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1.
Molecules ; 27(17)2022 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-36080159

RESUMO

The aim of this study was to investigate the cytotoxic activity of the Coriandrum sativum (C. sativum) ethanolic extract (CSEE) in neuroblastoma cells, chemically characterize the compounds present in the CSEE, and predict the molecular interactions and properties of ADME. Thus, after obtaining the CSEE and performing its chemical characterization through dereplication methods using UPLC/DAD-ESI/HRMS/MS, PM6 methods and the SwissADME drug design platform were used in order to predict molecular interactions and ADME properties. The CSEE was tested for 24 h in neuroblastoma cells to the establishment of the IC50 dose. Then, the cell death was evaluated, using annexin-PI, as well as the activity of the effector caspase 3, and the protein and mRNA levels of Bax and Bcl-2 were analyzed by ELISA and RT-PCR, respectively. By UHPLC/DAD/HRMS-MS/MS analysis, the CSEE showed a high content of isocoumarins-dihydrocoriandrin, coriandrin, and coriandrones A and B, as well as nitrogenated compounds (adenine, adenosine, and tryptophan). Flavonoids (apigenin, hyperoside, and rutin), phospholipids (PAF C-16 and LysoPC (16:0)), and acylglicerol were also identified in lower amount as important compounds with antioxidant activity. The in silico approach results showed that the compounds 1 to 6, which are found mostly in the C. sativum extract, obey the "Five Rules" of Lipinski, suggesting a good pharmacokinetic activity of these compounds when administered orally. The IC50 dose of CSEE (20 µg/mL) inhibited cell proliferation and promoted cell death by the accumulation of cleaved caspase-3 and the externalization of phosphatidylserine. Furthermore, CSEE decreased Bcl-2 and increased Bax, both protein and mRNA levels, suggesting an apoptotic mechanism. CSEE presents cytotoxic effects, promoting cell death. In addition to the promising results predicted through the in silico approach for all compounds, the compound 6 showed the best results in relation to stability due to its GAP value.


Assuntos
Coriandrum , Neuroblastoma , Linhagem Celular Tumoral , Coriandrum/química , Humanos , Neuroblastoma/tratamento farmacológico , Extratos Vegetais/química , Proteínas Proto-Oncogênicas c-bcl-2 , RNA Mensageiro , Espectrometria de Massas em Tandem , Proteína X Associada a bcl-2/genética
2.
Aesthetic Plast Surg ; 2022 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-35999462

RESUMO

BACKGROUND: Fat grafting is used in combination with mammoplasty to improve filling of the upper pole of the breasts. Its effectiveness remains in question due to unpredictable results. Difficulty in isolating the grafted fat and differentiating it from host tissues may hinder assessment of graft integration. The plane between the pectoral muscles is free of fat and has already been described with respect to placement of breast implants and fat grafting in breast surgeries. This study sought to evaluate via magnetic resonance imaging (MRI) the integration and retention of retropectoral fat grafts in mammoplasty. METHODS: Thirty patients with breast flaccidity who desired to undergo mammoplasty were selected. Fat collected from the abdomen was separated by sedimentation and transferred to the retropectoral region after undermining of the breast and resection of excess tissue. The patients underwent MRI preoperatively and at three and six months after surgery. Fat volumes were calculated by multiplying the values for the major vertical, horizontal, and anteroposterior axes by the constant 0.523. RESULTS: Twenty-five patients completed the study. The mean volume grafted was 116.4 ± 22.5 ml per breast. Six months after surgery, the mean fat graft volume in the retropectoral plane was 48.1 ± 25.71 ml, and the integration rate was 40.82% (range, 32.2-49.4%). The rate of complications related to fat grafting was 8%. CONCLUSIONS: In mammoplasty, retropectoral fat grafting showed good integration rates and is a safe and predictable approach that can contribute to improving the outcomes of aesthetic and reconstructive breast surgeries. LEVEL OF EVIDENCE IV, COHORT ANALYTIC STUDY: 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 .

