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1.
Facial Plast Surg Clin North Am ; 30(1): 63-70, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34809887

RESUMO

Le Fort fractures occur at uniform weak areas in the midface often due to blunt impact to the face. Sporting injuries are a common cause of facial trauma; however, use of protective equipment has reduced the number of sports-related injuries. All patients with traumatic injuries should be evaluated using Advanced Trauma Life Support protocol. Le Fort fractures can contribute to airway obstruction, and urgent intubation may be indicated. Surgery is indicated for most displaced Le Fort fractures to restore function and facial harmony. To facilitate reduction, the original occlusive relationship should be restored by placing the patient in MMF.


Assuntos
Traumatismos Faciais , Fraturas Maxilares , Fraturas Cranianas , Face , Ossos Faciais/cirurgia , Traumatismos Faciais/etiologia , Traumatismos Faciais/cirurgia , Humanos , Osteotomia de Le Fort
2.
Am J Case Rep ; 22: e931793, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34739477

RESUMO

BACKGROUND Mediastinal emphysema, also called pneumomediastinum, is a very infrequent condition in patients reporting to an Emergency Department. Mediastinal emphysema is the pathologic presence of free air enclosing the mediastinal structures. In the case of chest pain in a young healthy adult, pneumomediastinum as a differential diagnosis will undoubtedly be omitted. This would be especially likely if the symptoms are not preceded by an injury, intense vomiting, or an infection in this area. CASE REPORT We present a case in which a previously healthy 39-year-old woman experienced painless progressive face and neck swelling, dyspnea, and retrosternal pain several hours after a dental procedure. Physical examination revealed crackles on palpation of the skin on the right part of the face, neck, and chest. Neck and chest computed tomography confirmed subcutaneous neck and upper chest emphysema and pneumomediastinum. The patient was transferred to the thoracic surgery ward. After 2 days of prophylactic intravenous administration of antibiotics, she was discharged for further scheduled treatment at the Maxillofacial Surgery Clinic. CONCLUSIONS This report presented a rare case of a woman who reported to the Emergency Department with subcutaneous and mediastinal emphysema following routine molar dental extraction. Emergency Department physicians should be aware of the possibility of delayed complications after standard dental procedures. A detailed medical history and clinical examination will enable making a correct diagnosis so as not to jeopardize the health of a patient, and in the case of the development of mediastinitis, even the patient's life.


Assuntos
Enfisema Mediastínico , Enfisema Subcutâneo , Adulto , Face , Feminino , Humanos , Enfisema Mediastínico/diagnóstico por imagem , Enfisema Mediastínico/etiologia , Pescoço , Enfisema Subcutâneo/etiologia , Extração Dentária/efeitos adversos
3.
Sci Rep ; 11(1): 21449, 2021 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-34728650

RESUMO

The World Health Organisation has called for a 40% increase in personal protective equipment manufacturing worldwide, recognising that frontline workers need effective protection during the COVID-19 pandemic. Current devices suffer from high fit-failure rates leaving significant proportions of users exposed to risk of viral infection. Driven by non-contact, portable, and widely available 3D scanning technologies, a workflow is presented whereby a user's face is rapidly categorised using relevant facial parameters. Device design is then directed down either a semi-customised or fully-customised route. Semi-customised designs use the extracted eye-to-chin distance to categorise users in to pre-determined size brackets established via a cohort of 200 participants encompassing 87.5% of the cohort. The user's nasal profile is approximated to a Gaussian curve to further refine the selection in to one of three subsets. Flexible silicone provides the facial interface accommodating minor mismatches between true nasal profile and the approximation, maintaining a good seal in this challenging region. Critically, users with outlying facial parameters are flagged for the fully-customised route whereby the silicone interface is mapped to 3D scan data. These two approaches allow for large scale manufacture of a limited number of design variations, currently nine through the semi-customised approach, whilst ensuring effective device fit. Furthermore, labour-intensive fully-customised designs are targeted as those users who will most greatly benefit. By encompassing both approaches, the presented workflow balances manufacturing scale-up feasibility with the diverse range of users to provide well-fitting devices as widely as possible. Novel flow visualisation on a model face is presented alongside qualitative fit-testing of prototype devices to support the workflow methodology.


