Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 5.573
Filtrar
2.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 44(2): 208-212, 2022 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-35538754

RESUMO

Objective To study the influence of recombinant bovine basic fibroblast growth factor as an adjuvant therapy on scar alleviation and inflammatory cytokines in patients with atrophic acne scar. Methods The random number table was employed to randomly assign 120 patients with atrophic acne scar into a test group and a control group.Both groups of patients were treated with CO2 lattice laser.After the operation,the control group was routinely smeared with erythromycin ointment and the test group was coated with recombinant bovine basic fibroblast growth factor gel.The clinical efficacy,clinical indicators,scar alleviation,and inflammatory cytokine levels before and after treatment were compared,and adverse reactions were counted. Results The test group had higher total effective rate(P=0.040) and lower total incidence of adverse reactions(P=0.028) than the control group.Compared with the control group,the test group showcased short erythema duration after treatment(P=0.025),early scab forming(P=0.002),and early edema regression(P<0.001).After treatment,the proportion of grade 1 scars graded by Goodman and Baron's acne scar grading system in the test group and control group increased(P=0.001,P=0.027),and the proportion of grade 4 scars decreased(P<0.001,P=0.034).Moreover,the proportion of grade 1 scars in the test group was higher than that in the control group(P=0.031) after treatment,and the proportion of grade 4 scars presented an opposite trend(P=0.031).After treatment,the levels of tumor necrosis factor-α(TNF-α) and interleukin-1ß(IL-1ß) in both groups declined(all P<0.001),and the test group had lower TNF-α and IL-1ß levels than the control group(all P<0.001). Conclusion The recombinant bovine basic fibroblast growth factor gel as an adjuvant therapy of CO2 lattice laser can effectively alleviate the atrophic acne scar,relieve local inflammatory reaction,and has good curative effect and less adverse reactions.


Assuntos
Acne Vulgar , Cicatriz , Acne Vulgar/complicações , Acne Vulgar/tratamento farmacológico , Animais , Atrofia/complicações , Dióxido de Carbono , Bovinos , Cicatriz/tratamento farmacológico , Cicatriz/etiologia , Cicatriz/patologia , Fator 2 de Crescimento de Fibroblastos/uso terapêutico , Humanos , Resultado do Tratamento , Fator de Necrose Tumoral alfa
3.
Clin Plast Surg ; 49(2): 313-328, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35367038

RESUMO

Calf augmentation is a very gratifying procedure with immediate and reproducible results. The procedure can be successfully performed by novice and expert surgeons alike, making sure to respect anatomic boundaries and avoiding over dissection. Major complications can be avoided with meticulous closure of the wound and restriction of activity postoperatively as well as use of compression stockings until sufficient scar tissue has developed.


Assuntos
Perna (Membro) , Procedimentos Cirúrgicos Reconstrutivos , Cicatriz/etiologia , Cicatriz/prevenção & controle , Cicatriz/cirurgia , Dissecação , Humanos , Perna (Membro)/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos
4.
J Surg Orthop Adv ; 31(1): 56-60, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35377310

RESUMO

We report the results, scar appearance, and patient satisfaction of a direct anterior approach total hip arthroplasty performed through an oblique inguinal incision. Patients were separated into direct anterior THA (n = 29) or an oblique inguinal incision anterior approach (n = 41). Clinical and radiographic data was compared, scar appearance was assessed by the Vancouver Scar Scale (VSS), and satisfaction was assessed by a simple questionnaire. Harris Hip Scores significantly improved in each group (1.8×10-8) and improved similarly between groups (p ≥ 0.35). The VSS score was lower in the inguinal incision versus the standard incision group (0.68 [range 0-3] vs. 1.56 [range 0-4], p = 0.015). Scar satisfaction was higher in the inguinal incision group with 87% compared to only 32% in the standard approach. The inguinal incision approach was safe, offered similar postoperative results, and resulted in improved patient scar satisfaction compared to the standard anterior approach by using an incision that more closely resembled normal anatomy. (Journal of Surgical Orthopaedic Advances 31(1):056-060, 2022).