3.
J Craniofac Surg ; 33(4): e398-e401, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-36041096

RESUMO

OBJECTIVE: To evaluate whether the maxillary complex would be sagittally, vertically, or mutually displaced after the transverse maxillary correction by surgically assisted rapid maxillary expansion and how the facial profile would be affected. MATERIALS AND METHODS: The sample comprised 28 adult patients (mean age 25.8 [age range 19-39 years]; 50% women) with transverse maxillary deficiency greater than 7 mm who underwent the surgical rapid maxillary expansion. Cephalometric analysis (n  = 112), intra- and extra-oral registries, and radiographic records were taken before treatment (T1), right after the end of the expansion (T2), 4 months after the expansion (T3), and 10 months after the end of the expansion (T4). Dental and skeletal cephalometric measurements were evaluated at each time-point, whereas soft tissue cephalometric analyses were determined at 2 time points (T1 and T4). RESULTS: The results indicated that no sagittal, vertical, skeletal, or soft tissue variation was found after the surgical expansion. However, statistically significant dental changes (P  < 0.05) were observed in dental angles (1.NA/1.SN/1.PoOR/1.PP) throughout the different time-points. The authors found statistically relevant posterior inclination of the incisors from T2 to T3 based on multiple comparisons. CONCLUSIONS: Surgically assisted rapid maxillary expansion does not promote anterior and vertical displacement of the maxilla. Notwithstanding, the surgical intervention causes upper incisor palatal inclination.


Assuntos
Maxila , Técnica de Expansão Palatina , Adulto , Cefalometria/métodos , Feminino , Humanos , Incisivo , Estudos Longitudinais , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Estudos Retrospectivos , Adulto Jovem
4.
Aesthet Surg J ; 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35830484

RESUMO

BACKGROUND: For decades, the postoperative wearing of abdominal binders has been suggested to reduce dead space and prevent mobilization of the musculoaponeurotic layer, as an attempt to decrease the risk of seroma formation and recurrent diastasis. OBJECTIVES: The study sought to evaluate whether the postoperative wearing of an abdominal binder provides any additional contribution to the reduction of either seroma formation or recurrent diastasis recti when abdominoplasty is performed with the use of quilting sutures. METHODS: Thirty-four women undergoing abdominoplasty were randomized into 2 groups: the binder group (n = 16) wore abdominal binders, and the control group (n = 18) did not wear abdominal binders during the postoperative period. Ultrasound examination was performed on postoperative days 7 and 14 to assess seroma formation and at 6 months postoperatively to assess recurrence of diastasis recti. Student's t-test for independent samples was applied to compare means between two numerical variables. Generalized Estimation Equation models were used to evaluate the seroma volume at different timepoints for the different groups. RESULTS: No significant differences in seroma volume were found between groups on postoperative days 7 (p = 0.830) and 14 (p = 0.882). Four and 3 cases of subclinical recurrent diastasis were observed by ultrasound examination in the supraumbilical and infraumbilical regions, respectively, but without significant differences (p = 1.000) between groups. Recurrent diastasis was not detected during physical examinations. CONCLUSIONS: The postoperative wearing of abdominal binders was neither effective in preventing seroma formation nor recurrent diastasis following abdominoplasty with quilting sutures.

5.
Arch Plast Surg ; 49(3): 352-359, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35832157

RESUMO

Background Breast augmentation with implants is the most commonly performed cosmetic plastic surgery in Brazil and worldwide. The aim of this study was to assess patient satisfaction and quality of life following subpectoral breast augmentation with either microtextured or macrotextured implants, using the BREAST-Q. Methods A prospective study was conducted with 40 women with hypomastia undergoing subpectoral breast augmentation. The patients were randomly allocated to two groups to receive either microtextured or macrotextured breast implants. All participants were assessed preoperatively (baseline) and after 2 and 4 months of surgery for quality of life and patient satisfaction with the surgical results, using the BREAST-Q augmentation module, a patient-reported outcome measure. Results The patients had a mean age of 28.9 ± 6.45 years. The microtextured ( n = 20) and macrotextured ( n = 20) groups were homogeneous for sex, age, education level, marital status, and number of children ( p > 0.05). Both groups showed significant improvement in satisfaction with breasts ( p < 0.001), psychosocial well-being ( p < 0.001), and sexual well-being ( p < 0.001) at the 2- and 4-month follow-up visits compared with baseline. The observed improvements were associated with high effect size values of 5.09, 3.44, and 3.90, respectively. In contrast, significant decreases from baseline in physical well-being scores ( p = 0.001) were found 2 and 4 weeks after surgery in both groups. Conclusion Subpectoral breast augmentation with either microtextured or macrotextured breast implants improved satisfaction with breasts and quality of life in patients with hypomastia.

