Dynamic Video-Photograph Studio: A New Rhinoplasty Documentation.

BACKGROUND: Photographic documentation of the nose is the standard procedure for many surgeons who perform rhinoplasty across the world. One of the most challenging views in the photograph documentation is the frontal view that requires special photographic skills and may create a bias. Our dynamic video recording process allows us to improve the quality of patient evaluation, making the assessment more convenient and enabling the documentation of high-level rhinoplasty database. OBJECTIVES: Our main goal was to present our selected video recording process that ensures standardized, high-quality documentation of the data from rhinoplasty patients. As per our knowledge, this tool has not been published before. METHODS: We have invented a rotational platform-based chair that allows us to make a dynamic evaluation of the patients under standardized photograph settings (patient's position, camera, and lighting features) through a video recording. RESULTS: We demonstrated that the quality of our rotational video recording process is similar to that of standardized photographs. However, this additional dynamic evaluation helps to avoid Photoshop® corrections which may result in bias. CONCLUSIONS: This high-quality patient evaluation represents advancement in the photograph-documentation process in the modern era of rhinoplasty. This new dynamic video recording process prevents image misinterpretation, helps improve the quality of patient evaluations, makes the process more convenient, and enables the documentation of high-quality data for rhinoplasty patients. Moreover, this new recording process is an excellent tool for educational purposes and presentations. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Lyell's Syndrome and Antimalarials: A Case Report and Clinical Review.

Toxic epidermal necrolysis (TEN) or Lyell's syndrome is a rare, however, life-threatening mucocutaneous disorder with an epidermal detachment of a total body surface area (TBSA) of >30%. It is triggered by an idiosyncratic immune-allergic reaction to a drug, with many possible drugs implicated. Treatment success relies on early diagnosis and withdrawal of suspected/causative drug(s) and supportive care. Clinical evidence for specific therapies is still sparse. It is described a case of Lyell syndrome by sulfonamides for chemoprophylaxis of malaria. The patient presented with an extensive, rapidly evolving skin detachment, which progressed, despite supportive therapy, involving about 80% of TBSA. This led us to initiate a course of immunoglobulin with good clinical response. The aim of this work is to provide a discussion of the case and simultaneously make a practical literature review of TEN.

[The role of adipose tissue and macrophages in chronic inflammation associated with obesity: clinical implications]. / Papel do tecido adiposo e dos macrófagos no estado de inflamação crónica associada à obesidade: implicações clínicas.

In the last decades, life style modifications particularly those related to food patterns and food choices, gave risen to a worldwide pandemic disease with no precedent in Human History: obesity. Energy storing and free fatty acids production were the only adipose tissue functions. However, it has been well established other adipose tissue functions like low grade pro-inflammatory molecules production (cytokines, adipokines and chemotactic factors) evolved in obese inflammatory condition. In this inflammatory state, adipocytes active role is inflammatory mediators (adipokines) production and and cell to cell interaction with resident macrophages. Adipose tissue low vascularization is even lower in the obese; so, hypoxia can be a critical factor in inflammatory obese state manifestation. Adipose tissue cytokines production and pre-adipocyte conversion into macrophage results in adipose tissue and macrophages interactions. One of the mononuclear phagocytic system components, macrophage, has an important role in obese-related inflammatory state. These cells have been found to be increased in number and shape proportional to Body Mass Index, rising to up to 60% of total adipose tissue components. The macrophages proportional accumulation could lead to an increase in pro-inflammatory molecules expression and contribute to the inflammatory state in a significant way. The reversion of the low grade inflammation and the reduction of risk factors in obese individuals seem to occur when a reduction in Body Mass Index is achieved and loss of adipose tissue is observed. We performed a critical review of last five years literature in order to better describe the impact of adipose tissue and macrophages interactions in low grade chronic inflammatory condition in the obese and their role in comorbidities pathogenesis.