Assuntos
Artroplastia de Quadril , Artroplastia de Quadril/métodos , Cicatriz/diagnóstico por imagem , Cicatriz/etiologia , Humanos , Satisfação do Paciente , Período Pós-Operatório
6.
J Neuroinflammation ; 19(1): 95, 2022 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-35429978

RESUMO

BACKGROUND: Excessively deposited fibrotic scar after spinal cord injury (SCI) inhibits axon regeneration. It has been reported that platelet-derived growth factor receptor beta (PDGFRß), as a marker of fibrotic scar-forming fibroblasts, can only be activated by platelet-derived growth factor (PDGF) B or PDGFD. However, whether the activation of the PDGFRß pathway can mediate fibrotic scar formation after SCI remains unclear. METHODS: A spinal cord compression injury mouse model was used. In situ injection of exogenous PDGFB or PDGFD in the spinal cord was used to specifically activate the PDGFRß pathway in the uninjured spinal cord, while intrathecal injection of SU16f was used to specifically block the PDGFRß pathway in the uninjured or injured spinal cord. Immunofluorescence staining was performed to explore the distributions and cell sources of PDGFB and PDGFD, and to evaluate astrocytic scar, fibrotic scar, inflammatory cells and axon regeneration after SCI. Basso Mouse Scale (BMS) and footprint analysis were performed to evaluate locomotor function recovery after SCI. RESULTS: We found that the expression of PDGFD and PDGFB increased successively after SCI, and PDGFB was mainly secreted by astrocytes, while PDGFD was mainly secreted by macrophages/microglia and fibroblasts. In addition, in situ injection of exogenous PDGFB or PDGFD can lead to fibrosis in the uninjured spinal cord, while this profibrotic effect could be specifically blocked by the PDGFRß inhibitor SU16f. We then treated the mice after SCI with SU16f and found the reduction of fibrotic scar, the interruption of scar boundary and the inhibition of lesion and inflammation, which promoted axon regeneration and locomotor function recovery after SCI. CONCLUSIONS: Our study demonstrates that activation of PDGFRß pathway can directly induce fibrotic scar formation, and specific blocking of this pathway would contribute to the treatment of SCI.


Assuntos
Axônios , Cicatriz , Indóis , Regeneração Nervosa , Pirróis , Receptor beta de Fator de Crescimento Derivado de Plaquetas , Traumatismos da Medula Espinal , Animais , Axônios/efeitos dos fármacos , Axônios/patologia , Cicatriz/tratamento farmacológico , Cicatriz/etiologia , Cicatriz/metabolismo , Cicatriz/patologia , Fibrose , Indóis/farmacologia , Locomoção , Camundongos , Regeneração Nervosa/efeitos dos fármacos , Regeneração Nervosa/fisiologia , Proteínas Proto-Oncogênicas c-sis/metabolismo , Pirróis/farmacologia , Receptor beta de Fator de Crescimento Derivado de Plaquetas/antagonistas & inibidores , Receptor beta de Fator de Crescimento Derivado de Plaquetas/metabolismo , Recuperação de Função Fisiológica , Medula Espinal/patologia , Traumatismos da Medula Espinal/tratamento farmacológico , Traumatismos da Medula Espinal/metabolismo , Traumatismos da Medula Espinal/patologia
7.
J Integr Complement Med ; 28(4): 355-362, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35426735

RESUMO

Background: Objectives of soft tissue mobilization applied to cesarean section (C-section) scars are to decrease stiffness and to reduce pain. Research investigating these effects is lacking. Materials and methods: The authors conducted a descriptive, exploratory, proof-of-concept clinical study. Women aged 18 to 40 years who had undergone at least one C-section were recruited. A trained osteopath performed standardized mobilization of the C-section scar once a week for 2 weeks. Scar quality and pain characteristics, viscoelastic properties, pressure pain thresholds, and tactile pressure thresholds were measured before and after each session. Paired Student's t-tests and Friedman's test with Dunn-Bonferroni adjustment were performed to assess the immediate and short-term effects of mobilizations. Kendall's W and Cohen's d were calculated to determine effect sizes over the short term. Simple bootstrapped bias-corrected and accelerated 95% median confidence intervals were computed. Results: Thirty-two participants completed the study. The Patient and Observer Scar Assessment Scale questionnaire revealed differences with small and moderate effects for stiffness (p = 0.021, d = 0.43), relief (p < 0.001, d = 0.28), surface area (p = 0.040, d = 0.36), flexibility (p = 0.007, d = 0.52), and participant opinion (p = 0.001, d = 0.62). Mobilizations increased elasticity (p < 0.001, W = 0.11), decreased stiffness (p < 0.001, W = 0.30), and improved pressure pain thresholds (p < 0.001, W = 0.10) of the C-section, with small to moderate effects. The results also showed decreased tone and mechanical stress relaxation time, as well as increased tactile pressure thresholds at the different measurement times (p < 0.05), but trivial effect sizes (W < 0.10). Creep showed trivial effect and no significant difference (p = 0.09). Conclusion: This study showed that two sessions of mobilization of C-section scar might have a beneficial effect on some viscoelastic properties of the C-section as well as on pain. Some variables of interest useful for future empirical studies are highlighted. ClinicalTrial. Gov NCT04320355.