6.
Rev Assoc Med Bras (1992) ; 68(4): 498-501, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35649073

RESUMO

OBJECTIVE: This study aimed to translate the BREAST-Q© - Breast Reconstruction Expectations Module (preoperative) 2.0 into Portuguese and adapt it to the Brazilian cultural context. METHODS: Authorization for translation and cross-cultural adaptation of the questionnaire was obtained from the holders of the instrument's distribution rights. The questionnaire was translated and retro-translated. For cultural adaptation, the instrument was applied to 40 patients who had breast reconstruction surgery scheduled. Cronbach's alpha was used to assess the internal consistency. RESULTS: The mean age of the patients was 53.5 years, and the majority (72.5%) was undergoing reconstruction with implants. Good and excellent internal consistencies were observed for the Coping and Appearance expectations scales (Cronbach's alpha values of 0.878 and 0.909, respectively). For the Pain scale, the internal consistency was moderate (0.738), and it was acceptable (0.587) for the Medical team. CONCLUSION: The BREAST-Q© - Breast Reconstruction Expectations Module (preoperative) 2.0 was successfully translated and adapted to the Brazilian context.


Assuntos
Comparação Transcultural , Mamoplastia , Brasil , Humanos , Pessoa de Meia-Idade , Motivação , Reprodutibilidade dos Testes
7.
Rev. bras. cir. plást ; 37(2): 228-232, abr.jun.2022. ilus
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1379873

RESUMO

Introdução: O posicionamento das Cartilagens Laterais Inferiores (CLI) está diretamente relacionado à boa funcionalidade nasal. Quando essas cartilagens apresentam um mau posicionamento cefálico, a parede lateral da válvula nasal externa fica sem suporte adequado, podendo levar à insuficiência valvular. O objetivo é definir qual o posicionamento anatômico ideal das CLI associado à otimização da válvula nasal externa. Métodos: Revisão de literatura narrativa nas seguintes bases de dados: SciELO, LILACS e Medline. Os descritores utilizados foram: "cartilagens nasais"; "obstrução nasal" e "rinoplastia", sendo selecionados 15 artigos essenciais para o entendimento do assunto. Revisão de literatura: O posicionamento do ramo lateral das CLI forma o contorno da ponta nasal e dá estabilidade à parede lateral da válvula nasal externa. Constantian definiu que o posicionamento ideal do ramo lateral das CLI à margem da asa nasal deve ser 45° ou menos. Para Toriumi, o ângulo é mensurado a partir do ramo lateral das CLI em relação ao plano sagital mediano e o valor adequado é de aproximadamente 45°. Para Silva, o posicionamento das CLI é mensurado pelo ângulo de divergência entre as CLI e tem como valor apropriado aproximadamente 90°. Conclusão: A válvula nasal externa apresenta melhor funcionamento quando as CLI estão bem posicionadas, a saber: o ângulo formado entre a borda lateral das CLI e a margem alar é próximo de 45° ou menos; o ângulo formado entre as CLI e o plano sagital mediano é próximo de 45°; o ângulo de divergência formado entre as CLI é próximo a 90°.


