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1.
Nat Immunol ; 23(1): 23-32, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34937933

RESUMO

Systemic immune cell dynamics during coronavirus disease 2019 (COVID-19) are extensively documented, but these are less well studied in the (upper) respiratory tract, where severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replicates1-6. Here, we characterized nasal and systemic immune cells in individuals with COVID-19 who were hospitalized or convalescent and compared the immune cells to those seen in healthy donors. We observed increased nasal granulocytes, monocytes, CD11c+ natural killer (NK) cells and CD4+ T effector cells during acute COVID-19. The mucosal proinflammatory populations positively associated with peripheral blood human leukocyte antigen (HLA)-DRlow monocytes, CD38+PD1+CD4+ T effector (Teff) cells and plasmablasts. However, there was no general lymphopenia in nasal mucosa, unlike in peripheral blood. Moreover, nasal neutrophils negatively associated with oxygen saturation levels in blood. Following convalescence, nasal immune cells mostly normalized, except for CD127+ granulocytes and CD38+CD8+ tissue-resident memory T cells (TRM). SARS-CoV-2-specific CD8+ T cells persisted at least 2 months after viral clearance in the nasal mucosa, indicating that COVID-19 has both transient and long-term effects on upper respiratory tract immune responses.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Nasofaringe/imunologia , Nariz/citologia , Mucosa Respiratória/imunologia , SARS-CoV-2/imunologia , Anticorpos Antivirais/sangue , COVID-19/imunologia , COVID-19/patologia , Granulócitos/imunologia , Antígenos HLA-DR/metabolismo , Humanos , Células Matadoras Naturais/imunologia , Monócitos/imunologia , Nasofaringe/citologia , Nasofaringe/virologia , Neutrófilos/imunologia , Nariz/imunologia , Nariz/virologia , Estudos Prospectivos , Mucosa Respiratória/citologia , Mucosa Respiratória/virologia
2.
Plast Reconstr Surg ; 149(1): 25e-27e, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34936611

RESUMO

SUMMARY: The bulbous and box tips are two common morphologies encountered in rhinoplasty. Nasal tip reshaping is a challenging aspect of rhinoplasty. Understanding the classifications of nasal tip morphologies aids when performing a nasal-facial analysis. The management algorithm for both tip morphologies shares various techniques. These techniques include but are not limited to cephalic trim, transdomal sutures, and interdomal sutures. A graduated approach to managing the variations in bulbous and boxy tips will help in achieving consistent results. New concepts applied to the management include supporting alar rims with alar contour grafts, closing dead space through a series of techniques, and managing the soft-tissue envelope, which is often in excess.


Assuntos
Nariz/anatomia & histologia , Planejamento de Assistência ao Paciente , Rinoplastia/métodos , Estética , Humanos , Nariz/cirurgia , Resultado do Tratamento
3.
Equine Vet J ; 54(1): 11-23, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34519074

RESUMO

Equid gammaherpesviruses are ubiquitous and widespread in the equine population. Despite their frequent detection, their contribution to immune system modulation and the pathogenesis of several diseases remains unclear. Genetic variability and the combination of equid gammaherpesvirus strains a horse is infected with might be clinically significant. Initial gammaherpesvirus infection occurs in foals peripartum with latency then established in peripheral blood mononuclear cells. A novel EHV-5 study suggests that following inhalation equid gammaherpesviruses might obtain direct access to T and B lymphocytes via the tonsillar crypts to establish latency. EHV-5 is associated with equine multinodular pulmonary fibrosis, however, unlike with EHV-2 there is currently minimal evidence for its role in milder cases of respiratory disease and poor performance. Transmission is presumed to be via the upper respiratory tract with periodic reactivation of the latent virus in adult horses. Stress of transport has been identified as a risk factor for reactivation and shedding of equine gammaherpesviruses. There is currently a lack of evidence for the effectiveness of antiviral drugs in the treatment of equine gammaherpesvirus infections.