Assuntos
Cesárea , Cicatriz , Adolescente , Adulto , Cesárea/efeitos adversos , Cicatriz/etiologia , Feminino , Humanos , Massagem , Dor , Limiar da Dor , Gravidez , Adulto Jovem
8.
BMC Cardiovasc Disord ; 22(1): 169, 2022 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-35421939

RESUMO

BACKGROUND: Radiofrequency ablation has been shown to be a safe and effective treatment for scar-related ventricular arrhythmias (VA). Recent preliminary studies have shown that real time integration of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) images with electroanatomical map (EAM) data may lead to increased procedure efficacy, efficiency, and safety. METHODS: VOYAGE is a prospective, randomized, multicenter controlled open label study designed to compare in terms of efficacy, efficiency, and safety a CMR aided/guided workflow to standard EAM-guided ventricular tachycardia (VT) ablation. Patients with an ICD or with ICD implantation expected within 1 month, with scar related VT, suitable for CMR and multidetector computed tomography (MDCT) will be randomized to a CMR-guided or CMR-aided approach, whereas subjects unsuitable for imaging or with image quality deemed not sufficient for postprocessing will be allocated to standard of care ablation. Primary endpoint is defined as VT recurrences (sustained or requiring appropriate ICD intervention) during 12 months follow-up, excluding the first month of blanking period. Secondary endpoints will include procedural efficiency, safety, impact on quality of life and comparison between CMR-guided and CMR-aided approaches. Patients will be evaluated at 1, 6 and 12 months. DISCUSSION: The clinical impact of real time CMR-guided/aided ablation approaches has not been thoroughly assessed yet. This study aims at defining whether such workflow results in more effective, efficient, and safer procedures. If proven to be of benefit, results from this study could be applied in large scale interventional practice. Trial registrationClinicalTrials.gov, NCT04694079, registered on January 1, 2021.


Assuntos
Ablação por Cateter , Taquicardia Ventricular , Ablação por Cateter/efeitos adversos , Cicatriz/diagnóstico por imagem , Cicatriz/etiologia , Cicatriz/patologia , Meios de Contraste , Gadolínio , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Estudos Prospectivos , Qualidade de Vida , Taquicardia Ventricular/diagnóstico por imagem , Taquicardia Ventricular/etiologia
9.
Zhonghua Shao Shang Za Zhi ; 38(4): 385-388, 2022 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-35462519

RESUMO

The wound healing time, tension of wound edge, proliferation of fibroblast, and extracellular matrix deposition are the important factors of scar formation, and botulinum toxin type A can regulate the above. Prevention and treatment of scar with botulinum toxin type A is one of the hot topics of clinical research in recent years. This paper briefly reviews researches by scholars at home and abroad on the mechanism, clinical application, complications, and adverse effects of botulinum toxin type A in scar prevention and treatment.


Assuntos
Toxinas Botulínicas Tipo A , Cicatriz , Toxinas Botulínicas Tipo A/farmacologia , Toxinas Botulínicas Tipo A/uso terapêutico , Cicatriz/tratamento farmacológico , Cicatriz/etiologia , Cicatriz/prevenção & controle , Matriz Extracelular/efeitos dos fármacos , Matriz Extracelular/patologia , Fibroblastos/efeitos dos fármacos , Humanos , Cicatrização/efeitos dos fármacos
10.
Fertil Steril ; 117(5): 1099-1101, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35361484