Assuntos
Face/fisiologia , Equipamento de Proteção Individual , Fotogrametria/métodos , COVID-19/prevenção & controle , COVID-19/virologia , Desenho Assistido por Computador , Desenho de Equipamento , Face/anatomia & histologia , Humanos , Impressão Tridimensional , SARS-CoV-2/isolamento & purificação
4.
Sensors (Basel) ; 21(21)2021 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-34770646

RESUMO

Human Activity Recognition (HAR) has become increasingly crucial in several applications, ranging from motion-driven virtual games to automated video surveillance systems. In these applications, sensors such as smart phone cameras, web cameras or CCTV cameras are used for detecting and tracking physical activities of users. Inevitably, spoof detection in HAR is essential to prevent anomalies and false alarms. To this end, we propose a deep learning based approach that can be used to detect spoofing in various fields such as border control, institutional security and public safety by surveillance cameras. Specifically, in this work, we address the problem of detecting spoofing occurring from video replay attacks, which is more common in such applications. We present a new database containing several videos of users juggling a football, captured under different lighting conditions and using different display and capture devices. We train our models using this database and the proposed system is capable of running in parallel with the HAR algorithms in real-time. Our experimental results show that our approach precisely detects video replay spoofing attacks and generalizes well, even to other applications such as spoof detection in face biometric authentication. Results show that our approach is effective even under resizing and compression artifacts that are common in HAR applications using remote server connections.


Assuntos
Identificação Biométrica , Algoritmos , Computadores , Face , Atividades Humanas , Humanos
5.
J Craniofac Surg ; 32(3): e276-e278, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-34779591

RESUMO

ABSTRACT: Dermal filler injections, one of the most commonly performed procedures in facial esthetic surgery, are rising in popularity. This has also led to an increase in nonmedical grade filler injections performed by nonmedical personnel, including that of injectable silicone. Surgical removal of silicone fillers is challenging, as the hydrophobic material often disperses within the soft tissue as droplets. This can lead to a systemic inflammatory reaction requiring steroid treatment. MRI localization of the filler material does not enable intraoperative guidance, and palpitation of the material is challenging since the filler droplets are often too small to palpate and located in multiple planes. We present a case demonstrating the advantages of utilizing intraoperative ultrasound to localize and silicone filler material. Utilizing this technique, we were able to achieve a high degree of excision of silicone filler material and the patient was able to stop her previous necessary immunosuppressive steroid regimen successfully.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Face/diagnóstico por imagem , Face/cirurgia , Feminino , Humanos , Injeções , Silicones , Ultrassonografia
6.
Medicina (Kaunas) ; 57(11)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34833392

RESUMO

Background and Objectives: Vascular variations appear as morphologically distinct patterns of blood diverging from the most commonly observed vessel patterns. The facial artery is considered to be the main vessel for supplying blood to the anterior part of the face. An anatomical understanding of the facial artery, its course, its topography, and its branches is important in medical and dental practice (especially in neck and face surgery), and is also essential for radiologists to be able to interpret vascular imaging in the face following angiography of the region. A profound knowledge of the arteries in the region will aid in minimizing the risks to the patient. Materials and Methods: In our publication a narrative literature review and a case report are presented. Results: A rare case of a facial artery pattern has been described anatomically for the first time with respect to its course and branching. This variation was found on the left side of a 60-year-old male corpse during anatomical dissection. The anterior branch of the facial artery arched in the direction of the labial angle, and there divided into the inferior and superior labial arteries. At the same time, the posterior branch coursed vertically and superficially to the masseter muscle. It here gave off the premasseteric branch, and continued towards the nose, where it ran below the levator labii superioris and the levator labii superioris alaeque nasi muscles and terminated at the dorsum nasi. Conclusions: Our review of the literature and the case report add to knowledge on the facial artery with respect to its topographical anatomy and its branching and termination patterns, as well as the areas of supply. An exact knowledge of individual facial artery anatomy may play an important role in the planning of flaps or tumor excisions due to the differing vascularization and can also help to prevent artery injuries during aesthetic procedures such as filler and botulinum toxin injections.


