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1.
Arq. bras. oftalmol ; 82(6): 511-513, Nov.-Dec. 2019. graf
Artigo em Inglês | LILACS | ID: biblio-1038696

RESUMO

ABSTRACT Facial filler injection for soft-tissue augmentation, wrinkle reduction, and rejuvenation has recently become increasingly popular. This procedure is well accepted and widely performed because of its safety and excellent outcomes. However, complications may occur even in the most skilled hands. A 36-year-old female presented with immediate loss of vision in her right eye following the periocular injection of cosmetic hyaluronic acid facial filler into the glabellar region. The visual loss was accompanied by weakness of her left arm. Blindness may complicate cosmetic facial filler injection. The treating physician should have a firm knowledge of the facial vascular anatomy, and the patient should be aware of the potential blinding complications associated with facial filler injection.


RESUMO A injeção de preenchimento facial para o aumento de tecido mole, redução de rugas e rejuvenescimento tornou-se recentemente3 cada vez mais popular. Este procedimento é bem aceito e amplamente realizado devido à sua segurança e excelentes resultados. Porém, complicações podem ocorrer mesmo nas mãos mais habilidosas. Uma mulher de 36 anos apresentou perda da visão no seu olho direito imediatamente após uma injeção periocular de preenchimento facial à base de ácido hialurônico cosmético na região glabelar. A perda visual foi acompanhada de fraqueza no braço esquerdo. A cegueira pode ser uma complicação da injeção de preenchimento facial para fins cosméticos. O médico deve ter um sólido conhecimento da anatomia vascular da face e o paciente deve estar ciente das possíveis complicações associadas à injeção de preenchimento facial.


Assuntos
Humanos , Feminino , Adulto , Cegueira/induzido quimicamente , Face , Preenchedores Dérmicos/efeitos adversos , Ácido Hialurônico/efeitos adversos , Descolamento Retiniano/induzido quimicamente , Injeções Intradérmicas/efeitos adversos , Técnicas Cosméticas/efeitos adversos
2.
Arq Bras Oftalmol ; 82(6): 511-513, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31531542

RESUMO

Facial filler injection for soft-tissue augmentation, wrinkle reduction, and rejuvenation has recently become increasingly popular. This procedure is well accepted and widely performed because of its safety and excellent outcomes. However, complications may occur even in the most skilled hands. A 36-year-old female presented with immediate loss of vision in her right eye following the periocular injection of cosmetic hyaluronic acid facial filler into the glabellar region. The visual loss was accompanied by weakness of her left arm. Blindness may complicate cosmetic facial filler injection. The treating physician should have a firm knowledge of the facial vascular anatomy, and the patient should be aware of the potential blinding complications associated with facial filler injection.


Assuntos
Cegueira/induzido quimicamente , Preenchedores Dérmicos/efeitos adversos , Face , Ácido Hialurônico/efeitos adversos , Adulto , Técnicas Cosméticas/efeitos adversos , Feminino , Humanos , Injeções Intradérmicas/efeitos adversos , Descolamento Retiniano/induzido quimicamente
3.
Skin Res Technol ; 25(6): 835-838, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31215072

RESUMO

BACKGROUND: Clinically, depigmentation after local corticosteroid injection is not rare. But there are less articles about its reflectance confocal microscopy (RCM) and histological features. This study aimed to define the RCM features and histopathologic findings of hypopigmentation after local corticosteroid injection and to analyze the correlations between the above two methods. METHODS: Forty cases with hypopigmentation after local corticosteroid injection were used to analyze the clinical and RCM features. Subsequently, for 20 of 40, an excision biopsy of the same imaged areas for histopathologic examination was executed. RESULTS: Our results showed that all 40 cases had round or ellipse hypopigmented macules with obscure boundary and 26 of 40 lesions' long diameter went along limbs. The RCM features and the histological findings revealed all patients had variable degrees of epidermal thinning, flattening rete ridges, reduced melanin, and no inflammatory cell infiltration. MART-1 analysis revealed the number of melanocytes was normal but with no or less melanin by Fontana-Masson staining. CONCLUSIONS: Depigmentation after local corticosteroid injection was a kind of disease with intact melanocytes, whose function was impaired. RCM features offer a high consistency with histopathologic findings. It thus constitutes a promising adjuvant tool for its diagnosis and for therapeutic follow-up.