RESUMO

OBJECTIVE: To describe a surgical technique of laparoscopic resection of a cesarean scar pregnancy (CSP) with an immediate myometrial reconstruction. The advantage of such a technique is that it is a minimally-invasive procedure that can treat the ectopic pregnancy and the defected scar at the same time with good postoperative results. DESIGN: Video article with the description of a surgical minimally-invasive technique. SETTING: Academic medical center. PATIENT(S): A 34-year-old patient, Gravida 6 Para 4 Abortus 1, with a history of 4 previous cesarean sections presented to the emergency department with abdominal pain and vaginal bleeding. The patient was hemodynamically stable. An endovaginal ultrasound revealed a viable pregnancy of 8 weeks implanted in the cesarean scar, with a residual myometrium of <1 mm. Because of increasing abdominal pain, vaginal bleeding, and a desire to preserve future fertility, an emergent laparoscopy was performed. INTERVENTION(S): Laparoscopy was performed using a CO2 AcuPulse laser device (Lumenis Inc. Salt Lake City, Utah). A continuous wave mode was used, with a power of 30 Watt and a round-shaped beam of 1.5 mm in diameter. The laser was connected to a 10-mm Hopkins endoscope 0° (Karl Storz, Tuttlingen, Germany). A complete adhesiolysis was performed, and the urinary bladder was detached from the anterior abdominal wall. The vesicouterine fold was opened to expose the isthmic part of the uterus where the ectopic pregnancy was implanted. The defected scar was resected en bloc with the pregnancy, using the laser. The limits of the resection depended on the residual myometrial thickness. We considered a myometrial thickness of >8 mm as healthy tissue. A metallic probe was introduced vaginally into the endocervix to differentiate the anterior part from the posterior part of the uterus. This probe facilitates the manipulation of the cervix and, thus, the laparoscopic intracorporeal suturing during the myometrial reconstruction. A 2-layered suturing was performed. The first layer of the suture consisted of 3 interrupted figure-of-8 sutures using a monofilament absorbable suture (Monocryl 0, ETHICON-Johnson and Johnson medical devices New Brunswick, New Jersey). A second superficial layer consisted of a continuous nonlocking suture using the same type of thread. MAIN OUTCOME MEASURE(S): Laparoscopic excision of the CSP and immediate repair of the scar defect without any postoperative complications. RESULT(S): An emergent laparoscopy was performed, with excision of the CSP and immediate reconstruction of the residual myometrium. No complications occurred, the blood loss was estimated at 200 mL, and no blood transfusion was necessary. The patient was discharged 24 hours after the intervention. Six months after surgery, the remaining myometrial thickness was between 7 mm and 9.3 mm, and no residual cesarean scar defect (isthmocele) was visualized by ultrasound. CONCLUSION(S): Cesarean scar pregnancy is a rare form of ectopic pregnancy. The incidence, however, is increasing as a consequence of the rising cesarean section rate. Different surgical and nonsurgical techniques have been described in the literature. Laparoscopic excision of a CSP is an effective and feasible technique with the advantage of an immediate myometrial reconstruction. The cesarean scar defect diminishes, and this potentially could improve the future fertility of the patient and decrease the probability of abnormal uterine bleeding and chronic pelvic pain.


Assuntos
Laparoscopia , Gravidez Ectópica , Dor Abdominal , Adulto , Cesárea/efeitos adversos , Cicatriz/diagnóstico por imagem , Cicatriz/etiologia , Cicatriz/cirurgia , Feminino , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Gravidez , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/etiologia , Hemorragia Uterina/complicações
11.
J Int Med Res ; 50(4): 3000605221095683, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35485849

RESUMO

OBJECTIVE: Implantation of the conceptus in a twin cesarean scar pregnancy (CSP) is considered the rarest type of ectopic pregnancy. Preserving the fetus in utero and effectively dealing with CSP can be challenging. This study aimed to determine the clinical value of ultrasonography by monitoring imaging changes in twin CSP following selective feticide. METHODS: Ultrasonographic and clinical data were collected from four patients with twin CSP who were treated between December 2017 and December 2018 at our hospital. RESULTS: All patients had a history of cesarean section, followed by a heterotopic CSP, with one embryo implanted into the uterine cavity and the other located in the anterior isthmus. All of the patients were pregnant with twins with double chorionic and amniotic sacs, and all gave birth in our hospital. The patients underwent feticide at 8 to 9 weeks of gestation, after which we focused on monitoring the implantation. Delivery was performed by cesarean section according to scores of an ultrasonic scoring system and clinical manifestations. The patients' uterus was preserved and they recovered. CONCLUSIONS: This study shows that ultrasound is useful for determining the timing of clinical termination of CSP by selective feticide.


