Reação tipo corpo estranho a preenchimento facial com poliamida / Foreign body reaction to polyamide filling in the face

O uso de substâncias para preenchimento dérmico é crescente, e o número de complicações devido à sua utilização, significativo. Neste trabalho, relatamos um caso de granulomas de corpo estranho após preenchimento facial com gel de poliamida, chamado AqualiftTM, produto não encontrável nas bases de dados da literatura científica. São discutidos aspectos clínicos, terapêuticos e histopatológicos. Faz-se uma advertência relativa ao uso desta substância.

Dermal fillers are increasingly used, and the number of complications due to their use is significant. In this work, we report the case of foreign body granulomas due to the facial injection of a polyamide gel, named AqualiftTM, a product not found in scientific literature databases. Clinical, therapeutic and hystopathological aspects are discussed. A warning is made, concerning the use of this substance.

Jael syndrome: removal of a knife blade impacted in the maxillofacial region under local anaesthesia.

The presence of retained foreign bodies in the maxillofacial region as a consequence of penetrating injuries from knives is poorly documented in the scientific literature. This manuscript reports the case of a 30-year-old Caucasian with a knife blade lodged in the maxillofacial skeleton. Following clinical and radiographic exams, it was determined that the object had penetrated through the left nostril and nasal septum, in the direction of the right maxillary sinus, and remained impacted without causing injury to important anatomical structures. After systemic assessment and determination of the exact location of the knife blade, the object was removed in an outpatient setting under local anaesthesia. This manuscript aims to report a rare case of a transfacial penetrating injury involving a knife blade that was removed in an outpatient setting while also discussing the proper conduct and treatment options for similar cases in the context of a brief literature review.

Report of a case of solitary fibrous tumour of the orbit.

BACKGROUND: Solitary fibrous tumors of the orbit are uncommon lesions, only one relatively large series having been published. Neoplasms, formerly considered as separate entities, including hemangiopericytoma, are presently encompassed as solitary fibrous tumors, a unifying designation. There is a tendency towards recurrence and some cases are malignant. Their rarity justifies the publication of new cases, in order to increase the amount of information about this pathological entity. CASE REPORT: A 40-year-old female patient developed swelling in the left lower lid and after slow progression of the symptom during 2 years, presented herself to our elective surgery service. Image exams showed a 20-mm encapsulated tumor. Surgical treatment was performed: complete excision, made difficult by the growth of the lesion amid the inferior rectus and inferior oblique muscles. Histopathological and immunochemical examinations with CD34 positivity, diagnosed a solitary fibrous tumor, without suggestive signs of malignancy. After a follow-up of 40 months, no recurrence has been detected. DISCUSSION: Solitary fibrous tumors, though uncommon, should be considered in the differential diagnosis of orbital expansive lesions. The key point to diagnosis is finding CD34 positivity in immunohistochemical examination. Such tumors have a tendency for recurrence, even after more than 5 years.

Estudo experimental do aquecimento adequado de solução cristaloide por micro-ondas e dedução de equação para seu cálculo / Experimental study of adequate microwave warming of crystalloids and derivation of an equation for calculating heating parameters", "_e": "n

INTRODUÇÃO: Fluidos cristaloides são comumente aquecidos em forno de micro-ondas, para uso endovenoso ou subcutâneo (em lipoaspirações). A literatura médica é pobre em trabalhos estabelecendo parâmetros científicos para esse processo. O objetivo deste estudo foi estudar experimentalmente o aquecimento de solução salina (cloreto de sódio a 0,9%), a partir de diferentes temperaturas iniciais, deduzir uma equação para permitir o cálculo de parâmetros de aquecimento e estudar o decréscimo de temperatura da solução aquecida. MÉTODO: Frascos para infusão endovenosa (500 ml e 1.000 ml) de solução salina tiveram sua temperatura inicial ajustada para 15°C, 20°C e 25°C, sendo aquecidos por micro-ondas até 60 segundos (500 ml) e 120 segundos (1.000 ml). A temperatura da solução salina foi medida durante e ao final do aquecimento e até 30 minutos após esse processo. A partir dos resultados, foi deduzida uma equação. RESULTADOS: O aquecimento por 60 segundos elevou a temperatura de frascos de 500 ml de solução salina em cerca de 20°C. Foram necessários 120 segundos para a mesma elevação de temperatura de frascos de 1.000 ml. A equação deduzida foi: TIF = TII + [0,165 x Tempo (segundos) / Volume (litros)], onde TIF = temperatura interna final e TII = temperatura interna inicial. Não foram encontradas diferenças significantes entre as temperaturas interna e externa após o aquecimento. CONCLUSÕES: A determinação da temperatura inicial é fundamental na obtenção da temperatura final desejada, após o aquecimento de fluidos cristaloides por micro-ondas. Uma equação pôde ser deduzida, tornando possível o cálculo da temperatura final a partir de várias temperaturas iniciais. A temperatura externa dos frascos reflete adequadamente sua temperatura interna.