Assuntos
Artérias , Face , Artérias/diagnóstico por imagem , Cadáver , Face/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Nariz , Retalhos Cirúrgicos
7.
Sensors (Basel) ; 21(22)2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34833572

RESUMO

In recent times, as interest in stress control has increased, many studies on stress recognition have been conducted. Several studies have been based on physiological signals, but the disadvantage of this strategy is that it requires physiological-signal-acquisition devices. Another strategy employs facial-image-based stress-recognition methods, which do not require devices, but predominantly use handcrafted features. However, such features have low discriminating power. We propose a deep-learning-based stress-recognition method using facial images to address these challenges. Given that deep-learning methods require extensive data, we constructed a large-capacity image database for stress recognition. Furthermore, we used temporal attention, which assigns a high weight to frames that are highly related to stress, as well as spatial attention, which assigns a high weight to regions that are highly related to stress. By adding a network that inputs the facial landmark information closely related to stress, we supplemented the network that receives only facial images as the input. Experimental results on our newly constructed database indicated that the proposed method outperforms contemporary deep-learning-based recognition methods.


Assuntos
Aprendizado Profundo , Reconhecimento Facial , Bases de Dados Factuais , Face , Expressão Facial
8.
Wiad Lek ; 74(9 cz 2): 2340-2344, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34824181

RESUMO

OBJECTIVE: The aim: Facial and leg telangiectasia are usual cosmetic concern for females who have different skin phototypes and ages. Until now, the various treatments for these problem have frequently failed or led to unwanted side-effects. Based on approved pre-calculated doses, the present study highlights the clinical effects and safety of treatment after using the exact laser parameters from 1064-nm Nd: YAG laser. PATIENTS AND METHODS: Materials and methods: Twenty people with facial and leg telangiectasia underwent a single laser treatment, based on pre-calculated laser parameters for each case. RESULTS: Results: All subjects showed visible improvement, with 95-100% clearance of face telangiectasia directly after the first treatment, and 50-100% clearance of the lower extremity vessels after one to three days; with minimal side-effects. CONCLUSION: Conclusions: Treatment of facial and leg telangiectasia by using true, exact, and mathematically pre-calculated parameters of long pulse 1064 nm Nd: YAG laser was an effective and safe procedure of clearing face and leg telangiectasia.


Assuntos
Terapia a Laser , Telangiectasia , Face , Feminino , Humanos , Lasers , Perna (Membro) , Pele , Telangiectasia/cirurgia , Resultado do Tratamento
9.
Am J Orthod Dentofacial Orthop ; 160(6): 862-871, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34814981