Assuntos
Gammaherpesvirinae , Infecções por Herpesviridae , Herpesvirus Equídeo 1 , Doenças dos Cavalos , Animais , Gammaherpesvirinae/genética , Infecções por Herpesviridae/veterinária , Cavalos , Leucócitos Mononucleares , Nariz
4.
Biosens Bioelectron ; 196: 113693, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34700263

RESUMO

The electronic nose is a reliable practical sensor device that mimics olfactory organs. Although numerous studies have demonstrated excellence in detecting various target substances with the help of ideal models, biomimetic approaches still suffer in practical realization because of the inability to mimic the signal processing performed by olfactory neural systems. Herein, we propose an electronic nose based on the programable surface chemistry of M13 bacteriophage, inspired by the neural mechanism of the mammalian olfactory system. The neural pattern separation (NPS) was devised to apply the pattern separation that operates in the memory and learning process of the brain to the electronic nose. We demonstrate an electronic nose in a portable device form, distinguishing polycyclic aromatic compounds (harmful in living environment) in an atomic-level resolution (97.5% selectivity rate) for the first time. Our results provide practical methodology and inspiration for the second-generation electronic nose development toward the performance of detection dogs (K9).


Assuntos
Técnicas Biossensoriais , Nariz Eletrônico , Animais , Bacteriófago M13 , Biomimética , Cães , Nariz
5.
Am J Rhinol Allergy ; 36(1): 41-46, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33957801

RESUMO

OBJECTIVES: Peak nasal inspiratory flow (PNIF) measurement is an inexpensive and user-friendly method to assess nasal patency. However, the repeatability of PNIF measurements, as well as the threshold value of a change in PNIF, which can be considered significant remain unclear. This study aims to investigate the repeatability of PNIF measurements and the change in PNIF after the administration of 0.05% oxymetazoline. METHODS: Repeated measurements of PNIF (Clement Clarke In-Check nasal inspiratory flow meter; Clement Clarke International, Ltd, Harlow, Essex, UK) were obtained in 333 healthy volunteers (174 women). Based on age, participants were categorized into three groups (6-7 years, 13-14 years, and 20-45 years). We obtained five measurements in each participant. PNIF was remeasured in 294 subjects 30 min after administration of 0.05% oxymetazoline. The variability in PNIF measurements was assessed using the coefficient of variation (CV = standard deviation × 100%/mean). RESULTS: The first four PNIF measurements significantly differed from each other. The difference in PNIF measurements ceased to be statistically significant only between the fourth and fifth measurements (p = 0.19). PNIF repeatability was acceptable; the median CV was 15.5% (0-66), which did not significantly differ between age groups. The administration of 0.05% oxymetazoline led to a statistically significant increase in the PNIF value by 14.3% (-45, 157%) (p = 0.000000). CONCLUSIONS: 1. No statistically significant difference was observed in PNIF values only between the fourth and fifth measurements; therefore, at least three measurements are essential to draw meaningful conclusions. 2. PNIF measurements were satisfactorily characterized by a relatively low CV (15%). 3. The administration of 0.05% oxymetazoline led to an increase in PNIF by approximately 14% over the baseline value.


Assuntos
Obstrução Nasal , Oximetazolina , Criança , Feminino , Humanos , Capacidade Inspiratória , Nariz
6.
Clin Plast Surg ; 49(1): 1-11, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782128

RESUMO

Requiring both high-level technical skills and artistic sense, rhinoplasty continues to be one of the most challenging procedures in plastic surgery despite its popularity. A thorough preoperative consultation of the rhinoplasty patient forms the foundation of a successful case. During the consultation, the physician should obtain a detailed medical and nasal history, understand the patient's areas of concern, conduct a nasal analysis, and evaluate the patient's candidacy for surgery. This article reviews the key functional, esthetic, and psychosocial considerations that should be taken into account during a preoperative consultation for a rhinoplasty patient.


Assuntos
Rinoplastia , Cirurgia Plástica , Estética , Humanos , Nariz/cirurgia , Cuidados Pré-Operatórios
7.
Clin Plast Surg ; 49(1): 111-121, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782129

RESUMO

The crooked nose is a challenging esthetic and functional problem. The surgeon must carefully evaluate baseline facial asymmetry as well as whether deviation stems from the upper third, middle third, or lower third of the nose. Surgical intervention should be tailored accordingly, with techniques geared toward addressing each deviated section. Modified dorsal preservation techniques represent a newer means to address deviations. Operative results must be measured, ideally through patient-reported outcomes measures, to quantify overall success.