BACKGROUND: Crystalloids are commonly heated in microwave ovens for intravenous or subcutaneous usage (e.g., in liposuction). However, few studies have empirically determined the parameters for this procedure. This study experimentally evaluated the heating of saline solution (sodium chloride 0.9%) at different initial temperatures to derive an equation to calculate heating parameters as well as the temperature decrease in saline solutions after heating. METHODS: The initial temperature of intravenous pouches containing saline solution (500 and 1,000 mL) was adjusted to 15°C, 20°C, or 25°C. The 500 and 1,000 mL pouches were then warmed in a microwave (900 W) for 60 and 120 seconds, respectively. The temperature of the saline solution was measured during heating and immediately and 30 minutes after heating. An equation was derived from the results. RESULTS: Warming the 500 and 1,000 mL pouches for 60 and 120 seconds, respectively, at 900 W increased the temperature of these pouches by 20°C. The derived equation was as follows: final temperature = initial temperature + [0.165 × time (s)/volume (L)]. No significant differences were found between the internal and external temperatures of the pouches after heating. CONCLUSIONS: Determining the initial temperature of crystalloid solutions is essential for obtaining the desired temperature after microwave warming. The equation derived in the present study enables calculation of the final temperature of solutions with various initial temperatures. The external temperature of the pouches accurately reflects their internal temperature.

Casa de Saúde Santa Fé: breve história de uma ex-colônia de hanseníase / Santa Fé Health Institute: brief history of a former leprosy colony

Este trabalho descreve a história de antiga colônia para o isolamento compulsório de hansenianos (lepra), o Sanatório (hoje Casa de Saúde) Santa Fé, em Três Corações, Minas Gerais. São estudadas as origens da política sanitária da internação compulsória, assim como as raízes do preconceito e do estigma em relação à hanseníase. Descrevem-se os aspectos básicos da vida em uma colônia, ao tempo dessa política. As mudanças na destinação do estabelecimento são enfocadas, assim como as suas perspectivas futuras.

This paper approaches the evolution of a former colony for the mandatory isolation of leprosy patients, Santa Fé Sanatory (presently, Health Institute), in Três Corações, Minas Gerais, through its decades-long existence. The origins of compulsory internation are studied, as well as the roots of prejudice and stigma. The history of the sanatorium is presented. The basic aspects of life in a colony, at the time of this policy, are described. The changes in the institution's destination are focused, as well as its future perspectives.

Epidemiologic profile and quality of life of patients treated for oral cancerin Juiz de Fora, Minas Gerais, Brazil

Objectives: To assess the quality of life of patients treated for oral cancer, analyzing their physical, social/family,functional and emotional well-being; to identify socioeconomic and clinical functional variables that maypotentially influence their quality of life; to describe the patients’ epidemiologic profile (sex and age) and tumorfeatures (histopathology, anatomical location and stage); to identify the frequency of risk factors associated withthe malignancy. Study design: Observational cross-sectional study-case series study undertaken in 2 cancer treatmentinstitutions in Juiz de Fora, Minas Gerais, Brazil, between 2000 and 2007. Results: Of the 88 registered oralcancer patients, 16 were selected for the study sample. The majority of the study sample (87%) included males,with a mean age of 57.06 years; 43.8% were retired; 50% had not completed elementary education. Most (56.3%)had a monthly income of less than the minimum wage. Most (83.7%) smoked before cancer diagnosis and 43.8%from this sample continued to smoke after treatment. In addition, those who drank alcohol before treatmentcontinued drinking (31.3%). The tongue was the predominant anatomic site (37.5%). The patients’ quality of lifescore was fair; the best result was for emotional well-being. Conclusions: Despite the limitations imposed by lowsurvival, it was possible to evaluate the quality of life of these patients. Patients having a family income higherthan the minimum monthly wage scored significantly better in final indexes FACT-G and FACT-HN than thosewith a lower income (AU)

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Epidemiologic profile and quality of life of patients treated for oral cancer in Juiz de Fora, Minas Gerais, Brazil.