Introduction: The Lower Lateral Cartilages (LLC) positioning is directly related to good nasal functionality. When these cartilages have cephalic malpositioning, the lateral wall of the external nasal valve is not adequately supported, which can lead to valvular insufficiency. The objective is to define the ideal anatomical positioning of the LLC associated with optimizing the external nasal valve. Methods: Review narrative literature in the following databases: SciELO, LILACS and Medline. The descriptors used were: "nasal cartilages,"; "nasal obstruction," and "rhinoplasty," being selected 15 essential articles for the understanding of the subject. Literature review: Positioning the lateral crura of the LLC forms the contour of the nasal tip and provides stability to the lateral wall of the external nasal valve. Constantian defined the ideal positioning of the lateral crura of the LLC at the margin of the nasal alae should be 45° or less. For Toriumi, the angle is measured from the lateral crura of the LLC concerning the midsagittal plane, and the appropriate value is approximately 45°. For Silva, the positioning of the LLC is measured by the angle of divergence between the LLCs, and its appropriate value is approximately 90°. Conclusion: The external nasal valve works better when the LLCs are well-positioned, namely: the angle formed between the lateral edge of the LLCs and the alar margin is close to 45° or less; the angle formed between the LLC and the midsagittal plane is close to 45°; the divergence angle formed between the LLC is close to 90°.

8.
Aesthetic Plast Surg ; 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35538245

RESUMO

BACKGROUND: Although there is limited evidence for regulating the use of prophylactic antibiotics in reduction mammaplasty, many plastic surgeons prescribe them, even in the postoperative period. This study aimed to conduct a national survey to investigate the antibiotic prophylaxis protocols followed by Brazilian plastic surgeons in reduction mammaplasty. METHODS: An anonymous survey comprising 19 questions was sent to all 4864 active members of the Brazilian Society of Plastic Surgery (SBCP). The surgeons electronically received the invitation to participate in the survey and the link to fill out the electronic form. RESULTS: In total, 859 surgeons (17.7%) responded. Most respondents (77.8%) were men and aged 35-55 years (61.5%); 58.6% of them had 10-29 years of specialty training. Only a minor proportion of the respondents (0.5%) reported not prescribing antibiotics at any time (95% confidence interval [CI]: 0.0-0.9), 9.9% (95% CI: 7.9-11.9) prescribed them only preoperatively, and 14.6% (95% CI: 12.2-16.9) prescribed continued antibiotic use for 24 h. The majority of the respondents (75.1%; 95% CI: 72.1-77.9) prescribed antibiotics for additional days after discharge. There were significant associations between antibiotic prescription and the surgeons' age group (p = 0.015), time since graduation (p < 0.001), experience in the specialty practice (p = 0.003), SBCP membership (p < 0.001), and surgical site infection rates (p = 0.011). CONCLUSION: Most responding plastic surgeons affirmed that they prescribed prophylactic antibiotics for more than 24 h in reduction mammaplasty cases. 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 .

9.
Indian J Plast Surg ; 55(1): 92-96, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35444745

RESUMO

The variation of the components' separation technique, which uses the anterior rectus sheath and the release of the oblique muscles, proved to be effective in tension reduction. This paper aimed to present the initial experience using a variation that preserves semilunaris through the incision of the lateral aspect of the rectus sheath. All of the 12 patients presented an abdominal wall defect that included incisional hernia, peritoneostomy, lateral implantation of the rectus muscle, and defect secondary to TRAM flap. The separation was done in the following stages: stage 1-anterior rectus sheath and stage 2-external oblique muscles. From the 12 patients, three presented early complications: seroma ( n = 2) and epitheliolysis ( n = 1). There were no recurrences or other late complications (48 months follow-up period). The separation of the anterior rectus sheath, and incision in the lateral recess to undermine the oblique muscles, allowed the treatment of abdominal wall defects, without late complications.