Assuntos
Deformidades Adquiridas Nasais , Rinoplastia , Estética , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Resultado do Tratamento
8.
Clin Plast Surg ; 49(1): 123-136, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782130

RESUMO

An understanding of anatomy and pathophysiology of the cleft nasal deformity is crucial to its management, including selection of correct surgical techniques for repair. Timing of intermediate and definitive rhinoplasty should be considered carefully, with definitive rhinoplasty occurring after management of facial skeletal deformities. At the time of definitive rhinoplasty, the septum, external and internal nasal valves, alar base malposition (and corresponding bony deficiency), and position and shape of the lower lateral cartilage and the columella all must be individually considered. Thorough knowledge of rhinoplasty techniques is crucial to address the cleft nasal deformity with optimal functional and aesthetic outcomes.


Assuntos
Fenda Labial , Rinoplastia , Cartilagem , Fenda Labial/cirurgia , Estética , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia
9.
Clin Plast Surg ; 49(1): 137-148, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782132

RESUMO

To manage the deficient nasal dorsum, a thorough knowledge of dorsal augmentation techniques should be mastered by the rhinoplasty specialist. Indications for dorsal augmentation may arise in both primary and revision rhinoplasty presentations. To direct operative planning, a complete facial analysis, noting the importance of maintaining overall nasofacial balance, is essential. An array of techniques, including autologous and nonautologous (ie, allogeneic and synthetic) sources, have been used globally-each carrying its own advantages and disadvantages. The authors believe autologous grafts to be the optimal source for dorsal augmentation because of their biocompatibility and ability to produce natural and long-lasting outcomes.


Assuntos
Fáscia , Rinoplastia , Fáscia/transplante , Humanos , Nariz/cirurgia , Coleta de Tecidos e Órgãos , Transplante Autólogo
10.
Clin Plast Surg ; 49(1): 149-160, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782133

RESUMO

Today non-Caucasian patients comprise an important group of patients seeking rhinoplasty. The term non-Caucasian is used interchangeably to speak about patients of ethnic origin. It becomes important to understand the interplay of culture, race, and ethnicity when evaluating patients and defining what their aesthetic ideals are and what will be needed for surgery. An integrated approach and management of the non-Caucasian patient is presented in which medical and surgical options are explored. The final goal when treating non-Caucasian patients should be trying to help patients achieve their aesthetic ideal in the best possible fashion.


Assuntos
Rinoplastia , Estética , Humanos , Nariz/cirurgia
11.
Clin Plast Surg ; 49(1): 161-178, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782134

RESUMO

Treatment of nasal base deformities is critical for a successful rhinoplasty. Several anatomic variations are seen on nasal base. Alar base deformities can be horizontal excess or deficiency, vertical excess or deficiency, cephalic malposition or caudal malposition of alar base, wide or narrow nostril sills, and columellar base deformities. Columellar base should be addressed before alar base resections. Correction of columellar base deformities and positioning of medial crural footplates should be the primary step of nasal base surgery to attain aesthetic ideals of the columellar base and improve external nasal valve function. The most common deformities requiring alar base modification include wide nasal base, alar flaring, large nostril size, and asymmetries of nostrils or alae. There are 3 basic types of excision on alar base surgery. (1) Alar wedge excision, (2) nostril sill excision, and (3) combined alar wedge and nostril sill excision. The alar wedge excision is an elliptical excision placed in the alar crease that is used to reduce the size and shorten the vertical length of alar lobule and correct the excessive flaring on the frontal view. Nostril sill excision is the technique which is used to decrease interalar distance and nostril sill length, and reduce the size of nostril. The combined alar wedge and nostril sill excision is used in cases with wide alar base and additionally, there is excessive flaring and large alar lobule.


Assuntos
Procedimentos Ortopédicos , Rinoplastia , Estética , Humanos , Cavidade Nasal , Septo Nasal/cirurgia , Nariz/cirurgia
12.
Clin Plast Surg ; 49(1): 191-195, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782136

RESUMO

Nonsurgical rhinoplasty is increasing in popularity, and when used appropriately, can be less costly and have less downtime than surgical rhinoplasty. It can offer patients a means of seeing how they would feel about a surgical rhinoplasty later. Injection can be safe but patients should still be counseled regarding the rare, possible risks of tissue loss and potentially irreversible tissue ischemia and irreversible blindness. Treatment with hyaluronidase can be partially effective when signs and symptoms are caught early; however, avoidance is still the best medicine along with seeking an experienced, qualified rhinoplasty plastic surgeon.


