Lack of Standardization in Commercial Thickeners Used in the Management of Dysphagia.

INTRODUCTION: Oral feeding safety is necessary to provide nutrition, hydration, and eating pleasure for patients with dysphagia. Commercial thickeners are prescribed for these patients to change food viscosity and may alter the proper preparation of modified food. OBJECTIVE: Analyze composition, employed terminology, preparation instructions, recommended amount and weight of provided measuring spoons, nutritional information, and viscosity of 7 commercial thickeners. METHODS: The sample comprised all thickeners from different brands available in Brazil, named A to G. Products were submitted to viscosity analysis using viscometer and the International Dysphagia Diet Standardization Initiative (IDDSI) test. Samples were prepared with mineral water (25°C) and with the amount of thickener recommended to obtain intermediate viscosity (level 2) according to the manufacturer's instructions. RESULTS: Products B, C, and E presented similar composition. Manufacturer's information about the amount and preparation procedure, time, temperature, and base liquid was incomplete. Viscosity tests revealed that thickener C was basically solid while D displayed results out of the desired viscosity level. CONCLUSIONS: The study showed differences in components and viscosity, beyond the lack of label details. There was no established correlation between viscosity classifications provided by National Dysphagia Diet and IDDSI.

Uso de enxerto autógeno para correção do dorso nasal após complicação de abscesso septal: relato de caso / Use of autogenous graft for correction of the nasal dorsum after complication of septal abscess: case report

Objetivo: relatar um caso de tratamento cirúrgico bem sucedido, de uma complicação de abscesso desepto nasal. Relato de caso: paciente submetida à rinosseptoplastia para correção do dorso nasal apóscomplicação de abscesso de septo nasal, no Serviço de Otorrinolaringologia do Hospital UniversitárioBettina Ferro de Souza, da Universidade Federal do Pará UFPA. Os dados foram coletados através deanamnese, documentação de fotografias no pré e pós-operatório. Evolução satisfatoria no pósoperatório(PO), sem complicações decorrentes da enxertia e com melhora estética e funcional.Considerações finais: o abscesso de septo nasal necessita de um diagnóstico precoce e tratamentocirúrgico imediato, para diminuir o risco de complicações infecciosas graves e sequelas funcionais eestéticas. A correção cirúrgica do nariz em sela com a utilização de enxerto autógeno apresenta osmelhores resultados se comparados aos outros tipos de enxertia, devido ao menor índice decomplicações, com resultados no pós-operatório favoráveis, sendo, atualmente, o material de eleiçãopara realização de rinoplastias reconstrutivas.

Objective: to report a case of successful surgical treatment of a complication of abscess of the nasalseptum. Method: we conducted a case report of patient who underwent to rhinoplasty for correction ofthe nasal complication after abscess of nasal septum, in the Service of Otorhinolaryngology of BettinaFerro de Souza University Hospital, Federal University of Pará. Data were collected through clinicalhistory, photographs documentation of preoperative and postoperative. Case report: the patient wasreferred to rhinoseptoplasty, progressing satisfactorily in the postoperative period withoutcomplications due to grafting and with aesthetic and functional improvement. Final comments: thenasal septal abscess requires early diagnosis and immediate treatment to reduce the risk of severeinfectious complications and functional and aesthetic sequelae. Surgical correctionmof saddle nosewith the use of autogenous graft have better results when compared with other types of grafting, due tothe lower rate of complications, with extremely favorable results after surgery, being currently thematerial of choice for performance of reconstructive rhinoplasty

Hérnia traumática da parede abdominal / Traumatic abdominal hernia

Doente do sexo feminino, referiu acidente automobilístico com fratura de pelve. Evoluiu com abaulamento em região lombar esquerda que se acentuava aos esforços físicos, apresentava tumor volumoso em região lombar esquerda. A ressonância magnética de abdome evidenciou defeito na parede abdominal. Foi feito diagnóstico de hérnia traumática de parede abdominal e indicada a cirurgia.