Assuntos
Corticosteroides/efeitos adversos , Hipopigmentação , Microscopia Confocal/métodos , Pele , Corticosteroides/administração & dosagem , Adulto , Idoso , Feminino , Histocitoquímica , Humanos , Hipopigmentação/induzido quimicamente , Hipopigmentação/diagnóstico por imagem , Hipopigmentação/patologia , Injeções Intradérmicas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Pele/química , Pele/diagnóstico por imagem , Pele/patologia
4.
Plast Reconstr Surg ; 143(6): 1277e-1289e, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31136496

RESUMO

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Process several patient-specific factors before reaching an optimal treatment strategy with appreciation for facial balance. 2. Define the advantages and disadvantages of various hyaluronic acid preparations and delivery techniques, to achieve a specific goal. 3. Perform advanced facial rejuvenation techniques adapted to each facial zone, combining safety considerations. 4. Prevent and treat complications caused by inadvertent intraarterial injections of hyaluronic acid. SUMMARY: The growing sophistication and diversity of modern hyaluronic acid fillers combined with an increased understanding of various delivery techniques has allowed injectable filler rejuvenation to become a customizable instrument offering a variety of different ways to improve the face: volume restoration, contouring, balancing, and feature positioning/shaping-beyond simply fading skin creases. As more advanced applications for hyaluronic acid facial rejuvenation are incorporated into practice, an increased understanding of injection anatomy is important to optimize patient safety.


Assuntos
Preenchedores Dérmicos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Rejuvenescimento/fisiologia , Técnicas Cosméticas , Feminino , Humanos , Injeções Intradérmicas/efeitos adversos , Injeções Intradérmicas/métodos , Lábio/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Dor/prevenção & controle , Fatores de Risco , Envelhecimento da Pele/efeitos dos fármacos , Pigmentação da Pele/fisiologia
5.
Dermatol Surg ; 45(12): 1598-1604, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30893167

RESUMO

BACKGROUND: VYC-12 is a novel hyaluronic acid-based dermal filler designed to treat fine lines and improve skin quality. A specialist digital camera and proprietary Digital Analysis of the Cutaneous Surface (DACS) software have previously been used to objectively measure changes in skin features. OBJECTIVE: To assess the effect of facial treatment with VYC-12 on skin texture using the specialist camera. MATERIALS AND METHODS: This was a prospective, open-label, 2-center study of 40 women aged 35 to 60 years treated with multiple, microdepot intradermal injections of VYC-12 (2 mL in the face; 1 mL in the neck if required). Eight patients (20.0%) required a touch-up at Day 45. Images were acquired using the specialist camera at baseline and 45 days and 6 months after treatment, and were analyzed by DACS. Clinical improvements were also assessed subjectively using the Global Aesthetic Improvement Scale (GAIS). RESULTS: VYC-12 improved skin texture from baseline after 45 days (mean improvement: 25.9% ± 9.2%) and 6 months (mean improvement: 30.7% ± 18.2%). Improvements were also evident using the GAIS. There were no major adverse events. CONCLUSIONS: VYC-12 improves skin quality, as measured using an objective, fast, and reproducible measuring tool. VYC-12 represents a valuable addition to the treatment armamentarium.