RESUMO

INTRODUCTION: The objective of this study was to compare the accuracy of 3-dimensional (3D) digital facial photographs taken by the Bellus3D Face Camera Pro (Bellus3D) (Bellus3D Inc, Los Gatos, Calif) and the 3dMDface system (3dMD) (3dMD Inc, Atlanta, Ga) with one another and with direct anthropometry (DA). METHODS: A mannequin head was selected as the research object. Twenty facial landmarks were labeled on the basis of the 8 interlandmark distances and 5 angles that were defined. A 150-mm digital Vernier caliper (Mitutoyo Inc, Tokyo, Japan) with an accuracy of 0.02 mm was applied to directly measure the interlandmark distances, and the angles were calculated according to the law of cosines. All the measurements were conducted 3 times by each operator under identical conditions. Then, each scanner was used to acquire 3D photographs 5 times, generating 10 digital stereophotographs. Linear distances and angles were measured on the 3D facial photographs reconstructed with open-source MeshLab software (ISTI [Italian National Research Council], Rome, Italy). Each linear distance and angle were measured 3 times by 1 operator, and 3 examiners conducted the measurements independently. To obtain the trueness, equivalence tests were applied to compare the measurements of the 2 scanners and DA. In addition, the average absolute deviations were calculated to directly compare the trueness of 3 methods (Bellus3D vs 3dMD vs DA). Finally, the intraclass correlation coefficient was used to assess the interobserver agreement and the precision of 2 scanners. RESULTS: As for the trueness, 7 out of 8 of the linear distance measurements (N-Pn, Sn-Pog, ORE-IRE, OLE-ILE, RLC-RMC, LLC-LMC, and CR-CL) and 3 out of 5 of the angular measurements (MLA, NFA, and INI) obtained by 3dMD were equivalent to those obtained by DA. Five out of 8 measurements (N-Pn, Sn-Pog, RLC-RMC, LLC-LMC, and CR-CL) and 1 out of 5 of the angular measurements (MLA) obtained by Bellus3D were equivalent to the measurements obtained with DA. All but 3 of the measurements (ORE-IRE, NFA, and INI) obtained with Bellus3D were equivalent to 3dMD. The mean absolute difference between 3dMD and DA was 0.36 ± 0.20 mm and 0.45° ± 0.56°; the deviation between Bellus3D and DA was 0.61 ± 0.47 mm and 0.99° ± 0.61°; and the deviation between Bellus3D and 3dMD was 0.38 ± 0.37 mm and 0.62° ± 0.39°. Regarding the precision of the 2 scanners, the intraclass correlation coefficient value of 3dMD was approximately 1.00, and that of Bellus3D was 0.99. The interobserver agreement for each linear and angular measurement was 0.99. CONCLUSIONS: The trueness of each scanner was clinically acceptable for diagnosis and treatment planning. The precision of 3D photographs obtained by 3dMD and Bellus3D showed good scanning repeatability. The interobserver agreement between the 3 operators was rated as excellent (0.99).


Assuntos
Imageamento Tridimensional , Fotogrametria , Antropometria , Face/anatomia & histologia , Face/diagnóstico por imagem , Humanos , Reprodutibilidade dos Testes
10.
Orv Hetil ; 162(47): 1871-1875, 2021 11 21.
Artigo em Húngaro | MEDLINE | ID: mdl-34801985

RESUMO

Összefoglaló. Az agy és a szem vascularis katasztrófái számos esetben egymáshoz társuló vagy egymást elore jelzo kórképek. Az arteria centralis retinae occlusio az ér rekanalizációjának hiányában a retina szöveteinek irreverzibilis károsodását okozza. Sem a nemzetközi, sem a hazai stroke-irányelvek nem foglalkoznak az ocularis stroke problémakörével, annak ellenére, hogy az arteria centralis retinae occlusio okozta retinalis ischaemia minden tekintetben megfelel az akut ischaemiás stroke definíciójának. Az eddig rendelkezésre álló irodalmi adatok alapján arteria centralis retinae occlusio esetén az intravénás thrombolysis 4,5 órán belül alkalmazva növeli a szignifikáns mértéku visusjavulás esélyét. Az országban jelenleg 4 centrum (Pécsi Tudományegyetem, Szegedi Tudományegyetem, Debreceni Egyetem, Semmelweis Egyetem) tervezi az ocularis stroke kezelésében a thrombolysis bevezetését. A maradandó látásromlás és a szekunder cerebrovascularis események megelozése érdekében elengedhetetlen az alapellátásban és a társszakmákban dolgozó kollégákkal való szoros együttmuködés. Orv Hetil. 2021; 162(47): 1871-1875. Summary. Vascular events of the brain and the eye may occur concomitantly or sequentially. In the absence of recanalization, central retinal artery occlusion causes irreversible damage to the retinal tissues. Even though retinal ischemia secondary to central retinal artery occlusion meets the definition of acute ischemic stroke, neither the international nor the Hungarian stroke guidelines mention ocular stroke. Based on the available literature, intravenous thrombolysis of the central retinal artery within 4.5 hours of occlusion can increase the odds of significant vision improvement. Currently 4 centers (University of Pécs, Debrecen, Szeged, and Semmelweis University) are planning to introduce thrombolysis in the treatment of ocular stroke. To prevent permanent visual loss and secondary cerebrovascular events, timely intervention requires the collaboration between general practitioners and other specialties. Orv Hetil. 2021; 162(47): 1871-1875.