Assuntos
Rinoplastia , Humanos , Isquemia , Nariz/cirurgia
13.
Clin Plast Surg ; 49(1): 49-59, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782139

RESUMO

The nose is a complex three-dimensional structure with critical structural and functional roles; its relationship to surrounding structures is, in part, responsible for a harmonious, pleasing visage as a whole. There are many variables and dimensions that can be adjusted to alter the esthetic appearance, structural components, and functional role of the nose and many tools and maneuvers available to the rhinoplasty surgeon to adjust these numerous variables. Although every rhinoplasty operation should be individualized, a systematic order and algorithm may be helpful in operative planning as well as establishing a logical progression of steps and maintaining stability. While each adjustment may have a primary anticipated effect, it will invariably have a secondary impact.


Assuntos
Rinoplastia , Algoritmos , Humanos , Nariz/cirurgia
14.
Clin Plast Surg ; 49(1): 61-70, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782140

RESUMO

Controlling the nasal tip to achieve excellent structural and cosmetic outcomes is challenging in rhinoplasty surgery. A strong foundation and understanding of the nasal tripod complex and the various methods for restoring tip support mechanisms when disrupted either from surgery or other means is critical. The columellar strut graft, septal extension graft, and tongue-in-groove suture technique are well-described methods to control and support the nasal tip. There are advantages and disadvantages to each method, but one should be comfortable with the nuances of each to master nasal tip surgery.


Assuntos
Nariz , Rinoplastia , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia , Próteses e Implantes , Técnicas de Sutura
15.
Clin Plast Surg ; 49(1): 81-95, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782142

RESUMO

Dorsal hump reduction is one of the most common techniques used in modern rhinoplasty, yet it carries a high propensity for untoward aesthetic and functional sequelae, as evidenced by a nontrivial revision rate. Component dorsal hump reduction with stepwise deconstruction and manipulation of component parts allows for an adaptable and precise approach to variances in anatomy and in desired aesthetic result. Secondary changes must be anticipated and addressed at the index operation to avoid negative results and prevent the need for revision. Adequate reconstruction of the midvault is paramount to achieving optimal aesthetic and functional outcomes.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Estética , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia
16.
J Med Virol ; 94(2): 454-460, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-31017663

RESUMO

Acute respiratory infections (ARIs) are a major cause of morbidity among children. Respiratory viruses are commonly detected in both symptomatic and asymptomatic periods. The rates of infection and community epidemiology of respiratory viruses in healthy children needs further definition to assist interpretation of molecular diagnostic assays in this population. Children otherwise healthy aged 1 to 8 years were prospectively enrolled in the study during two consecutive winters, when ARIs peak in New Zealand. Parents completed a daily symptom diary for 8 weeks, during which time they collected a nasal swab from the child for each clinical ARI episode. A further nasal swab was collected by research staff during a clinic visit at the conclusion of the study. All samples were tested for 15 respiratory viruses commonly causing ARI using molecular multiplex polymerase chain reaction assays. There were 575 ARIs identified from 301 children completing the study, at a rate of 1.04 per child-month. Swabs collected during an ARI were positive for a respiratory virus in 76.8% (307 of 400), compared with 37.3% (79 of 212) of swabs collected during asymptomatic periods. The most common viruses detected were human rhinovirus, coronavirus, parainfluenza viruses, influenzavirus, respiratory syncytial virus, and human metapneumovirus. All of these were significantly more likely to be detected during ARIs than asymptomatic periods. Parent-administered surveillance is a useful mechanism for understanding infectious disease in healthy children in the community. Interpretation of molecular diagnostic assays for viruses must be informed by understanding of local rates of asymptomatic infection by such viruses.


Assuntos
Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Vírus/isolamento & purificação , Doença Aguda , Infecções Assintomáticas/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Masculino , Técnicas de Diagnóstico Molecular , Reação em Cadeia da Polimerase Multiplex , Nova Zelândia/epidemiologia , Nariz/virologia , Vigilância da População , Prevalência , Infecções Respiratórias/diagnóstico , Estações do Ano , Vírus/classificação , Vírus/genética
18.
Ann Plast Surg ; 88(1): 7-13, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34928242