Assuntos
Aborto Induzido , Gravidez Ectópica , Cesárea/efeitos adversos , Cicatriz/diagnóstico por imagem , Cicatriz/etiologia , Feminino , Humanos , Gravidez , Gravidez Ectópica/diagnóstico por imagem , Gravidez Ectópica/etiologia , Gravidez Ectópica/cirurgia , Ultrassonografia
12.
Br J Surg ; 109(4): 332-339, 2022 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-35237788

RESUMO

BACKGROUND: Tangential excision of burned tissue followed by skin grafting is the cornerstone of burn surgery. Hydrosurgery has become popular for tangential excision, with the hypothesis that enhanced preservation of vital dermal tissue reduces scarring. The aim of this trial was to compare scar quality after hydrosurgical versus conventional debridement before split-skin grafting. METHODS: A double-blind randomized within-patient multicentre controlled trial was conducted in patients with burns that required split-skin grafting. One wound area was randomized to hydrosurgical debridement and the other to Weck knife debridement. The primary outcome was scar quality at 12 months, assessed with the observer part of the Patient and Observer Scar Assessment Scale (POSAS). Secondary outcomes included complications, scar quality, colour, pliability, and histological dermal preservation. RESULTS: Some 137 patients were randomized. At 12 months, scars of the hydrosurgical debrided wounds had a lower POSAS observer total item score (mean 2.42 (95 per cent c.i. 2.26 to 2.59) versus 2.54 (95 per cent c.i. 2.36 to 2.72; P = 0.023)) and overall opinion score (mean 3.08 (95 per cent c.i. 2.88 to 3.28) versus 3.30 (95 per cent c.i. 3.09-3.51); P = 0.006). Patient-reported scar quality and pliability measurements were significantly better for the hydrosurgically debrided wounds. Complication rates did not differ between both treatments. Histologically, significantly more dermis was preserved with hydrosurgery (P < 0.001). CONCLUSION: One year after surgery scar quality and pliability was better for hydrosurgically debrided burns, probably owing to enhanced histological preservation of dermis. REGISTRATION NUMBER: Trial NL6085 (NTR6232 (http://www.trialregister.nl)).


Assuntos
Queimaduras , Cicatriz , Queimaduras/patologia , Queimaduras/cirurgia , Cicatriz/etiologia , Desbridamento , Humanos , Pele/patologia , Transplante de Pele/efeitos adversos
13.
Ocul Surf ; 24: 83-92, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35247582

RESUMO

Drug induced cicatrizing conjunctivitis (DICC) is defined as a disease in which conjunctival cicatrization develops as a response to the chronic use of inciting topical and, rarely, systemic medications. DICC accounts for up to one third of cases of pseudopemphigoid, a large group of cicatrizing conjunctival diseases sharing similar clinical features to those of mucous membrane pemphigoid (MMP) but generally without the morbidity of progressive scarring or the need for systemic immunosuppression. The preservatives in topical anti-glaucoma medications (AGM) are the most frequently implicated inciting causes of DICC although topical antivirals, vasoconstrictors and mydriatics and some systemic drugs have been implicated. The literature review summarizes the classification, epidemiology, etiopathogenesis, histopathology, clinical presentation, diagnosis, management, and treatment outcomes of DICC in the context of a case series of 23 patients (42 eyes) with AGM induced DICC, from India and the UK. In this series all subjects reacted to preserved AGM with one exception, who also reacted to non-preserved AGM. At diagnosis >70% of eyes showed punctal scarring, inflammation, and forniceal shortening. Pemphigoid studies were negative in the 19/23 patients in whom they were carried out. DICC can be classified as non-progressive, progressive with positive pemphigoid immunopathology or progressive with negative pemphigoid immunopathology. It is unclear whether progressive DICC is a stand-alone disease, or concurrent (or drug induced) ocular MMP. Progressive cases should currently be treated as ocular MMP. The diagnosis can be made clinically when there is rapid resolution of symptoms and inflammation, usually within 1-16 weeks, after withdrawal of suspected inciting medications, ideally by temporary substitution of oral carbonic anhydrase inhibitors. If the response to withdrawal is uncertain, or the progression of inflammation and scarring continues then patients must be evaluated to exclude concurrent (or drug induced) MMP, and other potential causes of CC, for which the treatment and prognosis is different. Management, in addition to withdrawing inciting medications, may require short-term treatment of conjunctival inflammation with steroids, treatment of associated corneal disease with contact lenses or surface reconstructive surgery, control of intra-ocular pressure with non-preserved AGM and, in some, surgery for glaucoma or for trichiasis and entropion.