Assuntos
Isquemia Encefálica , Oclusão da Artéria Retiniana , Acidente Vascular Cerebral , Olho , Face , Humanos , Oclusão da Artéria Retiniana/tratamento farmacológico , Acidente Vascular Cerebral/tratamento farmacológico
11.
J Craniofac Surg ; 32(8): e784-e787, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34727455

RESUMO

ABSTRACT: This review aims to introduce the role of facial expression in communication, the areas involved in facial expression especially the eye and eyebrow, the "Poem of the Eyebrow" (Blason du Sourcil), and preferred brow archetypes.The ability to interpret and respond properly to facial expressions contributes to emotional self-competence and satisfactory social and cognitive development. Certain areas may intensify the emotional message, clarifying the expression and reducing ambiguity. Specific facial areas might make expressions more difficult to interpret. The region of the eye is the most prominent facial region for emotion interpretation. Roles of eyebrow density and position in the interpretation of facial expression of emotion depend, at least in part, upon the emotion being expressed. For face recognition, the eyebrows may be at least as influential as the eyes.French poet Maurice Sceve wrote "Poem to the Eyebrow." This poem contains some noteworthy verses about the function of the eyebrow: Eyebrow that makes the boldest fearful, and gives courage to even cowards.Among brow archetypes, "Anastasia type" (brow starts on a perpendicular line drawn from the middle of the nostril, arches on a line drawn from the center of the nose through the center of the pupil, and ends on a line drawn from the edge of the corresponding nasal ala through the outer edge of the eye) was the most preferred. The middle brow height was most preferred (the distance from the lateral canthus to the lateral end of eyebrow is two-thirds of the eye width).


Assuntos
Sobrancelhas , Expressão Facial , Pálpebras , Face , Humanos , Nariz
12.
J Appl Oral Sci ; 29: e20210199, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34644780

RESUMO

OBJECTIVE: To assess craniofacial changes from early adulthood to the seventh decade of life in individuals with normal occlusion. METHODOLOGY: The sample comprised lateral cephalograms of 21 subjects with normal occlusion (11 male, 10 female), taken at 17 (T1) and 61 years of age (T2). Anteroposterior and vertical maxillomandibular relationships, and dentoalveolar and soft tissue changes were analyzed. Interphase comparisons were performed using paired t-tests. Differences between sexes, and subgroups with and without tooth loss were evaluated using t-tests (p<0.05). RESULTS: Maxillary and mandibular anterior displacement, and facial and ramus height increased from T1 to T2. Maxillary molars showed significant mesial angulation. Maxillary and mandibular molars, and mandibular incisors developed vertically during the evaluation period. Soft tissue changes included a decrease of the nasolabial angle, upper and lower lip retrusion, decrease of upper lip thickness and increase of the lower lip and soft chin thickness. Maxillary incisor exposure by the upper lip decreased 3.6 mm in 40 years. Males presented counterclockwise rotation of the mandible, whereas females showed mandibular clockwise rotation and backward displacement of the chin. The group with tooth loss showed a greater increase of the posterior facial height and ramus height. CONCLUSION: We observed aging changes in dentoskeletal structures and soft tissue, as well as sexual differences for craniofacial changes during the maturational process. Subjects with multiple tooth losses showed a greater increase in mandibular ramus height.