Assuntos
Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Dor Processual/diagnóstico , Envelhecimento da Pele/efeitos dos fármacos , Adulto , Preenchedores Dérmicos/efeitos adversos , Estética , Face/diagnóstico por imagem , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Processamento de Imagem Assistida por Computador , Injeções Intradérmicas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Processual/etiologia , Satisfação do Paciente , Fotografação , Estudos Prospectivos , Pele/efeitos dos fármacos , Resultado do Tratamento
6.
MCN Am J Matern Child Nurs ; 44(2): 108-114, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30807328

RESUMO

BACKGROUND: Treating pain during immunization should be a part of pediatric primary healthcare around the world, as untreated pain in children has short- and long-term consequences. Few studies of pharmacologic and nonpharmacologic methods of pain relief during immunization have been conducted in low- and middle-income countries. Finding pain-mitigating interventions that are low-cost, effective, and feasible across all settings, including with low-resourced settings could improve primary healthcare. PURPOSE: To evaluate the effectiveness of oral sucrose versus breastfeeding as methods of pain management during immunization of infants through 6 months of age. METHODS: A randomized controlled experimental design was used; 120 infants were randomly assigned to control, sucrose, or breastfeeding groups. Data were collected in an Egyptian primary health center. Outcome measures including pain (as per the FLACC pain scale), crying time, and heart rate were measured at three time points. RESULTS: There were significant differences in pain scores and crying duration during and after immunization (p < .001) for the breastfeeding group compared with the sucrose and control groups. IMPLICATIONS FOR PRACTICE: Health staff and parents need education and support in use of breastfeeding for pain management during immunization. More studies are needed to evaluate effectiveness of breastfeeding versus other pain management methods for managing infants' immunization-related pain.


Assuntos
Aleitamento Materno/métodos , Imunização/efeitos adversos , Manejo da Dor/normas , Dor/tratamento farmacológico , Sacarose/uso terapêutico , Análise de Variância , Egito , Feminino , Humanos , Lactente , Injeções Intradérmicas/efeitos adversos , Injeções Intradérmicas/métodos , Masculino , Dor/etiologia , Manejo da Dor/métodos , Medição da Dor/métodos , Sacarose/administração & dosagem
8.
J Cosmet Dermatol ; 18(3): 788-797, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29921041

RESUMO

BACKGROUND: Striae distensae are very common cutaneous disorders that produce great psychological stress for women. OBJECTIVE: measure and compare between efficacy and tolerability of three modalities for treatment of striae distensae. PATIENTS AND METHODS: Forty-five female patients with striae distensae were randomly selected from the outpatient dermatology clinics of Al-Zahra university Hospital within 6 months period. Patients divided into three groups according to the therapeutic modalities were used. Group A: treated with carboxytherapy using carbon dioxide (CO2) injection, Group B: where patients were treated with intradermal injection of autologous platelet-rich plasma (PRP), and Group C: where we used tripolar radiofrequency (RF) for treatment. RESULTS: All treated groups showed overall clinical improvement as regards the width, texture, and overall improvement after treatment (P > .05), with no statistically significant differences between the three groups. Patient's satisfaction was statistically significantly better in both group C (93.33%) and group A (80%) while group B (53.33%) was less with minimal side effects such as pain and ecchymosis, which were more frequent in group B than the other two groups; but with no statistically significance differences both groups A and C were effective with no significant differences in both types of striae and in any site of the body but group B is significantly more effective on striae rubra on trunk, with better improvement of lesions texture. CONCLUSION: The three modalities of treatments proved to be effective clinically and histopathologically in treating both types of striae, which were well tolerated by the patients with minimal, transient side effects and our study results gave us guidelines for their clinical application.


Assuntos
Dióxido de Carbono/administração & dosagem , Técnicas Cosméticas/efeitos adversos , Plasma Rico em Plaquetas , Terapia por Radiofrequência , Estrias de Distensão/terapia , Adulto , Dióxido de Carbono/efeitos adversos , Equimose/epidemiologia , Equimose/etiologia , Feminino , Humanos , Injeções Intradérmicas/efeitos adversos , Dor/epidemiologia , Dor/etiologia , Satisfação do Paciente , Ondas de Rádio/efeitos adversos , Resultado do Tratamento , Adulto Jovem
10.
JAMA Facial Plast Surg ; 20(6): 445-451, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29978203