Assuntos
Conjuntivite , Penfigoide Mucomembranoso Benigno , Penfigoide Bolhoso , Cicatriz/diagnóstico , Cicatriz/etiologia , Cicatriz/terapia , Conjuntivite/tratamento farmacológico , Conjuntivite/terapia , Humanos , Inflamação , Metaloproteinases da Matriz , Penfigoide Mucomembranoso Benigno/diagnóstico , Penfigoide Mucomembranoso Benigno/terapia , Penfigoide Bolhoso/complicações
16.
JACC Clin Electrophysiol ; 8(4): 453-461, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35246406

RESUMO

OBJECTIVES: In this study, the authors investigated the ablation success of scar homogenization with combined (epicardial + endocardial) vs endocardial-only approach for ventricular tachycardia (VT) in patients with ischemic cardiomyopathy (ICM) at 5 years of follow-up. BACKGROUND: Best ablation approach to achieve long-term success rate in VT patients with ICM is not known yet. METHODS: Consecutive ICM patients undergoing VT ablation at our center were classified into group 1: endocardial + epicardial scar homogenization and group 2: endocardial scar homogenization. Patients with previous open heart surgery were excluded. Epicardial ablation was performed despite being noninducible after endocardial ablation in all group 1 patients. All patients underwent bipolar substrate mapping with standard scar settings defined as normal tissue >1.5 mV and severe scar <0.5 mV. Noninducibility of monomorphic VT was the procedural endpoint in both groups. Patients were followed up every 4 months for 5 years with implantable device interrogations. RESULTS: A total of 361 patients (group 1: n = 70 and group 2: n = 291) were included in the study. At 5 years, 81.4% (n = 57/70) patients from group 1 and 66.3% (n = 193/291) from group 2 were arrhythmia-free (P = 0.01) Of those patients, 26 of 57 (45.6%) and 172 of 193 (89.1%) from group 1 and group 2 respectively were on anti-arrhythmic drugs (AAD) (log-rank P < 0.001). After adjusting for age, sex, and obstructive sleep apnea, endo-epicardial scar homogenization was associated with a significant reduction in arrhythmia-recurrence (HR: 0.48; 95% CI: 0.27-0.86; P = 0.02). CONCLUSIONS: In this series of patients with ICM and VT, epicardial substrate was detected in all group 1 patients despite being noninducible after endocardial ablation. Moreover, combined endo-epicardial scar homogenization was associated with a significantly higher success rate at 5 years of follow-up and a substantially lower need for antiarrhythmic drugs after the procedure compared with the endocardial ablation alone.


Assuntos
Cardiomiopatias , Ablação por Cateter , Isquemia Miocárdica , Taquicardia Ventricular , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Cicatriz/etiologia , Endocárdio/cirurgia , Humanos , Isquemia Miocárdica/complicações , Isquemia Miocárdica/cirurgia , Taquicardia Ventricular/complicações , Taquicardia Ventricular/cirurgia , Resultado do Tratamento
17.
Pharmacology ; 107(5-6): 241-249, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35354154

RESUMO

BACKGROUND: Botulinum toxin type A (BTA) has a wide range of clinical applications, and its use in improving aesthetics is one of them. The aim of this study was to better assess the efficacy and safety of BTA in patients with facial scars. SUMMARY: We extracted the data of the visual analog scale (VAS) score, Vancouver scar scale (VSS) score, scar width, observer scar assessment scale (OSAS), patient scar assessment scale (PSAS), and/or drug-related adverse events. Five studies provided the data of VAS score, and the results showed that the VAS score in the BTA group was significantly higher than that in the control group. Three randomized controlled trials (RCTs) reported the VSS score. A statistically significant difference exists between the BTA group and the control group. Three RCTs reported the scar width after BTA treatment. A more favorable change was found in the BTA group with scar width even without statistical significance. Data about the OSAS and PSAS scores were available in two trials. There was no significant difference in OSAS and PSAS scores between the BTA group and the control group. Only three studies recorded three slight adverse events. There were no reports of severe complications. In conclusions, this study demonstrated that BTA has the potential to improve facial scars with an acceptable safety profile.


