Adverse reactions to the injection of face and neck aesthetic filling materials: a systematic review.

BACKGROUND: Adverse reactions, caused during the inflammation and healing process, or even later, can be induced by the injection of dermal filler and can present a variety of clinical and histological characteristics. In this study we aimed to review the adverse reactions associated with the injection of aesthetic filling materials in the face and neck. MATERIAL AND METHODS: The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Studies published that mentioned adverse reactions in patients with aesthetic filling materials in the face or neck were included. Risk of bias was assessed using the Joanna Briggs Institute appraisal tool. After a 2-step selection process, 74 studies were included: 51 case reports, 18 serial cases, and five cohorts. RESULTS: A total of 303 patients from 20 countries were assessed. Lesions were more prevalent in the lip (18%), nasolabial folds (13%), cheeks (13%), chin (10%), submental (8%), glabella (7%), and forehead (6%). Histopathological analysis revealed a foreign body granuloma in 87.1% of the patients, 3% inflammatory granuloma, 3% lipogranuloma, 2.3% xanthelasma-like reaction, 1% fibrotic reaction, 0.7% amorphous tissues, 0.7% xanthelasma, 0.3% sclerosing lipogranuloma, 0.3% siliconoma, and 0.3% foreign body granuloma with scleromyxedema. In addition, two patients displayed keratoacanthoma and two others displayed sarcoidosis after cutaneous filling. The most commonly used materials were silicone fillers (19.7%), hyaluronic acid (15.5%), and hydroxyethyl methacrylate/ethyl methacrylate suspended in hyaluronic acid acrylic hydrogel (5.6%). All patients were treated, and only 12 had prolonged complications. CONCLUSIONS: There is evidence that adverse reaction can be caused by different fillers in specific sites on the face. Although foreign body granuloma was the most common, other adverse lesions were diagnosed, exacerbating systemic diseases. In this way, we reinforce the importance of previous systemic evaluations and histopathological analyses for the correct diagnosis of lesions.

A novel de novo heterozygous ALPL nonsense mutation associated with adult hypophosphatasia.

Using genetic, clinical, biochemical, and radiographic assessment and bioinformatic approaches, we present an unusual case of adult HPP caused by a novel de novo heterozygous nonsense mutation in the alkaline phosphatase (ALPL). INTRODUCTION: Hypophosphatasia (HPP) is caused by genetic alterations of the ALPL gene, encoding the tissue-nonspecific isozyme of alkaline phosphatase (TNSALP). Here, the purpose was to perform clinical and molecular investigation in a 36-year-old Caucasian woman suspected to present adult HPP. METHODS: Medical and dental histories were obtained for the proposita and family members, including biochemical, radiographic, and dental assessments. ALPL mutational analysis was performed by the Sanger sequencing method, and the functional impact prediction of the identified mutations was assessed by bioinformatic methods. RESULTS: We identified a novel heterozygous nonsense mutation in the ALPL gene (NM_000478.6:c.768G>A; W[TGG]>*[TGA]) associated with spontaneous vertebral fracture, severe back pain, musculoskeletal pain, low bone density, and short-rooted permanent teeth loss. Functional prediction analysis revealed that the Trp256Ter mutation led to a complete loss of TNSALP crown domain and extensive loss of other functional domains (calcium-binding domain, active site vicinity, and zinc-binding site) and over 60% loss of homodimer interface residues, suggesting that the mutant TNSALP molecules are nonfunctional and form unstable homodimers. Genotyping of the ALPL in the proposita's parents, sister, and niece revealed that in this case, HPP occurred due to a de novo mutation. CONCLUSION: The present study describes a novel genotype-phenotype and structure-function relationship for HPP, contributing to a better molecular comprehension of HPP etiology and pathophysiology.

2p24.2 (rs7552) is a susceptibility locus for nonsyndromic cleft lip with or without cleft palate in the Brazilian population.