OBJECTIVES: To assess the quality of life of patients treated for oral cancer, analyzing their physical, social/family, functional and emotional well-being; to identify socioeconomic and clinical functional variables that may potentially influence their quality of life; to describe the patients' epidemiologic profile (sex and age) and tumor features (histopathology, anatomical location and stage); to identify the frequency of risk factors associated with the malignancy. STUDY DESIGN: Observational cross-sectional study-case series study undertaken in 2 cancer treatment institutions in Juiz de Fora, Minas Gerais, Brazil, between 2000 and 2007. RESULTS: Of the 88 registered oral cancer patients, 16 were selected for the study sample. The majority of the study sample (87%) included males, with a mean age of 57.06 years; 43.8% were retired; 50% had not completed elementary education. Most (56.3%) had a monthly income of less than the minimum wage. Most (83.7%) smoked before cancer diagnosis and 43.8% from this sample continued to smoke after treatment. In addition, those who drank alcohol before treatment continued drinking (31.3%). The tongue was the predominant anatomic site (37.5%). The patients' quality of life score was fair; the best result was for emotional well-being. CONCLUSIONS: Despite the limitations imposed by low survival, it was possible to evaluate the quality of life of these patients. Patients having a family income higher than the minimum monthly wage scored significantly better in final indexes FACT-G and FACT-HN than those with a lower income.

Juvenile ossifying fibroma of the jaw.

Juvenile ossifying fibroma is a benign lesion with aggressive local growth. It is similar to an ossifying fibroma, although it is more aggressive and of earlier onset. Some cases of ossifying fibroma are part of a syndrome that includes hyperparathyroidism (caused by adenoma or carcinoma) and renal lesions, possibly caused by a recently discovered genetic mutation. These tumours must be treated by radical excision, to prevent recurrence. We report a case of recurrent juvenile ossifying fibroma, in an 18-year-old girl. The treatment was radical en-bloc resection, which was reconstructed at the same operation with an iliac crest bone graft. After one year, there has been satisfactory integration of the graft and the teeth have been implanted.

Incidência de suicídios e uso de agrotóxicos por trabalhadores rurais em Luz (MG), Brasil / Incidence of suicides and rural workers use of pesticides in Luz, Minas Gerais, Brazil

Este artigo apresenta um estudo sobre a incidência de suicídios em Luz (MG), verificando as eventuais relações com agrotóxicos. Para tanto, adotou-se estudo descritivo com 50 moradores de uma micro-região, entrevistados mediante questionário. Realizaram-se dosagens de acetilcolinesterase, gama-glutamiltransferase (GGT), transaminase glutâmico-oxalacética (TGO) e transaminase glutâmico-pirúvica (TGP) no soro e pesquisas nos prontuários hospitalares e no cartório do registro civil, estudando-se os casos de suicídios entre os anos de 2000 e 2004. A pesquisa nos prontuários e no cartório permitiu verificar a ocorrência de 8,1 atendimentos/mês de casos de intoxicação por agrotóxicos, sendo19 suicídios (22,6/100.000 hab./ano) no período. Desses, 18 eram trabalhadores rurais do sexo masculino. O mecanismo de suicídio foi, em 57,9% dos casos, envenenamento com agrotóxicos. Dos entrevistados, 98% relataram usar regularmente agrotóxicos, 72% não utilizaram nenhum equipamento de proteção, 56% nunca leram as bulas e 40% afirmaram ter tido intoxicação. Encontrou-se elevação da TGO e da TGP em 33,33% dos homens e da GGT em 21,42% das mulheres e 13,88% dos homens. Não foi detectada redução da atividade da acetilcolinesterase. Constatou-se que a incidência de suicídios foi mais que o dobro da maior média estadual brasileira e que o número de atendimentos de intoxicações foi alto se comparado aos do Sinitox.