Assuntos
Toxinas Botulínicas Tipo A , Apneia Obstrutiva do Sono , Toxinas Botulínicas Tipo A/efeitos adversos , Cicatriz/tratamento farmacológico , Cicatriz/etiologia , Humanos , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/tratamento farmacológico , Resultado do Tratamento
19.
Medicina (Kaunas) ; 58(3)2022 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-35334583

RESUMO

Background and Objectives: The aim of this study is to evaluate changes in uterine scar thickness after previous cesarean delivery longitudinally during pregnancy, and to correlate cesarean section (CS) scar myometrial thickness in the first trimester in two participants groups (CS scar with a niche and CS scar without a niche) with the low uterine segment (LUS) myometrial thickness changes between the second and third trimesters. Materials and Methods: In this prospective longitudinal study, pregnant women aged 18-41 years after at least one previous CS were included. Transvaginal sonography (TVS) was used to examine uterine scars after CS at 11-14 weeks. The CS scar niche ("defect") was defined as an indentation at the site of the CS scar with a depth of at least 2 mm in the sagittal plane. Scar myometrial thickness was measured, and scars were classified subjectively as a scar with a niche (niche group) or without a niche (non-niche group). In the CS scar niche group, RMT (distance from the serosal surface of the uterus to the apex of the niche) was measured and presented as CS scar myometrial thickness in the first trimester. The myometrial thickness at the internal cervical os was measured in the non-niche group. The full LUS and myometrial LUS thickness at 18-20 and 32-35 weeks of gestation were measured in the thinnest part of the scar area using TVS. Friedman's ANOVA test was used to analyse scar thickness during pregnancy and Mann-Whitney test to compare scar changes between CS scar niche and non-niche women groups. For a pairwise comparison in CS scar thickness measurements in the second and third trimesters, we used Wilcoxon Signed Ranks test. Results: A total of 122 eligible participants were recruited to the study during the first trimester of pregnancy. The scar niche was visible in 40.2% of cases. Uterine scar myometrial thickness decreases during pregnancy from 9.9 (IQR, 5.0-12.9) at the first trimester to 2.1 (IQR, 1.7-2.7) at the third trimester of pregnancy in the study population (p = 0.001). The myometrial CS scar thickness in the first trimester (over the niche) was thinner in the women's group with CS scar niche compared with the non-niche group (at internal cervical os) (p < 0.001). The median difference between measurements in the CS scar niche group and non-niche group between the second and third trimester was 2.4 (IQR, 0.8-3.4) and 1.1 (IQR, 0.2-2.6) (p = 0.019), respectively. Myometrial LUS thickness as percentage decreases significantly between the second and third trimester in the CS scar niche group compared to the non-niche group (U = 1225; z = -2.438; p = 0.015). Conclusions: CS scar myometrial thickness changes throughout pregnancy and the appearance of the CS scar niche was associated with a more significant decrease in LUS myometrial thickness between the second and third trimesters.


Assuntos
Cesárea , Cicatriz , Adolescente , Adulto , Cesárea/efeitos adversos , Cicatriz/diagnóstico por imagem , Cicatriz/etiologia , Feminino , Humanos , Estudos Longitudinais , Gravidez , Estudos Prospectivos , Ultrassonografia , Adulto Jovem
20.
J Drugs Dermatol ; 21(3): 309-310, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35254751

RESUMO

Platelet-rich plasma (PRP) is an autologous concentration of plasma from a patient’s blood containing platelets up to 7 times higher than normal plasma. Originally indicated to improve connective tissue regeneration in orthopedic surgery, PRP has also proven to be advantageous in the treatment of androgenic alopecia (AGA), alopecia areata (AA), and other forms of non-scarring alopecia.


Assuntos
Alopecia em Áreas , Lúpus Eritematoso Discoide , Plasma Rico em Plaquetas , Alopecia/etiologia , Alopecia/terapia , Alopecia em Áreas/etiologia , Alopecia em Áreas/terapia , Cicatriz/etiologia , Cicatriz/terapia , Humanos , Lúpus Eritematoso Discoide/complicações , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/terapia , Transplante Autólogo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...