10.
Plast Reconstr Surg ; 149(6): 1106e-1113e, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35383695

RESUMO

BACKGROUND: The changes in the pattern of lymphatic drainage of the superficial abdominal wall after abdominoplasty are still unknown. These changes may increase the risk of numerous complications, including seroma formation. Depending on the alterations, the manual lymphatic drainage technique should be modified in postoperative patients. The aim of this study was to map the pattern of lymphatic drainage of the superficial infraumbilical abdominal wall after abdominoplasty. METHODS: Twenty women with indications for abdominoplasty were selected in the Plastic Surgery Division of the Federal University of São Paulo. Intradermal lymphoscintigraphy with dextran 500-99m-technetium was performed in 20 female patients in the preoperative phase and 1 and 6 months after abdominoplasty to evaluate superficial lymphatic drainage of the abdominal wall. RESULTS: Before surgery, all patients presented with abdominal lymphatic drainage toward the inguinal lymph nodes. One and 6 months after abdominoplasty, only 15 percent exhibited the same drainage pathway. Drainage toward the axillary lymph node chain occurred in 65 percent of the patients, 10 percent displayed a drainage pathway toward both the axillary and inguinal lymph nodes, and lymphatic drainage was indeterminate in 10 percent of the cases. CONCLUSIONS: A significant change in lymphatic drainage pathway occurred in the infraumbilical region after abdominoplasty. The axillary drainage path was predominant after the operation, in contrast to the inguinal path observed in the preoperative period. However, 35 percent of cases exhibited alternative drainage. No significant changes were documented between 1 and 6 months postoperatively. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Parede Abdominal , Abdominoplastia , Parede Abdominal/cirurgia , Abdominoplastia/efeitos adversos , Abdominoplastia/métodos , Axila/cirurgia , Feminino , Humanos , Linfonodos/cirurgia , Linfocintigrafia
11.
Rev. Assoc. Med. Bras. (1992) ; 68(4): 498-501, Apr. 2022. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1376165

RESUMO

SUMMARY OBJECTIVE: This study aimed to translate the BREAST-Q© — Breast Reconstruction Expectations Module (preoperative) 2.0 into Portuguese and adapt it to the Brazilian cultural context. METHODS: Authorization for translation and cross-cultural adaptation of the questionnaire was obtained from the holders of the instrument's distribution rights. The questionnaire was translated and retro-translated. For cultural adaptation, the instrument was applied to 40 patients who had breast reconstruction surgery scheduled. Cronbach's alpha was used to assess the internal consistency. RESULTS: The mean age of the patients was 53.5 years, and the majority (72.5%) was undergoing reconstruction with implants. Good and excellent internal consistencies were observed for the Coping and Appearance expectations scales (Cronbach's alpha values of 0.878 and 0.909, respectively). For the Pain scale, the internal consistency was moderate (0.738), and it was acceptable (0.587) for the Medical team. CONCLUSION: The BREAST-Q© — Breast Reconstruction Expectations Module (preoperative) 2.0 was successfully translated and adapted to the Brazilian context.

12.
Eur J Plast Surg ; : 1-31, 2022 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-35308897

RESUMO

Background: Throughout its illustrious history, plastic surgery has searched for novel regenerative therapies and procedures. Recently, interest has emerged in using adipose tissue-derived stem cells (ASCs) in an ethical, easy, and reproducible manner. ASCs are generally not administered alone but as a constituent of the stromal vascular fraction (SVF) in clinical practice. Herein, we searched for innovative fat collection and ASC isolation technologies and applications and evaluated each study's relevance to plastic surgery. Methods: A narrative literature review was carried out using the MEDLINE/PubMed databases. Studies published from January 1993 to August 2020 and written in English, Portuguese, or Spanish were considered. Results: The selection process yielded 33 articles for subsequent review, involving exploratory, selective, and interpretive reading, material choice, and text analysis. Twenty-three articles employed enzymatic dissociation methods to isolate ASCs, and 25 employed liposuction as the plastic surgery technique. Moreover, articles describing new devices (n = 2), techniques (n = 4), computational models (n = 1), tissue scaffolds (n = 21), and therapies and/or treatments (n = 5) were identified. Conclusions: Given the importance of fat tissue for plastic surgery purposes, innovative ASC isolation and liposuction technologies could change how the surgeon conducts surgeries and improve surgical outcomes. Furthermore, many articles investigating tissue scaffolds demonstrate the importance of this area of research and development in plastic surgery and regenerative medicine. Continued efforts in the identified research areas will eventually bring in vivo human plastic surgery applications and regenerative medicine into the operating room. Level of evidence: Not gradable.