The article presents the incidence of suicides and attended cases of poisoning in the micro-region of Luz, Minas Gerais, and their possible relationship with pesticides. A descriptive study was held involving 50 local residents, who were asked to answer a questionnaire. Acetylcholinesterase, gamma-glutamyltransferase (GGT), Serum glutamic oxaloacetic transaminase (SGOT), and Serum glutamic pyruvic transaminase (SGPT) were measured, and suicides between the years 2000 to 2004 were analyzed through hospital and civil registryrecords. The results pointed at 8.1 cases/month pesticide poisoning. During the period under study, 19 suicidal deaths occurred (22.6/100,000 inhab./year), 18 involving male rural workers, 57.9% of these caused by pesticide poisoning. From the interviewed residents, 98% reported they handled pesticides regularly, 72% had never used any protection equipment, 56% had never read any information sheets, and 40% had been poisoned by pesticides. Increase of SGOT and SGPT was observed in 33.33% of the male subjects, while GGT elevation was found in21.42% of the women and 13.88% of the men. Reduction of Acetylcholinesterase activity was not detected. Incidence of suicides was more than twice the highest state average in Brazil and, compared to Sinitox data, the number of pesticide poisoning cases was high.

Effectiveness of nasopalatine nerve block for anesthesia of maxillary central incisors after failure of the anterior superior alveolar nerve block technique.

The purpose of this study was to assess the effectiveness of nasopalatine nerve block for anesthesia of maxillary central incisors after failure of the anterior superior alveolar nerve (ASAN) block technique. Secondarily, the possible innervation of the maxillary central incisors by the nasopalatine nerve was also investigated. Twenty-seven healthy, young adult volunteers (age: 17-26 years; gender: 9 males and 18 females) were enrolled in this study. All participants were undergraduate dental students of the University of Vale do Rio Verde de Três Corações. The volunteers had the anterior superior alveolar nerves anesthetized and a thermal sensitivity test (cold) was performed on the maxillary central incisors. The volunteers that responded positively to cold stimulus received a nasopalatine nerve block and the thermal sensitivity test was repeated. All participants were anesthetized by a single operator. Three patients presented sensitivity after both types of bilateral blocks and were excluded from the percentage calculations. In the remaining 24 patients, 16 had their maxillary central incisors anesthetized by the anterior superior alveolar block and 8 remained with sensitivity after the ASAN block. All these 8 patients had their maxillary central incisors successfully anesthetized by the nasopalatine block. In this study, 33.3% of the subjects had the innervation of one or both maxillary central incisors derived from the nasopalatine nerve, whilst most subjects (66.7%) had such teeth innervated by the anterior superior alveolar nerve. The nasopalatine nerve block was effective in anesthetizing the maxillary central incisors when the anterior superior alveolar nerve block failed.

Effectiveness of nasopalatine nerve block for anesthesia of maxillary central incisors after failure of the anterior superior alveolar nerve block technique

The purpose of this study was to assess the effectiveness of nasopalatine nerve block for anesthesia of maxillary central incisors after failure of the anterior superior alveolar nerve (ASAN) block technique. Secondarily, the possible innervation of the maxillary central incisors by the nasopalatine nerve was also investigated. Twenty-seven healthy, young adult volunteers (age: 17-26 years; gender: 9 males and 18 females) were enrolled in this study. All participants were undergraduate dental students of the University of Vale do Rio Verde de Três Corações. The volunteers had the anterior superior alveolar nerves anesthetized and a thermal sensitivity test (cold) was performed on the maxillary central incisors. The volunteers that responded positively to cold stimulus received a nasopalatine nerve block and the thermal sensitivity test was repeated. All participants were anesthetized by a single operator. Three patients presented sensitivity after both types of bilateral blocks and were excluded from the percentage calculations. In the remaining 24 patients, 16 had their maxillary central incisors anesthetized by the anterior superior alveolar block and 8 remained with sensitivity after the ASAN block. All these 8 patients had their maxillary central incisors successfully anesthetized by the nasopalatine block. In this study, 33.3 percent of the subjects had the innervation of one or both maxillary central incisors derived from the nasopalatine nerve, whilst most subjects (66.7 percent) had such teeth innervated by the anterior superior alveolar nerve. The nasopalatine nerve block was effective in anesthetizing the maxillary central incisors when the anterior superior alveolar nerve block failed.