The population of Brazil is highly admixed, with each individual showing variable levels of Amerindian, European and African ancestry, which may interfere in the genetic susceptibility of known risk loci to nonsyndromic cleft lip with or without cleft palate (NSCL±P). Here, we investigated 5 reported genome-wide loci for NSCL±P in an ancestry-structured case-control study containing 1697 Brazilian participants (831 NSCL±P and 866 healthy controls). SNPs rs7552 in 2q24.2, rs8049367 in 16p13.3, rs1880646, rs7406226, rs9891446 in 17p13, rs1588366 in 17q23.2 and rs73039426 in 19q13.11 were genotyped using TaqMan allelic discrimination assays and genomic ancestry was estimated using a panel of 40 biallelic short insertion/deletion polymorphic markers informative of the Brazilian population. Logistic regression analysis of the single-markers revealed rs7552 in 2p24.2 as a susceptibility risk marker for NSCL±P, yielding an odds ratio (OR) of 1.71 (95% confidence interval (CI): 1.31-2.24, P = 9 × 10-6 ) in the homozygous state. Several SNP-SNP interactions containing rs7552 reached significance after adjustment for multiple tests (both Bonferroni assumption and 1000 permutation test), with the most significant interaction involving the 3-loci among rs7552, rs9891446 and rs73039426 (P = 6.1 × 10-9 and p1000 permutation = 0.001). Our study is the first to support the association of rs7552 in 2p24.2 with NSCL±P in the highly admixed Brazilian population.

Clinical and genetic analysis of patients with cherubism.

OBJECTIVE: To describe the clinical and genetic features of patients with cherubism. MATERIAL AND METHODS: A descriptive analysis of 14 cases from nine different families was carried out. Clinicopathological, imaging, and follow-up data were retrieved from patients' medical files and correlated with the genetic profile of each patient. Genomic DNA isolated from buccal mucosa cells was subjected to direct sequencing analysis of the SH3BP2 gene. RESULTS: Females were more affected than males (8:6), and the mean age at diagnosis was 8.6 years (range 3-30 years). Eleven patients exhibited simultaneous bilateral involvement of the maxilla and mandible. Two patients did not have a familial history of cherubism. Progressive growth pattern was found in six patients and stable lesions were observed in other seven patients, whereas in one patient, complete spontaneous remission was documented during the follow-up (31 years). Mutations were found in 13 cases and included the typical heterozygous missense mutations R415Q, P418T, and P418H at exon 9 of SH3BP2. No correlation between the mutations and the clinical manifestations was observed. CONCLUSION: Three different point mutations in the SH3BP2 gene were detected with variable clinical involvement. Genotype-phenotype association studies in larger population with cherubism are necessary to provide important knowledge about molecular mechanisms related to the disease.

Reactive natural phosphate applied at different time points and combined with nitrogen fertilizers affects the production of marandu grass / Fosfato natural reativo aplicado em épocas distintas e associado a fertilizantes nitrogenados afetam a produção de capim-marandu

The objective of this study was to evaluate the ideal time of application of reactive natural phosphate combined with nitrogen fertilizers for Marandu grass fertilization. The experiment was conducted in a greenhouse using a random block design with six treatments and six replicates. A 3x2 factorial scheme consisting of three times of application of reactive natural phosphate (before, together and after liming) and two nitrogen sources (ammonium sulfate and urea) was used. No interaction was observed between the time of reactive natural phosphate application and nitrogen fertilizer. However, in the first cut, reactive natural phosphate resulted in a larger number of leaves and tillers (47 leaves/pot and 13 tillers/pot) when applied after liming and increased leaf blade mass (4.26 g/pot) when applied together with liming. In the second and third cut, the time of application did not influence any of the variables studied, except for residual dry matter which was lower (20.17 g/pot) when reactive natural phosphate was applied before liming. Treatment with ammonium sulfate resulted in a lower pH in the three cuts performed. In the second and third cut, a higher leaf blade dry mass (12.5 and 14.8 g/pot, respectively) and a larger number of leaves (95 and 111 leaves/pot, respectively) and tillers (29 and 39 tillers/pot, respectively) were observed for the treatment with ammonium sulfate. The time of application of reactive natural phosphate exerted no significant effect on the agronomic efficiency of the three cuts. However, in the third cut, the application of reactive natural phosphate together with or after liming was superior to the soluble phosphate source. Reactive natural phosphate should be applied together with or after liming, regardless of the nitrogen fertilizer used. Ammonium sulfate optimizes the development of Marandu grass after regrowth of this forage.