13.
Injury ; 53(2): 453-456, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34819230

RESUMO

INTRODUCTION: Reviewing the profile of patients admitted at the Burns Intensive Care Unit at São Paulo Hospital - UNIFESP, as well as the available literature, it becomes evident the need for tools able to predict those patients' outcomes. Distinct score models are used in different health centers, not only as prognostic models, but also as research and quality control tools. Amongst these prognostic scores, there are two strands, the burns specific scores - which consider the injury's characteristics - and the general critical patient's scores. OBJECTIVE: This study aims to analyze the differences and tendencies in mortality prediction of two broadly used scores when applied to São Paulo Hospital's Burns Intensive Care Unit patients, ABSI - burns specific score - and SAPS 3 - general score for critical patients. METHODS: This is an individual, observational, retrospective and comparative study, developed with medical records review. Both scores were applied to every patient admitted at São Paulo Hospital's Burns Intensive Care Unit from 2011 to 2016. Statistical analyses used the non-parametric test of Kolmogorov-Smirnov, a p-value <0.05 was considered significant. RESULTS: 122 patients were included, the average age was 34,4 years old. 70,5% of patients were male and 49% had a total body surface area burned of 20%. 27% of the patients died. Statistical analyses do not show significant differences between ABSI and SAPS3 mortality predictions for burns patients at this health center. CONCLUSION: The study evidences that SAPS 3 score, frequently used at general Intensive Care Units, has a similar performance to ABSI score, which is specific for burns populations. ABSI score is easier to implement, as it is simpler and able to show instant results.


Assuntos
Queimaduras , Escore Fisiológico Agudo Simplificado , Brasil/epidemiologia , Estado Terminal , Humanos , Unidades de Terapia Intensiva , Masculino , Estudos Retrospectivos
14.
Aesthet Surg J ; 42(6): 628-634, 2022 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-34791039

RESUMO

BACKGROUND: Quilting sutures attaching the abdominal flap to the aponeurosis contribute to the prevention of seroma formation following abdominoplasty. The sutures distribute the tension over the subcutaneous tissue along the flap length, theoretically decreasing tension at the distal (cutaneous) end of the flap. This is expected to reduce the risks of necrosis, dehiscence, and enlarged or hypertrophic scars. OBJECTIVES: This study sought to verify whether quilting sutures decrease the tension required to advance the dermal-fat flap in abdominoplasty. METHODS: Thirty-four women undergoing abdominoplasty with quilting sutures participated in the study. The tensile force required for flap advancement was measured with a digital force gauge before and after placement of quilting sutures and then compared. Differences in tensile force were tested for correlations with BMI, age, weight of flap tissue removed, number of previous pregnancies, and postoperative complications, including seroma formation, hematoma, necrosis, dehiscence, and enlarged or hypertrophic scars. RESULTS: A mean reduction in tension of 27.7% was observed at the skin suture after the placement of quilting sutures (P < 0.001). No significant correlation was found between reduced flap tension and BMI, age, weight of tissue removed, or number of births. One case of seroma formation and 2 cases of enlarged scars were observed, but no case of hematoma, necrosis, or wound dehiscence was detected. CONCLUSIONS: The use of quilting sutures to attach the abdominal flap to the aponeurosis of the anterior abdominal wall reduced tension at the advancing edge of the flap in abdominoplasty.