Assuntos
Face , Mandíbula , Adulto , Envelhecimento , Cefalometria , Face/anatomia & histologia , Feminino , Humanos , Incisivo , Masculino , Maxila
13.
Sensors (Basel) ; 21(20)2021 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-34695939

RESUMO

To capture scientific evidence in elderly care, a user-defined facial expression sensing service was proposed in our previous study. Since the time-series data of feature values have been growing at a high rate as the measurement time increases, it may be difficult to find points of interest, especially for detecting changes from the elderly facial expression, such as many elderly people can only be shown in a micro facial expression due to facial wrinkles and aging. The purpose of this paper is to implement a method to efficiently find points of interest (PoI) from the facial feature time-series data of the elderly. In the proposed method, the concept of changing point detection into the analysis of feature values is incorporated by us, to automatically detect big fluctuations or changes in the trend in feature values and detect the moment when the subject's facial expression changed significantly. Our key idea is to introduce the novel concept of composite feature value to achieve higher accuracy and apply change-point detection to it as well as to single feature values. Furthermore, the PoI finding results from the facial feature time-series data of young volunteers and the elderly are analyzed and evaluated. By the experiments, it is found that the proposed method is able to capture the moment of large facial movements even for people with micro facial expressions and obtain information that can be used as a clue to investigate their response to care.


Assuntos
Face , Expressão Facial , Idoso , Envelhecimento , Humanos , Movimento
14.
Shanghai Kou Qiang Yi Xue ; 30(4): 389-393, 2021 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-34693432

RESUMO

PURPOSE: This study investigated the effectiveness of orofacial myofunctional therapy(OMT) in improving facial morphology of children with obstructive sleep apnea (OSA) after adenotonsillectomy (AT). METHODS: Ten children aged from 4-7 years with persistent oral breathing for more than 1 month after adenotonsillectomy were chosen to receive orofacial myofunctional therapy. The patients were required to take photos before and after orofacial myofunctional therapy. In order to compare the soft changes before and after OMT treatment, twelve representative mark points were selected and used for proportion and angle measurements. Graphpad Prism 8 statistical software was used for statistical analysis, to compare the differences in facial morphology of patients before and after treatment. RESULTS: Compared with before OMT, a significant difference was found in the proportion of Sn-Ls/Sn-Stms(P=0.0002), Sn-Stms/Sn-Me'(P<0.05), as well as in the angle of Gs-Sn-Pos (P<0.05), nasolabial angle(P=0.0005), mentolabial angle (P=0.0026) after OMT treatment. CONCLUSIONS: Orofacial myofunctional therapy can be considered as an effective complementary treatment for OSA patients with oral breathing after adenotonsillectomy.


Assuntos
Apneia Obstrutiva do Sono , Tonsilectomia , Adenoidectomia , Criança , Face , Humanos , Terapia Miofuncional , Apneia Obstrutiva do Sono/terapia
15.
Ophthalmologe ; 118(10): 981, 2021 10.
Artigo em Alemão | MEDLINE | ID: mdl-34609580

Assuntos
Olho , Face , Humanos
16.
Sensors (Basel) ; 21(19)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34640848

RESUMO

Frequent spontaneous facial self-touches, predominantly during outbreaks, have the theoretical potential to be a mechanism of contracting and transmitting diseases. Despite the recent advent of vaccines, behavioral approaches remain an integral part of reducing the spread of COVID-19 and other respiratory illnesses. The aim of this study was to utilize the functionality and the spread of smartwatches to develop a smartwatch application to identify motion signatures that are mapped accurately to face touching. Participants (n = 10, five women, aged 20-83) performed 10 physical activities classified into face touching (FT) and non-face touching (NFT) categories in a standardized laboratory setting. We developed a smartwatch application on Samsung Galaxy Watch to collect raw accelerometer data from participants. Data features were extracted from consecutive non-overlapping windows varying from 2 to 16 s. We examined the performance of state-of-the-art machine learning methods on face-touching movement recognition (FT vs. NFT) and individual activity recognition (IAR): logistic regression, support vector machine, decision trees, and random forest. While all machine learning models were accurate in recognizing FT categories, logistic regression achieved the best performance across all metrics (accuracy: 0.93 ± 0.08, recall: 0.89 ± 0.16, precision: 0.93 ± 0.08, F1-score: 0.90 ± 0.11, AUC: 0.95 ± 0.07) at the window size of 5 s. IAR models resulted in lower performance, where the random forest classifier achieved the best performance across all metrics (accuracy: 0.70 ± 0.14, recall: 0.70 ± 0.14, precision: 0.70 ± 0.16, F1-score: 0.67 ± 0.15) at the window size of 9 s. In conclusion, wearable devices, powered by machine learning, are effective in detecting facial touches. This is highly significant during respiratory infection outbreaks as it has the potential to limit face touching as a transmission vector.