RESUMO

Importance: Complications caused by autologous fat filling have been reported. Comprehensive knowledge of the possible adverse effects of autologous fat filling is needed. Objective: To determine the association of autologous fat filling with ophthalmic function complications. Design, Setting, and Participants: Four adult New Zealand white rabbits were killed for a facial anatomy study. Sixty-four adult New Zealand white rabbits underwent fat harvest using the Coleman technique. Autologous fat was minced or digested with collagenase 1 and centrifuged to separate fat lipid and fat granules. Either 0.2 mL or 0.4 mL of minced fat, fat granules, fat lipid, or saline (control) was retrogradely injected into the facial artery of rabbit models. Electroretinography and ophthalmic fundoscopy were performed to measure the retina and fundus artery occlusions 2 weeks after surgery. Main Outcomes and Measures: Visual impairment, blindness, and death. Results: Injection of 0.2 mL of fat granules, fat lipid, and saline resulted in 100% (8 of 8), 62.5% (5 of 8), and 0 ophthalmic complications, respectively; and 0.4 mL resulted in 87.5% (7 of 8), 12.5% (1 of 8), and 0 ophthalmic complications, respectively. Injection of 0.2 mL and 0.4 mL minced fat led to 100% (8 of 8) ophthalmic complications and death, respectively. The mortality rates were 37.5% (3 of 8), 12.5% (1 of 8), and 0 for 0.2 mL emboli injection, and 100% (8 of 8), 50% (4 of 8), and 0 for 0.4 mL, respectively. Conclusions and Relevance: In this study, minced fat injection was associated with more ophthalmic complications than injection of fat granules and fat lipid. Increasing the injection volume of fat tissues could raise the incidence of morbidity and mortality. Level of Evidence: NA.


Assuntos
Tecido Adiposo/transplante , Técnicas Cosméticas/efeitos adversos , Artéria Oftálmica/lesões , Oclusão da Artéria Retiniana/etiologia , Transplante Autólogo/efeitos adversos , Animais , Face/irrigação sanguínea , Injeções Intradérmicas/efeitos adversos , Masculino , Coelhos , Fatores de Risco
11.
Am J Case Rep ; 19: 825-828, 2018 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-30002360

RESUMO

BACKGROUND Dermal fillers are increasingly used for medical and aesthetic purposes in clinical practice. Common complications following filler injections include bruising, itching, infections, allergic reactions, and tissue necrosis. This case is the first report of Herpes simplex virus type 1 (HSV-1) encephalitis as a possible complication of dermal filler injection. CASE REPORT A 27-year-old woman with no past medical history presented with altered mental state, headaches, and seizures. She had a nasal dermal filler injection for aesthetic purpose five weeks before her acute presentation. A diagnosis of HSV-1 encephalitis was made based on brain imaging with computed tomography and magnetic resonance imaging (MRI) findings that showed bilateral frontotemporal lobe hyperintensity. Analysis of her cerebrospinal fluid (CSF) confirmed the presence of HSV-1 DNA. Despite anti-viral treatment with acyclovir, she developed postencephalitic syndrome. CONCLUSIONS This case report highlights the possibility that among the complications of the use of cosmetic dermal fillers, the transmission of HSV-1 and the development of HSV-1 encephalitis should be recognized.


Assuntos
Preenchedores Dérmicos/efeitos adversos , Encefalite por Herpes Simples/etiologia , Herpesvirus Humano 1/isolamento & purificação , Adulto , Técnicas Cosméticas , Encefalite por Herpes Simples/tratamento farmacológico , Feminino , Humanos , Injeções Intradérmicas/efeitos adversos , Nariz
12.
Aesthet Surg J ; 38(8): 811-822, 2018 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-29554209