Assuntos
Abdominoplastia , Cicatriz Hipertrófica , Abdominoplastia/efeitos adversos , Feminino , Hematoma , Humanos , Necrose/etiologia , Necrose/prevenção & controle , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Seroma/etiologia , Seroma/prevenção & controle , Técnicas de Sutura , Suturas
15.
Plast Reconstr Surg ; 148(6): 1264-1269, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34847112

RESUMO

SUMMARY: The position of the lower lateral cartilages is directly related to good nasal functionality. When these cartilages exhibit cephalic malposition, the angle of divergence between cartilages is usually less than 60 degrees, which can cause external nasal valve insufficiency. The objective of this study was to validate the rhinogoniometer, an innovative surgical instrument that allows for diagnosing the position of this cartilage intraoperatively. In the intraoperative period, the angle of divergence, which is the angle formed between the two lateral branches of the lower lateral cartilages, was measured in 31 primary rhinoplasty patients. The rhinogoniometer measurement was compared with that of the computerized analysis, and the reproducibility of measurements with the rhinogoniometer between two different surgeons was determined. When comparing the values obtained by the two methods, a significant difference was found (p = 0.034). On average, the angles measured by the rhinogoniometer were 3.7 degrees smaller than the measurements made by the software. It was observed that when the angles measured by both methods were above 75 degrees, the differences between the two measurements were higher (p = 0.022). However, for angles up to 75 degrees, the measurement using the rhinogoniometer was, on average, 0.79 degrees higher than the measurement taken by the software. When the difference in angles obtained by the two methods between different surgeons was evaluated, there was a significant difference (p < 0.023). In conclusion, at angles up to 75 degrees, the rhinogoniometer showed a negligible difference of 0.79 degrees higher than the measurement obtained via software. Measurements with the rhinogoniometer were also shown to be reproducible with different surgeons.


Assuntos
Antropometria/instrumentação , Cartilagens Nasais/anatomia & histologia , Rinoplastia/instrumentação , Estudos Transversais , Método Duplo-Cego , Humanos , Cartilagens Nasais/cirurgia , Reprodutibilidade dos Testes , Rinoplastia/métodos , Software , Resultado do Tratamento
16.
Rev Assoc Med Bras (1992) ; 67(7): 1069-1074, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34817528

RESUMO

OBJECTIVE: This study aimed to compare the publications authored by plastic surgeons with those from other specialties' surgeons on patient-reported outcomes of oncoplastic surgery. METHODS: A review was carried out on the Medline database, emcompassing five years (2015-2020). Studies about partial breast reconstruction after conservative treatment, immediate or delayed, by any technique, which presented patient-reported outcomes, were included. RESULTS: We found 292 articles, from which 142 met the eligibility criteria. Publications were stratified into groups 1 (plastic surgeons) and 2 (other surgical specialties), and also into groups A (only plastic surgeons), B (only other specialties) and C (both), and compared statistically. Most publications (60.6%) were attributed to specialties other than plastic surgery. Nineteen percent had only plastic surgeons as authors, 50% only other specialties' surgeons, and 31% had both. There was no difference between groups regarding the impact factor of the journals in any of the stratifications, and the majority was published in journals with impact factor ≤2. CONCLUSION: In the last years, surgeons from specialties other than plastic surgery published more about the results of the oncoplastic surgery reported by the patients. There was no statistical difference between the groups regarding the impact factor of the journals.


Assuntos
Neoplasias da Mama , Mamoplastia , Cirurgiões , Cirurgia Plástica , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Medidas de Resultados Relatados pelo Paciente
17.
Rev Assoc Med Bras (1992) ; 67(8): 1109-1112, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34669854

RESUMO

OBJECTIVE: The aim of this study is to elaborate a protocol for the care of acute traumatic tissue injuries in the prehospital mobile service. METHODS: An extensive search of anteriority that did not reveal the existence of such protocol in other services across the globe was carried out. Subsequently, the literature review was executed on Medline and Lilacs. Related and referenced scientific literature served as the basis for the elaboration and creation of the protocol and its flowchart. The complete protocol was then measured for expert judges with the Delphi methodology. A questionnaire (using the Likert scale) and the initial version protocol were sent by electronic means to 13 medical and nurse coordinators of all SAMU from Paraná. RESULTS: Seven experts returned completed questionnaires in the first round and five in the second round. Average required global content validation index was obtained for the validation requirements of the protocol and its flowchart. CONCLUSIONS: A protocol for the care of acute traumatic tissue injuries in the prehospital mobile service was developed and authenticated with the viability of routine professional use by the health professional.