Assuntos
COVID-19 , Face , Feminino , Humanos , Aprendizado de Máquina , SARS-CoV-2 , Máquina de Vetores de Suporte
17.
BMJ Case Rep ; 14(9)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593546

RESUMO

Subcutaneous emphysema is a possible but infrequent consequence of dental procedures. We present the case of a 6-year-old healthy boy transferred from a dental clinic immediately after local anaesthesia for tooth extraction, due to sudden orbital and facial swelling. On physical examination, oedema of the left upper eyelid with fine crepitus on palpation and left hemiface oedema with local pain were observed. Ophthalmologic observation was normal. CT scan of the face and orbits documented extensive infiltration of the subcutaneous tissue planes of the left face by air, with extension to the external part of the body of the mandible, retromaxillary fat, masticatory muscle spaces, parapharyngeal space and adjacent to the orbital roof. After completing initial evaluation, the dentist confirmed the use of an air-driven device during local anaesthesia administration. The patient improved with conservative treatment. Early recognition of this condition is essential to provide an adequate clinical assessment with exclusion of possible life-threatening complications.


Assuntos
Enfisema , Enfisema Mediastínico , Enfisema Subcutâneo , Criança , Face , Humanos , Masculino , Mandíbula , Enfisema Subcutâneo/diagnóstico por imagem , Enfisema Subcutâneo/etiologia , Tomografia Computadorizada por Raios X , Extração Dentária/efeitos adversos
18.
FASEB J ; 35(11): e21955, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34613626

RESUMO

Kabuki syndrome (KS) is a rare genetic disorder caused primarily by mutations in the histone modifier genes KMT2D and KDM6A. The genes have broad temporal and spatial expression in many organs, resulting in complex phenotypes observed in KS patients. Hypotonia is one of the clinical presentations associated with KS, yet detailed examination of skeletal muscle samples from KS patients has not been reported. We studied the consequences of loss of KMT2D function in both mouse and human muscles. In mice, heterozygous loss of Kmt2d resulted in reduced neuromuscular junction (NMJ) perimeter, decreased muscle cell differentiation in vitro and impaired myofiber regeneration in vivo. Muscle samples from KS patients of different ages showed presence of increased fibrotic tissue interspersed between myofiber fascicles, which was not seen in mouse muscles. Importantly, when Kmt2d-deficient muscle stem cells were transplanted in vivo in a physiologic non-Kabuki environment, their differentiation potential is restored to levels undistinguishable from control cells. Thus, the epigenetic changes due to loss of function of KMT2D appear reversible through a change in milieu, opening a potential therapeutic avenue.


Assuntos
Anormalidades Múltiplas/metabolismo , Diferenciação Celular/genética , Proteínas de Ligação a DNA/metabolismo , Face/anormalidades , Doenças Hematológicas/metabolismo , Histona-Lisina N-Metiltransferase/metabolismo , Células Musculares/metabolismo , Fibras Musculares Esqueléticas/metabolismo , Proteína de Leucina Linfoide-Mieloide/metabolismo , Proteínas de Neoplasias/metabolismo , Transdução de Sinais/genética , Doenças Vestibulares/metabolismo , Anormalidades Múltiplas/genética , Adolescente , Animais , Criança , Pré-Escolar , Proteínas de Ligação a DNA/genética , Modelos Animais de Doenças , Feminino , Doenças Hematológicas/genética , Histona-Lisina N-Metiltransferase/genética , Humanos , Lactente , Masculino , Camundongos , Camundongos Transgênicos , Células Musculares/patologia , Mutação , Proteína de Leucina Linfoide-Mieloide/genética , Proteínas de Neoplasias/genética , Junção Neuromuscular/genética , Junção Neuromuscular/metabolismo , Doenças Vestibulares/genética
19.
J Craniofac Surg ; 32(7): 2384-2387, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705383