RESUMO

Background: Androgenetic alopecia (AGA) is characterized by miniaturization of the hair follicles gradually causing conversion of terminal hairs into vellus hairs, leading to progressive reduction of the density of hair on the scalp. Approved therapeutic options are limited and show side effects. Objectives: To evaluate injections of stromal vascular fraction (SVF), which is rich in adipose-derived stromal cells (ASCs) in combination with platelet-rich plasma (PRP) in the upper scalp as a new autologous treatment option for AGA. Methods: Ten male patients (age range, 25-72 years), suffering from AGA at stage II to III according to the Norwood-Hamilton scale, have been treated with a single injection of autologous PRS (ACPSVF: combination of PRP and SVF) in the upper scalp. Preinjection and 6 and 12 weeks postinjection changes in hair density were assessed using ultra high-resolution photography (Fotofinder). Results: Hair density was significantly increased after 6 weeks and 12 weeks postinjection (P = 0.013 and P < 0.001). In hair-to-hair matching analyses, new hair grew from active follicles. Furhtermore nonfunctioning hair follicles filled with hyperkeartotic plugs, up to today assumed incapable of forming new hair, proved to grow new hair. No side effects were noted after treatment. Conclusions: A single treatment of platelet-rich stroma injected in the scalp of patients with AGA significantly increased hair density within 6 to 12 weeks. Further research is required to determine the optimal treatment regimen. Preferred options to our opinion include the repetition of PRS or additional treatments with PRP.


Assuntos
Alopecia/terapia , Transplante de Células-Tronco Mesenquimais/métodos , Plasma Rico em Plaquetas , Adulto , Idoso , Alopecia/diagnóstico por imagem , Folículo Piloso/diagnóstico por imagem , Humanos , Injeções Intradérmicas/efeitos adversos , Injeções Intradérmicas/métodos , Masculino , Transplante de Células-Tronco Mesenquimais/efeitos adversos , Pessoa de Meia-Idade , Fotografação , Couro Cabeludo , Transplante Autólogo/efeitos adversos , Transplante Autólogo/métodos , Resultado do Tratamento
13.
J Cosmet Dermatol ; 17(4): 590-595, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28726351

RESUMO

BACKGROUND: There is an increasing trend shifting the esthetic focus downward from the face with a significant number of new treatments aimed at the aging neck. Hyaluronic acid (HA) filler injection is widely performed into the horizontal neck lines in Korea, but there are few reports assessing its effectiveness. OBJECTIVE: We aimed to evaluate the efficacy and safety of HA filler injection in the treatment of horizontal neck lines. PATIENTS AND METHODS: A retrospective chart review was performed on cases of horizontal neck lines treated with HA fillers. A total of 28 neck halves from 14 patients with Fitzpatrick skin types IV-V were included. All participants underwent a single treatment session with a 0.3 cc insulin syringe (31G×8 mm needle). Wrinkle assessment was conducted at baseline and 2 months after treatment. Two blinded physicians evaluated the improvement using a 5-point Global Aesthetic Improvement Scale (GAIS) (5-very much improved, 4-much improved, 3-improved, 2-no change, 1-worse) by comparing the pretreatment and post-treatment photographs. A questionnaire was used to evaluate patient satisfaction and the incidence of adverse reactions. RESULTS: Among the 28 neck halves, 35.7% were treated with the linear threading technique (LTT) and 64.3% were treated with the vertical technique (VT). The average amount of filler injection per side was 1.01±0.13 cc. The GAIS score of the horizontal neck lines measured at the 2-month follow-up after filler injection was 4.04±0.79 (overall); the GAIS score of the horizontal neck lines was 3.60±0.70 with the LTT and 4.27±0.75 with the VT (P=.027). Complications, such as skin irregularity and accentuation of neck lines, were observed, but they were transient. CONCLUSION: Our preliminary study results indicate that HA filler injection with a 0.3 cc insulin syringe could be a safe and effective treatment option for horizontal neck lines.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos/uso terapêutico , Ácido Hialurônico/uso terapêutico , Envelhecimento da Pele , Adulto , Técnicas Cosméticas/efeitos adversos , Técnicas Cosméticas/instrumentação , Preenchedores Dérmicos/efeitos adversos , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Injeções Intradérmicas/efeitos adversos , Pessoa de Meia-Idade , Pescoço , Satisfação do Paciente , Fotografação , Estudos Retrospectivos , Método Simples-Cego , Seringas
15.
J Invest Surg ; 31(4): 292-297, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28485991