O objetivo deste estudo foi avaliar a eficácia do bloqueio do nervo nasopalatino após falha na anestesia dos incisivos centrais superiores pelo bloqueio no nervo alveolar superior anterior (NASA). Secundariamente, investigou-se a possível inervação do incisivo central superior por ramos do nervo nasopalatino (NNP). Foram avaliados 27 voluntários saudáveis, adultos jovens (idade: 17-26 anos; sexo: 9 homens e 18 mulheres). Todos eram estudantes de Odontologia da Faculdade do Vale do Rio Verde de Três Corações. Os voluntários tiveram os nervos alveolares anteriores superiores anestesiados e em seguida foram submetidos a um teste de sensibilidade térmica nos incisivos centrais superiores. Aqueles pacientes que ainda apresentavam sensibilidade após o bloqueio do NASA receberam bloqueio do NNP e então o teste térmico foi repetido. Todos os pacientes foram anestesiados por um único operador. Três pacientes ainda apresentaram sensibilidade após ambos os bloqueios bilaterais (NASA e NNP) e foram excluídos das análises de percentagem. Dos 24 pacientes restantes, 16 tiveram seus incisivos centrais superiores anestesiados pelo bloqueio do NASA e 8 permaneceram com sensibilidade após este procedimento. Estes 8 pacientes submeteram-se ao bloqueio do NNP, o que resultou em sucesso na anestesia dos incisivos centrais superiores. Neste estudo, 33,3 por cento dos pacientes tinham a inervação de um ou de ambos os incisivos centrais superiores derivada do nervo nasopalatino, enquanto a maioria dos pacientes (66,7 por cento) tinha tais dentes inervados pelo nervo alveolar superior anterior. O bloqueio do NNP foi eficaz para anestesiar os incisivos centrais superiores, nos casos em que falhou o bloqueio do NASA.

Uso de filme de PVC em áreas doadoras de enxertos de pele parcial / Use of PVC film on donor areas of partial-thickness skin grafts

Apresenta-se uma modalidade de curativo para áreas doadoras de enxertos de pele parcial, utilizando-se filme plástico de PVC. Foram observados 25 pacientes, com evolução uniformemente boa. Recomenda-se a utilização deste material, por ter várias vantagens: ser facilmente encontrável, ser de fácil manipulação, ter custo muito baixo e, sobretudo, permitir bons resultados.

Pioderma gangrenoso: grave e mal conhecida complicação da cicatrização / Pyoderma gangrenosum: a severe and ill-known complication of healing

O Pioderma Gangrenoso, doença inflamatória da pele, é incomum e pouco conhecido. Surge em associação com outras doenças ou isoladamente. Também pode ser importante complicação de operações, causando perdas cutâneas devastadoras durante o período pós-operatório. Neste trabalho, faz-se uma breve revisão sobre este distúrbio, com foco nas repercussões sobre a Cirurgia Plástica. Apresenta-se, também, um caso de pioderma gangrenoso pós-operatório com três anos de evolução.

A standard burn model using rats

Experimental burn models are always needed, being essential for burn research. In the present study, we describe a standard Fischer F-344 rat burn model, in which burns are produced with a heated brass bar. The animals were anesthetized with ketamine (90 mg/kg). After the burns, they were resuscitated with saline. Burns ranging from 26 percent to 30percent of total body surface area resulted in a 62.5 percent mortality rate after 25 days. This model is an additional option for those interested in burn research

A simple experimental model of heat shock response in rats

Objective: To obtain a simple model for the elicitation of the heat shock response in rats. Design: Laboratory study. Setting: University research laboratories. Sample: Seventy-nine adult male albino rats (weight range 200g to 570g). Procedures: Exposure to heat stress by heating animals in a warm bath for 5 min after their rectal temperatures reached 107.60 F (42 degrees Celsius). Liver and lung samples were collected for heat-shock protein 70 (HSP70) detection (Western analysis). Results: Western analysis was positive for HSP70 in the liver and in the lungs of heated animals. There was a temporal correlation between heating and HSP70 detection: it was strongest one day after heating and reduced afterwards. No heated animals died. Conclusion: These data show that heating rats in a warm (45 degrees Celsius) bath, according to parameters set in this model, elicits efficiently the heat shock response.