RESUMO

ABSTRACT: Facial feminization surgery (FFS) with its proven safety and efficacy has become a mainstay surgical approach for those desiring gender-specific perceived feminine facial aesthetics. To date, specific characteristics of patients seeking FFS have been limited, with no studies investigating the role of the Human Immunodeficiency Virus (HIV) on FFS outcomes. The potential clinical implications of HIV and more specifically HIV-associated lipodystrophy, which can cause facial lipoatrophy, require further investigation. Given the importance of midface projection in feminizing the face, the authors aimed to investigate any associations HIV or Highly Active Antiretroviral Therapy may have on outcomes, including clinical consequences of facial lipoatrophy. The authors performed a retrospective chart review of all patients with a diagnosis of gender dysphoria referred to the senior author (EDR) for FFS between 2017 and 2020. Patients were grouped based on HIV status and demographics, history, and outcomes were assessed. Seventy-seven patients were included, with 28 patients (36.4%) having a diagnosis of HIV. A total of 25 (32.5%) and 23 (29.9%) patients underwent malar fat grafting and cheek implants, respectively. No significant difference was found between HIV-positive and HIV-negative patients when looking at the use of malar fat grafting, cheek implants, age, or complication rates. To the best of our knowledge, this study presents the largest cohort of HIV status assessment of FFS patients to date. Future studies, particularly on the long-term outcomes, are warranted, as is continued information sharing among providers and centers performing FFS, in order to continue advancing the literature and subsequently patient care.


Assuntos
Implantes Dentários , Feminização , Estética Dentária , Face/cirurgia , Humanos , Masculino , Estudos Retrospectivos
20.
J Craniofac Surg ; 32(7): 2397-2400, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705385

RESUMO

BACKGROUND: The demand for facial feminization surgery (FFS) amongst transgender women is on the rise, and requests for a single-stage full FFS (F-FFS) are becoming more frequent. The specific aim of this article is to present our institutional experience with both partial-FFS (P-FFS) and F-FFS with a specific emphasis on safety of each approach. METHODS: We examined the electronic medical record of all patients with the diagnosis of gender dysphoria that were referred to the senior author for FFS consultation at our institution, between June 2017 and October 2020. Patients were sub-grouped into those who underwent F-FFS (upper, middle, and lower facial thirds in a single anesthetic event) and those who underwent P-FFS. Univariate analysis was used to assess for difference in postoperative complications. RESULTS: We identified 77 patients who underwent 382 total procedures. The mean follow-up time was 7.5 months (Sd = 7.3) (interquartile range 1.75-12.0 months). Fifty-one (71.4%) patients underwent F-FFS and 21 (28.6%) patients underwent P-FFS. Compared to P-FFS, F-FFS was not associated with an increase in postoperative complication (1 out of 21 [4.8%] versus 4 out of 51 [7.8%]) ( P < 0.556). When comparing characteristics of patients with postoperative complications to patients with no postoperative complications, the average body mass index was significantly higher (30.9 versus 25.4, respectively). ( P < 0.029). CONCLUSIONS: Full-FFS is a set of procedures that has gained increased popularity among male-to-female transgender patients. Our results support the understanding that F-FFS is a safe and reliable approach, which may be preferable to patients and providers alike.


Assuntos
Disforia de Gênero , Transexualidade , Face/cirurgia , Feminino , Feminização , Disforia de Gênero/cirurgia , Humanos , Masculino , Estudos Retrospectivos , Transexualidade/cirurgia
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