RESUMO

INTRODUCTION: Liposuction is a popular surgical procedure. As in any surgery, there are risks and complications, especially when combined with fat injection. Case reports of fat embolism have described a possible explanation as the puncture and tear of gluteal vessels during the procedure, especially when a deep injection is planned. METHODS: A total of 10 dissections were performed in five fresh cadavers. Each buttocks was divided into four quadrants. We focused on the location where the gluteal vessels enter the muscle and the diameter of the vessels. Colorant at two different angles was injected (30° and 45°). We evaluated the relation of the colorant with the main vessels. RESULTS: We found two perforators per quadrant. The thickness of the gluteal muscle was 2.84 ± 1.54 cm. The area under the muscle where the superior gluteal vessels traverse the muscle was located 6.4 ± 1.54 cm from the intergluteal crease and 5.8 ± 1.13 cm from the superior border of the muscle. The inferior gluteal vessels were located 8.3 ± 1.39 cm from the intergluteal crease and 10 ± 2.24 cm from the superior border of the muscle. When we compared the fat injected at a 30° angle, the colorant stayed in the muscle. Using a 45° angle, the colorant was in contact with the superior gluteal artery and the sciatic nerve. No puncture or tear was observed in the vessels or the nerve. CONCLUSIONS: The location where the vessels come in contact with the muscle, which can be considered for fat injection, were located in quadrants 1 and 3. A 30° angle allows for an injection into the muscle without passing into deeper structures, unlike a 45° injection angle.


Assuntos
Tecido Adiposo/transplante , Contorno Corporal/efeitos adversos , Nádegas/cirurgia , Embolia Gordurosa/prevenção & controle , Lipectomia/efeitos adversos , Adulto , Artérias , Contorno Corporal/métodos , Nádegas/irrigação sanguínea , Cadáver , Corantes/administração & dosagem , Embolia Gordurosa/etiologia , Feminino , Humanos , Injeções Intradérmicas/efeitos adversos , Injeções Intradérmicas/métodos , Lipectomia/métodos , Masculino , México , Pessoa de Meia-Idade , Nervo Isquiático , Transplante Autólogo/efeitos adversos , Transplante Autólogo/métodos , Adulto Jovem
17.
J Cosmet Dermatol ; 17(4): 584-589, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28913927

RESUMO

BACKGROUND: The different rheological properties of hyaluronic acid (HA) filler reflect their specific manufacturing processes and resultant physicochemical characteristics. However, there are few researches about the relationship between product differences and clinical outcome when HA fillers are used for nasolabial folds (NLFs). AIMS: This study sought to compare the rheological properties, efficacy and safety of a monophasic HA filler, and a well-studied biphasic HA filler, in the treatment of NLFs. PATIENTS/METHODS: A total of 72 Korean subjects with moderate to severe NLFs were randomized to receive injections with monophasic HA or biphasic HA on the left or right side of the face. Efficacy was evaluated by the change in the Wrinkle Severity Rating Scale (WSRS) at 2, 10, 18, 26, and 52 weeks. Safety was assessed on the basis of all abnormal reactions during the clinical test period. To compare the rheological characteristics of two cross-linked HA fillers, viscoelastic analysis was performed. RESULTS: At week 26, the mean WSRS was 2.26±0.56 for the monophasic HA side and 2.24±0.54 for the biphasic HA side. Both treatments were well tolerated. The adverse reactions were mild and transient. Monophasic HA filler had lower elasticity and higher viscosity than biphasic HA filler. CONCLUSION: Despite a number of different rheological properties, monophasic HA is noninferior to biphasic HA in the treatment of moderate to severe NLFs for 52 weeks. Therefore, monophasic HA provides an alternative option for NLFs correction.