Objetivou-se avaliar a época de aplicação de fosfato natural reativo associado a fertilizantes nitrogenados na adubação do capim-marandu. O experimento foi realizado em casa de vegetação, em delineamento de blocos ao acaso, com seis tratamentos e seis repetições. Utilizou-se esquema fatorial 3x2, com três épocas de incorporação de fosfato natural reativo (antes, junto e depois da calagem) e duas fontes de nitrogênio (sulfato de amônio e ureia). Não houve interação entre as épocas de incorporação de fosfato natural reativo e os fertilizantes nitrogenados. Entretanto, no primeiro corte, o fosfato natural reativo, quando aplicado depois da calagem, proporcionou maior número de folhas e perfilhos (47 folhas/vaso e 13 perfilhos/vaso, respectivamente), contudo quando incorporado junto com a calagem proporcionou maior massa de lâminas foliares (4,26 g/vaso). No segundo e terceiro cortes, a época de incorporação não influenciou nenhuma das variáveis mencionadas, com exceção da massa seca de resíduo que foi menor (20,17 g/vaso) quando incorporado antes da calagem. O tratamento com sulfato de amônio resultou menor pH nos três cortes realizados. No segundo e terceiro cortes, notou-se maior massa seca de lâminas foliares (12,5 e 14,8 g/vaso, respectivamente), maior número de folhas (95 e 111 folhas/vaso, respectivamente) e perfilhos (29 e 39 perfilhos/vaso, respectivamente) no tratamento com sulfato de amônio. A época de incorporação do fosfato natural reativo não apresentou diferença significativa na eficiência agronômica nos três cortes. No entanto, no terceiro corte a incorporação do fosfato natural reativo junto e depois da calagem foram superiores à fonte fosfatada solúvel. Independente do fertilizante nitrogenado, o fosfato natural reativo deve ser incorporado junto ou depois da calagem. O sulfato de amônio otimiza o desenvolvimento do capim-marandu a partir da rebrota dessa forrageira.

Reactive natural phosphate applied at different time points and combined with nitrogen fertilizers affects the production of marandu grass / Fosfato natural reativo aplicado em épocas distintas e associado a fertilizantes nitrogenados afetam a produção de capim-marandu

The objective of this study was to evaluate the ideal time of application of reactive natural phosphate combined with nitrogen fertilizers for Marandu grass fertilization. The experiment was conducted in a greenhouse using a random block design with six treatments and six replicates. A 3x2 factorial scheme consisting of three times of application of reactive natural phosphate (before, together and after liming) and two nitrogen sources (ammonium sulfate and urea) was used. No interaction was observed between the time of reactive natural phosphate application and nitrogen fertilizer. However, in the first cut, reactive natural phosphate resulted in a larger number of leaves and tillers (47 leaves/pot and 13 tillers/pot) when applied after liming and increased leaf blade mass (4.26 g/pot) when applied together with liming. In the second and third cut, the time of application did not influence any of the variables studied, except for residual dry matter which was lower (20.17 g/pot) when reactive natural phosphate was applied before liming. Treatment with ammonium sulfate resulted in a lower pH in the three cuts performed. In the second and third cut, a higher leaf blade dry mass (12.5 and 14.8 g/pot, respectively) and a larger number of leaves (95 and 111 leaves/pot, respectively) and tillers (29 and 39 tillers/pot, respectively) were observed for the treatment with ammonium sulfate. The time of application of reactive natural phosphate exerted no significant effect on the agronomic efficiency of the three cuts. However, in the third cut, the application of reactive natural phosphate together with or after liming was superior to the soluble phosphate source. Reactive natural phosphate should be applied together with or after liming, regardless of the nitrogen fertilizer used. Ammonium sulfate optimizes the development of Marandu grass after regrowth of this forage.(AU)