RESUMO

ABSTRACT: The purpose of this article is to provide a guide for plastic surgeons, regardless of experience level, seeking to improve his/her endonasal rhinoplasty skills and comfort level. We have presented the advantages of our technique and its unifying principles and demonstrated how endonasal rhinoplasty can be used to achieve safe, anatomical, and predictable outcomes. Endonasal rhinoplasty is a separate thought process from open rhinoplasty and should not be viewed as a competing but rather parallel technique that is broadly applicable to many nasal deformities.We have described the basic goals of all rhinoplasties and highlighted 2 false assumptions that are responsible for most adverse rhinoplasty outcomes and 4 anatomical deficits that surgeons must recognize preoperatively to maximize function, proportion, and contour. Finally, the majority of primary rhinoplasties can be performed with 1 of 2 operative strategies that depend on the relationship of the dorsum to the lower nose. Because surgeons often presume that they will not be able to "see well enough" in endonasal rhinoplasty or worry they have not been adequately trained in the technique, we have provided a step-by-step guide to help overcome such fears and help these surgeons to achieve results that will exceed their patients' goals.


Assuntos
Doenças Nasais , Rinoplastia , Cirurgiões , Dorso , Feminino , Humanos , Masculino , Nariz
19.
Pediatr Pulmonol ; 57(1): 231-238, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34570949

RESUMO

BACKGROUND: Nasal nitric oxide (nNO) measurement is recommended as a first line screening test for primary ciliary dyskinesia (PCD). While reliable velum- and non-velum-closure techniques exist for preschool children and older individuals, no data are available for neonates. AIMS: To determine feasibility of nNO screening and nNO concentration in healthy newborns in the first week of life. METHODS: Nasal NO was analyzed in tidal breathing during natural sleep using a CLD-88 sp NO analyzer (chemoluminescence sensor) and a NIOX MINO (electrochemical sensor). Test success and nNO concentration were determined and compared between the two devices. RESULTS: Nasal NO was measured in 62 healthy neonates within the first week of life. Feasibility of nNO measurement was 100% for at least one nostril and 85.5% for both nostrils using the chemoluminescence device, but significantly lower with the electrochemical device (85.5% and 53.2%; p < .001). Median nNO concentration was 38 ppb (interquartile range, 27-55; range, 9-100) with the ECOMEDICS device and 23 (15-33, 8-59) with the NIOX MINO (p < .001), with a trend towards higher values for older subjects. None of the subjects exceeded nNO levels of 100 ppb. CONCLUSION: Measurement of nNO using a chemoluminescence device is highly feasible in newborns during natural sleep. However, nNO levels are considerably lower compared to the published data for older individuals and in the range of a PCD reference group of infants between 4 and 8 weeks of age, potentially resulting in a great overlap with subjects with PCD in this age group. Therefore, screening for PCD using nasal NO might not be useful in the first week of life. Upon clinical suspicion, other diagnostic tests such as high-speed video analysis of the cilia should be applied.


Assuntos
Testes Respiratórios , Síndrome de Kartagener , Pré-Escolar , Estudos de Viabilidade , Humanos , Lactente , Recém-Nascido , Óxido Nítrico , Nariz
20.
J Craniofac Surg ; 33(1): e78-e80, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34967530

RESUMO

ABSTRACT: The forehead flap is the gold standard procedure for nasal reconstruction to address a partial or complete rhinectomy. Traditionally, the three-dimensional (3D) nasal defect is manually templated intraoperatively to design the two-dimensional (2D) flap shape on intact morphology. In this clinical study, digital preoperative planning is used to template with computer-assisted design and manufacturing. Preoperative digital templates were implemented for 3 representative patients (1 in Supplementary Digital Content, http://links.lww.com/SCS/D60). This includes designs for a hemi-rhinectomy case from 3D mirroring, a partial total rhinectomy case generated from a 3D scan, and a total rhinectomy case generated from a 3D morphable model based on a prepathology 2D photo. Digital unwrapping flattened the patient's 3D nasal geometry designs to 2D skin flap shapes. Finally, the 2D designs were printed as traceable intraoperative templates at a 1:1 scale. This clinical study demonstrates the application of digital 3D preoperative templating to improve workflow for nasal reconstruction.


Assuntos
Testa , Nariz , Desenho Assistido por Computador , Testa/diagnóstico por imagem , Testa/cirurgia , Humanos , Imageamento Tridimensional , Nariz/diagnóstico por imagem , Nariz/cirurgia , Retalhos Cirúrgicos
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