Assuntos
Preenchedores Dérmicos/uso terapêutico , Ácido Hialurônico/uso terapêutico , Sulco Nasogeniano , Adulto , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Preenchedores Dérmicos/química , Elasticidade , Feminino , Humanos , Ácido Hialurônico/efeitos adversos , Ácido Hialurônico/química , Injeções Intradérmicas/efeitos adversos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Reologia , Método Simples-Cego , Envelhecimento da Pele , Fatores de Tempo , Viscosidade
19.
Clin Exp Dermatol ; 42(7): 728-734, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28649780

RESUMO

BACKGROUND: Tranexamic acid (TXA) has been used orally, intravenously, topically and intradermally (microinjection, microneedling) for treating melasma. However, the comparative efficacy of these different routes of administration remains underevaluated. AIM: To ascertain the comparative efficacy of different routes of administration of TXA. METHODS: In total, 100 consecutive patients with melasma (8 men, 92 women, age range 18-55 years) were randomly assigned to one of two groups comprising 50 patients each. Group A (3 men, 47 women) received oral TXA 250 mg twice daily, while group B (5 men, 45 women) received intradermal microinjections of TXA 4 mg/mL every 4 weeks. The treatment continued for 12 weeks in both groups. Percentage reduction in baseline Melasma Area and Severity Index (MASI) was assessed at 4-week intervals, and response was scored as very good (> 75% reduction), good (50% to < 75% reduction), moderate (25% to < 50% reduction), mild (< 25% reduction) or no response. RESULTS: The study was completed by 39 patients in group A and 41 patients in group B. Very good response was seen in 25 and 32 patients in groups A and B, respectively, while good response was seen in 14 and 9 patients, respectively. Both treatment methods were equally effective, with an average reduction of MASI at 12 weeks of 77.96 ± 9.39 in group A and 79.00 ± 9.64 in group B. The main adverse effects were mild epigastric discomfort, hypomenorrhea, headache and injection site pain, which did not warrant discontinuation of treatment. Two patients in group A had relapses at 24 weeks. CONCLUSION: TXA appears to be an effective and safe treatment for melasma, irrespective of its route of administration.


Assuntos
Melanose/tratamento farmacológico , Ácido Tranexâmico/administração & dosagem , Administração Oral , Adolescente , Adulto , Feminino , Humanos , Injeções Intradérmicas/efeitos adversos , Masculino , Microinjeções , Pessoa de Meia-Idade , Ácido Tranexâmico/efeitos adversos , Adulto Jovem
20.
J Control Release ; 258: 73-80, 2017 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-28479095

RESUMO

Intradermal immunization of mice against hepatitis B surface antigen (HBsAg) using a novel real-time controlled jet injector was assessed by comparison with intradermal and subcutaneous injection of antigen using a 27G needle and syringe. Three doses of aluminium-absorbed HBsAg were delivered at 0, 14, and 28days. Antibodies to HBsAg were detected only in mice injected with antigen with antibody levels increasing with secondary injections. Mice vaccinated by intradermal injection using the jet injector or subcutaneous needle injection exhibited comparable immune responses at day 47. Differences in titer observed between intradermal jet injected and needle injected animals reflect differences in the volume of antigen delivered. With the exception of minor bleeding at the injection site in a few animals injected either by jet injection or needle, no adverse events were observed in any of the mice used in the study.


Assuntos
Sistemas de Liberação de Medicamentos/instrumentação , Antígenos de Superfície da Hepatite B/administração & dosagem , Vacinas contra Hepatite B/administração & dosagem , Vírus da Hepatite B/imunologia , Hepatite B/prevenção & controle , Imunização/instrumentação , Animais , Sistemas de Liberação de Medicamentos/efeitos adversos , Feminino , Hepatite B/imunologia , Antígenos de Superfície da Hepatite B/imunologia , Vacinas contra Hepatite B/imunologia , Humanos , Imunização/efeitos adversos , Injeções Intradérmicas/efeitos adversos , Injeções Intradérmicas/instrumentação , Injeções a Jato/efeitos adversos , Injeções a Jato/instrumentação , Injeções Subcutâneas/efeitos adversos , Injeções Subcutâneas/instrumentação , Camundongos , Camundongos Endogâmicos BALB C , Agulhas
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