Objetivou-se avaliar a época de aplicação de fosfato natural reativo associado a fertilizantes nitrogenados na adubação do capim-marandu. O experimento foi realizado em casa de vegetação, em delineamento de blocos ao acaso, com seis tratamentos e seis repetições. Utilizou-se esquema fatorial 3x2, com três épocas de incorporação de fosfato natural reativo (antes, junto e depois da calagem) e duas fontes de nitrogênio (sulfato de amônio e ureia). Não houve interação entre as épocas de incorporação de fosfato natural reativo e os fertilizantes nitrogenados. Entretanto, no primeiro corte, o fosfato natural reativo, quando aplicado depois da calagem, proporcionou maior número de folhas e perfilhos (47 folhas/vaso e 13 perfilhos/vaso, respectivamente), contudo quando incorporado junto com a calagem proporcionou maior massa de lâminas foliares (4,26 g/vaso). No segundo e terceiro cortes, a época de incorporação não influenciou nenhuma das variáveis mencionadas, com exceção da massa seca de resíduo que foi menor (20,17 g/vaso) quando incorporado antes da calagem. O tratamento com sulfato de amônio resultou menor pH nos três cortes realizados. No segundo e terceiro cortes, notou-se maior massa seca de lâminas foliares (12,5 e 14,8 g/vaso, respectivamente), maior número de folhas (95 e 111 folhas/vaso, respectivamente) e perfilhos (29 e 39 perfilhos/vaso, respectivamente) no tratamento com sulfato de amônio. A época de incorporação do fosfato natural reativo não apresentou diferença significativa na eficiência agronômica nos três cortes. No entanto, no terceiro corte a incorporação do fosfato natural reativo junto e depois da calagem foram superiores à fonte fosfatada solúvel. Independente do fertilizante nitrogenado, o fosfato natural reativo deve ser incorporado junto ou depois da calagem. O sulfato de amônio otimiza o desenvolvimento do capim-marandu a partir da rebrota dessa forrageira.(AU)

Behavioral deficits in sepsis-surviving rats induced by cecal ligation and perforation.

Sepsis and its complications are the leading causes of mortality in intensive care units, accounting for 10-50% of deaths. Intensive care unit survivors present long-term cognitive impairment, including alterations in memory, attention, concentration, and/or global loss of cognitive function. In the present study, we investigated behavioral alterations in sepsis-surviving rats. One hundred and ten male Wistar rats (3-4 months, 250-300 g) were submitted to cecal ligation and puncture (CLP), and 44 were submitted to sham operation. Forty-four rats (40%) survived after CLP, and all sham-operated animals survived and were used as control. Twenty animals of each group were used in the object recognition task (10 in short-term memory and 10 in long-term memory), 12 in the plus-maze test and 12 in the forced swimming test. Ten days after surgery, the animals were submitted individually to an object recognition task, plus-maze and forced swimming tests. A significant impairment of short- and long-term recognition memory was observed in the sepsis group (recognition index 0.75 vs 0.55 and 0.74 vs 0.51 for short- and long-term memory, respectively (P < 0.05). In the elevated plus-maze test no difference was observed between groups in any of the parameters assessed. In addition, sepsis survivors presented an increase in immobility time in the forced swimming test (180 vs 233 s, P < 0.05), suggesting the presence of depressive-like symptoms in these animals after recovery from sepsis. The present results demonstrated that rats surviving exposure to CLP, a classical sepsis model, presented recognition memory impairment and depressive-like symptoms but not anxiety-like behavior.

Behavioral deficits in sepsis-surviving rats induced by cecal ligation and perforation

Sepsis and its complications are the leading causes of mortality in intensive care units, accounting for 10-50 percent of deaths. Intensive care unit survivors present long-term cognitive impairment, including alterations in memory, attention, concentration, and/or global loss of cognitive function. In the present study, we investigated behavioral alterations in sepsis-surviving rats. One hundred and ten male Wistar rats (3-4 months, 250-300 g) were submitted to cecal ligation and puncture (CLP), and 44 were submitted to sham operation. Forty-four rats (40 percent) survived after CLP, and all sham-operated animals survived and were used as control. Twenty animals of each group were used in the object recognition task (10 in short-term memory and 10 in long-term memory), 12 in the plus-maze test and 12 in the forced swimming test. Ten days after surgery, the animals were submitted individually to an object recognition task, plus-maze and forced swimming tests. A significant impairment of short- and long-term recognition memory was observed in the sepsis group (recognition index 0.75 vs 0.55 and 0.74 vs 0.51 for short- and long-term memory, respectively (P < 0.05). In the elevated plus-maze test no difference was observed between groups in any of the parameters assessed. In addition, sepsis survivors presented an increase in immobility time in the forced swimming test (180 vs 233 s, P < 0.05), suggesting the presence of depressive-like symptoms in these animals after recovery from sepsis. The present results demonstrated that rats surviving exposure to CLP, a classical sepsis model, presented recognition memory impairment and depressive-like symptoms but not anxiety-like behavior.

Retrobulbar hemorrhage: a case report.

