher in the patients with cancer as compared to the control (p < 0.005). However, there were IL-4, IL-17, and IL-1ß decreases in the patients with cancer (p < 0.05). No correlation was observed between the cytokines studied and IgE and clinically proven allergies in both investigated groups. There was an inverse association between cancer and clinical allergy manifestations. In head and neck, stomach, and prostate cancers, an immunosuppressive serum tumor environment was predominant. There was no difference in cytokines related to Th1 and Th2 parameters in relation to IgE. No correlation was found between clinically proved allergies and immunity markers related to the same allergens.
Subject(s)
Hypersensitivity/epidemiology , Hypersensitivity/etiology , Neoplasms/complications , Neoplasms/epidemiology , Aged , Biomarkers , Comorbidity , Cytokines/blood , Cytokines/metabolism , Disease Management , Disease Susceptibility , Female , Humans , Hypersensitivity/diagnosis , Hypersensitivity/metabolism , Immunoglobulin E/blood , Immunoglobulin E/immunology , Male , Middle Aged , Neoplasm Staging , Neoplasms/metabolism , Neoplasms/pathology , Risk Assessment , Risk FactorsABSTRACT
BACKGROUND: The aim was to describe the organisational changes in French EDs in response to the COVID-19 pandemic with regard to architectural constraints and compare with the recommendations of the various bodies concerning the structural adjustments to be made in this context. METHODS: As part of this cross-sectional study, all heads of emergency services or their deputies were contacted to complete an electronic survey. This was a standardised online questionnaire consisting of four parts: characteristics of the responding centre, creation of the COVID-19 zone and activation of the hospital's emergency operations plan, flow and circulation of patients and, finally, staff management. Each centre was classified according to its workload related to COVID-19 and its size (university hospital centre, high-capacity hospital centre and low-capacity hospital centre). The main endpoint was the frequency of implementation of international guidelines for ED organisation. RESULTS: Between 11 May and 20 June 2020, 57 French EDs completed the online questionnaire and were included in the analysis. Twenty-eight EDs were able to separate patient flows into two zones: high and low viral density (n=28/57, 49.1%). Of the centres included, 52.6% set up a specific triage area for patients with suspected COVID-19 (n=30/57). Whereas, in 15 of the EDs (26.3%), the architecture made it impossible to increase the surface area of the ED. CONCLUSION: All EDs have adapted, but many of the changes recommended for the organisation of ED could not be implemented. ED architecture constrains adaptive capacities in the context of COVID-19.
Subject(s)
COVID-19 , Emergency Service, Hospital/organization & administration , Health Services Needs and Demand , Pandemics , SARS-CoV-2 , Cross-Sectional Studies , France , Health Care Surveys , Hospital Design and Construction , HumansABSTRACT
RESUMO Introdução: Os procedimentos estéticos na região glútea têm ganhado evidência nas últimas décadas, com aumento da procura e aparecimento de novas técnicas. Somado ao desenvolvimento e maior facilidade de acesso aos métodos de imagem, assim como a crescente judicialização da medicina, tornam-se cada vez mais frequentes os exames de imagem nos pacientes submetidos a gluteoplastia, com destaque atualmente para a avaliação por ressonância magnética desta região. Dessa forma, a imagem entra cada vez mais na prática clínica diária do cirurgião plástico, requerendo do mesmo conhecimentos sobre conceitos básicos em relação à solicitação e interpretação dos exames. Neste artigo, revisamos aspectos de imagem por ressonância magnética de procedimentos estéticos da região glútea, bem como suas complicações. O objetivo é ilustrar através de estudos de ressonância magnética os achados habituais nos procedimentos de gluteoplastia, bem como algumas de suas complicações, além de propor um protocolo de exame por ressonância magnética da região. Foram selecionados selecionados casos ilustrativos de pacientes que se submeteram a procedimentos de gluteoplastia, sejam eles aprovados, off-label ou mesmo ilícitos, e que fizeram estudo de ressonância magnética em nosso serviço. Foi realizada ainda revisão bibliográfica sobre o tema.
ABSTRACT Introduction: Aesthetic procedures in the gluteal region are increasingly in evidence in recent decades with the augment in demand and the emergence of new techniques. This fact, coupled with the development and easier access to imaging methods and the increasing judicialization of medicine, makes imaging exams more frequent in patients undergoing gluteoplasty, with an emphasis currently on magnetic resonance imaging in this region. Thus, the image increasingly enters the plastic surgeon's daily clinical practice, requiring knowledge of basic concepts regarding the request and interpretation of the exams. In this article, we reviewed aspects of magnetic resonance imaging of aesthetic procedures in the gluteal region and their complications. The objective is to, through magnetic resonance studies, the usual findings in gluteoplasty procedures, as well as some of their complications, in addition to proposing an examination protocol for magnetic resonance imaging in the region. Illustrative cases of patients who underwent gluteoplasty procedures, whether approved, off-label or even illicit, were selected, in which we conducted a magnetic resonance study in our service. A bibliographic review was also done on the topic.