Assuntos
Serviços Médicos de Emergência , Brasil , Humanos , Inquéritos e Questionários
18.
Indian J Plast Surg ; 54(3): 362-366, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34667525

RESUMO

Augmentation-mastopexy is a frequent procedure with high rates of early recurrence of breast ptosis, mainly after subglandular approach. The dual-plane techniques, based on the cranial dissection of the pectoralis, is the most used, but this plane does not cover the inferior pole of the breast. Then, the possibility of a downward dissection of the muscle seems to be more reasonable to retain the implant and improve postoperative results. This study aimed to review the anatomy of the pectoralis in cadavers and the use of its downward dissection to create a pocket for breast implant as a "shirt pocket." This maneuver was associated with a superior-based dermoglandular flap to overprotect the inferior pole. No complications were related in the postoperative period. The anatomic review showed that the "shirt pocket" is a safe option if done carefully. The technique demonstrated to be feasible and seemed to be effective, being another alternative to prevent early recurrence of breast ptosis in these procedures.

19.
Artif Intell Med ; 120: 102161, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34629149

RESUMO

Early-stage detection of cutaneous melanoma can vastly increase the chances of cure. Excision biopsy followed by histological examination is considered the gold standard for diagnosing the disease, but requires long high-cost processing time, and may be biased, as it involves qualitative assessment by a professional. In this paper, we present a new machine learning approach using raw data for skin Raman spectra as input. The approach is highly efficient for classifying benign versus malignant skin lesions (AUC 0.98, 95% CI 0.97-0.99). Furthermore, we present a high-performance model (AUC 0.97, 95% CI 0.95-0.98) using a miniaturized spectral range (896-1039 cm-1), thus demonstrating that only a single fragment of the biological fingerprint Raman region is needed for producing an accurate diagnosis. These findings could favor the future development of a cheaper and dedicated Raman spectrometer for fast and accurate cancer diagnosis.


Assuntos
Melanoma , Neoplasias Cutâneas , Biópsia , Humanos , Aprendizado de Máquina , Melanoma/diagnóstico , Neoplasias Cutâneas/diagnóstico , Análise Espectral Raman
20.
Stem Cells Dev ; 30(23): 1171-1178, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34486404

RESUMO

Dermal fibroblasts (DFs) share several qualities with mesenchymal stem cell/multipotent stromal cells (MSCs) derived from various tissues, including adipose-derived stromal/stem cells (ASCs). ASCs and DFs are morphologically comparable and both cell types can be culture expanded through the utilization of their plastic-adherence properties. Despite these similar characteristics, numerous studies indicate that ASC and DF display distinct therapeutic benefits in clinical applications. To more accurately distinguish between these cell types, human DFs and ASCs isolated from three individual donors were analyzed for multipotency and cell surface marker expressions. The detection of cell surface markers, CD29, CD34, CD44, CD73, CD90, and CD105, were used for phenotypic characterization of the DFs and ASCs. Furthermore, both cell types underwent lineage differentiation based on histochemical staining and the expression of adipogenic related genes, CCAAT/Enhancer-Binding Protein alpha (CEBPα), Peroxisome proliferator-activated receptor gamma (PPARγ), UCP1, Leptin (LEP), and Adiponectin (ADIPOQ); and osteogenic related genes, Runt related transcription factor 2 (Runx2), Alkaline phosphatase (ALPL), Osteocalcin (OCN), and Osteopontin (OPN). Evidence provided by this study demonstrates similarities between donor-matched ASC and DF with respect to morphology, surface marker expression, differentiation potential, and gene expression, although appearance of enhanced adipogenesis in the ASC based solely on spectrophotometric analyses with no significant difference in real-time polymerase chain reaction detection of adipogenic biomarkers. Thus, there is substantial overlap between the ASC and DF phenotypes based on biochemical and differentiation metrics.


Assuntos
Tecido Adiposo , Células Estromais , Adipogenia , Diferenciação Celular , Células Cultivadas , Fibroblastos , Humanos , Osteogênese , Células-Tronco
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