Retrobulbar hemorrhage is a rare complication that may occur after mid-face injuries or following soft and hard tissue surgery around the eyes. The cardinal signs and symptoms of retrobulbar hemorrhage are pain, diplopia, ophthalmoplegia, a progression of increasing proptosis, and decreasing visual acuity leading to blindness. The diagnosis can be confirmed with computed tomography (CT) of the orbit or with ocular ultrasound. These diagnostic images are also important to define the size of the hematoma. This report describes a traumatic retrobulbar hemorrhage. In this case there were no signs of acute visual loss, and conservative treatment was possible without surgical intervention.

Sonographic markers of exencephaly below 10 weeks' gestation.

We report two cases of exencephaly diagnosed by transvaginal ultrasonography at 8 weeks 4 days and at 9 weeks 3 days of gestation. Both cases presented an irregular cephalic pole, and, in the case seen at 8 weeks 4 days, brain vesicles were also absent, whereas in the case seen at 9 weeks 3 days, the midline echo was indistinguishable with disorganized choroid plexuses. In both cases, anencephaly was evident at 11 and 12 weeks' gestation and the postmortem confirmed the diagnosis.

Diet of the colubrid snake, Thamnodynastes strigatus (Günther, 1858) from Paraná State, Brazil, with field notes on anuran predation

Dissection of 44 specimens of the colubrid snake Thamnodynastes strigatus (Serpentes: Colubridae) provided data on food habits. Prey items include frogs (71.4 percent of the sample), rodents (14.3 percent), fishes (10.7 percent), and lizards (3.6 percent). The most of the anuran species recorded (Bufo sp., Leptodactylus sp., Physalaemus cuvieri and Scinax fuscovarius) are ground dwellers or call at the water level. Field observations provided information on the feeding behavior

Diet of the colubrid snake, Thamnodynastes strigatus (Günther, 1858) from Paraná State, Brazil, with field notes on anuran predation.

Dissection of 44 specimens of the colubrid snake Thamnodynastes strigatus (Serpentes: Colubridae) provided data on food habits. Prey items include frogs (71.4% of the sample), rodents (14.3%), fishes (10.7%), and lizards (3.6%). The most of the anuran species recorded (Bufo sp., Leptodactylus sp., Physalaemus cuvieri and Scinax fuscovarius) are ground dwellers or call at the water level. Field observations provided information on the feeding behavior.

[Occurrence of Campylobacter spp among food handlers in hospital kitchens in urban areas of the southern region of Brazil]. / Ocorrência de Campylobater spp entre manipuladores de alimentos em cozinhas hospitalares de localidade urbana da região Sul do Brasil.

The lack of information regarding the occurrence of Campylobacter spp in food handlers and the potential public health risk involved, led to the undertaking of this work. The main purpose was to verify the presence of asymptomatic Campylobacter spp carries in food handlers of hospital and commercial foodservice kitchens. The average prevalence of carriers in kitchens was of 6.2%; that in commercial foodservice kitchens (10.5%) being higher than that found in hospital kitchens (2.2%) in a universe of 177 individuals studied. A close relationship was found between Campylobacter spp, carriers of masculine sex and age group, which was of about 20 to 35 years of age. There was also strong evidence suggesting a higher prevalence of Campylobacter spp among handlers of masculine sex than among those of feminine sex.

Enterotoxigenic Escherichia coli and Staphylococcus aureus in fish and seafood from the southern region of Brazil.

An investigation to evaluate the microbiological condition and safety of fish and seafood commonly harvested at the coast of Santa Catarina State and sold in Florianópolis was undertaken. One hundred and seventy-five samples of fish and fish fillets (Cynoscion leiarchus), shrimp tails (Peneaus paulensis), shellfish-meat (Anomalocardia brasiliensis and Metilus edulis), and crab-meat (Callinectes sapidus) were collected from markets and examined within 4 h of purchase. For isolation and enumeration of Escherichia coli the methods used were those of Speck et al. (1975) (Method 1) and Fishbein et al. (1976) (Method 2); for S. aureus, methods recommended by the U.S. Food and Drug Administration were used including biochemical identification of the strains. E. coli was more frequently detected with Method 1 than Method 2. Of 317 E. coli strains tested for STG and LT II toxins, only one (isolated from shellfish-meat) produced ST and none produced LT II toxin. S. aureus was isolated from 20% of 175 samples examined, including 60% of samples of shellfish-meat. Only nine of 109 S. aureus strains produced enterotoxins, including enterotoxin A (4), D (1) and AB (4). It is concluded that greater care must be taken to reduce contamination of fish and seafood during harvesting and post-harvest handling.