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1.
Niger J Clin Pract ; 23(9): 1318-1323, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32913174

RESUMO

Background: Preparation for surgery has traditionally included the removal of body hair from the intended surgical wound site. The effect of this practice on postoperative wound infection is yet to be fully elucidated. Aims: This study sought to determine if preoperative chemical depilation reduces the risk of surgical site infection (SSI). Methodology: Two methods of preoperative hair removal: razor shaving and depilatory cream were compared. The eligible patients were randomized into two groups and the presence of postoperative wound infection was evaluated using the Southampton wound grading system. Data were analyzed using SPSS version 21 Chicago-Illinois, statistical significance was inferred at Pvalue ≤ 0.05. Results: In total 100 patients were analyzed with 20 patients excluded due to co-morbidities and noncompletion of the study. The overall prevalence of SSI was 18.0% (7 (14.0%) and 11 (22.0%) in the depilatory cream and razor shaving groups, respectively). The difference in the rate of SSI was not statistically significant (P = 0.436). Hair was completely removed in 47 (94.0%) compared to 38 (76.0%) patients in the razor shaving group (P = 0.012) while skin injuries were noted in 21 (42.0%) vs 1 (2.0%) patients who had razor shaving and chemical depilation(P = <0.0001), respectively. Conclusion: There was no significant difference in SSI rates in patients that had preoperative chemical depilation when compared with razor shaving.


Assuntos
Remoção de Cabelo/métodos , Cuidados Pré-Operatórios/métodos , Infecção da Ferida Cirúrgica/prevenção & controle , Cicatrização/fisiologia , Adulto , Feminino , Remoção de Cabelo/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Restrição Física , Lesões dos Tecidos Moles/complicações , Lesões dos Tecidos Moles/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Adulto Jovem
2.
Dermatol Online J ; 26(4)2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32621692

RESUMO

Hidradenitis suppurativa is a chronic, painful disease that significantly reduces quality of life. Laser hair reduction is one modality that can be used in combination with other treatments to ameliorate the condition. We argue that insurance should provide coverage for this necessary service.


Assuntos
Remoção de Cabelo/economia , Hidradenite Supurativa/economia , Cobertura do Seguro , Seguro Saúde , Terapia com Luz de Baixa Intensidade/economia , Cabelo/efeitos da radiação , Remoção de Cabelo/métodos , Hidradenite Supurativa/terapia , Humanos , Estados Unidos
3.
Ann R Coll Surg Engl ; 102(9): 685-688, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32302208

RESUMO

INTRODUCTION: Pilonidal disease is a chronic condition involving the sacrococcygeal area. It can have a significant impact on quality of life, social activities and occupation. Surgery is the mainstay of treatment. However, laser depilation has been proposed as an adjunct to surgery and has shown improved results in some studies. We present our experience of laser depilation in the treatment of pilonidal disease in a district general hospital setting in the UK. MATERIALS AND METHODS: A prospectively maintained database of all consecutive patients who received laser depilation after elective surgery for pilonidal disease was analysed. Patients were offered a minimum of two sessions of laser depilation. The primary outcome measure was disease recurrence. Evidence of new symptoms or signs of pilonidal disease after one year from the latest surgical intervention was defined as recurrent disease. Data are presented as medians with interquartile ranges. RESULTS: A total of 64 patients underwent laser depilation after elective surgery between 1 June 2013 and 1 June 2018; 57 were eligible for final analysis. Sixty-five per cent of patients received six or more sessions of laser treatment. There were no short- or long-term complications related to laser depilation. Patients who had more than two sessions of laser depilation showed an improved recurrence rate. Overall, recurrence rate in our series was 12% at a median follow-up of 172 weeks. CONCLUSION: Laser depilation is a safe and effective adjunct to surgery in minimising the recurrence of pilonidal disease. Patients with primary pilonidal disease and those who are undergoing minimally invasive surgery may also benefit from adjuvant laser depilation. Further high-quality control trials are required to assess its efficacy and safety.


Assuntos
Remoção de Cabelo/métodos , Terapia a Laser/métodos , Seio Pilonidal/prevenção & controle , Prevenção Secundária/métodos , Adolescente , Adulto , Feminino , Hospitais de Distrito , Hospitais Gerais , Humanos , Masculino , Pessoa de Meia-Idade , Seio Pilonidal/cirurgia , Estudos Prospectivos , Reino Unido , Adulto Jovem
4.
Cir. Esp. (Ed. impr.) ; 98(4): 187-203, abr. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-197004

RESUMO

La infección de localización quirúrgica se asocia a prolongación de la estancia hospitalaria, aumento de la morbilidad, mortalidad y gasto sanitario. La adherencia a paquetes sistematizados que incluyan medidas de prevención validadas científicamente consigue disminuir la tasa de infección postoperatoria. La Sección de Infección Quirúrgica de la Asociación Española de Cirujanos ha realizado una revisión crítica de la evidencia científica y las más recientes guías internacionales, para seleccionar las medidas con mayor grado de evidencia a fin de facilitar su aplicación en los servicios de cirugía españoles. Cuentan con mayor grado de evidencia: no eliminación del vello del campo quirúrgico o eliminación con maquinilla eléctrica, descontaminación de la piel con soluciones alcohólicas, profilaxis antibiótica sistémica adecuada (inicio 30-60 minutos antes de la incisión, uso preferente en monodosis, administración de dosis intraoperatoria si indicada), mantenimiento de la normotermia y el control de la glucemia perioperatoria


Surgical site infection is associated with prolonged hospital stay and increased morbidity, mortality and healthcare costs, as well as a poorer patient quality of life. Many hospitals have adopted scientifically-validated guidelines for the prevention of surgical site infection. Most of these protocols have resulted in improved postoperative results. The Surgical Infection Division of the Spanish Association of Surgery conducted a critical review of the scientific evidence and the most recent international guidelines in order to select measures with the highest degree of evidence to be applied in Spanish surgical services. The best measures are: no removal or clipping of hair from the surgical field, skin decontamination with alcohol solutions, adequate systemic antibiotic prophylaxis (administration within 30-60 minutes before the incision in a single preoperative dose; intraoperative re-dosing when indicated), maintenance of normothermia and perioperative maintenance of glucose levels


Assuntos
Humanos , Cuidados Pré-Operatórios/métodos , Infecção da Ferida Cirúrgica/prevenção & controle , Antibacterianos/administração & dosagem , Antibioticoprofilaxia/métodos , Banhos , Glicemia , Temperatura Corporal , Desinfecção/métodos , Luvas Cirúrgicas , Remoção de Cabelo , Higiene das Mãos , Sistema Imunitário , Fatores Imunológicos/administração & dosagem , Desnutrição/terapia , Tratamento de Ferimentos com Pressão Negativa , Estado Nutricional , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus , Vestimenta Cirúrgica , Campos Cirúrgicos , Espanha
5.
Lasers Med Sci ; 35(7): 1549-1554, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32006263

RESUMO

The forehead flap is a dependable option for nasal reconstruction owing to its reliability and anatomic likeness to nasal skin. For patients with low hairlines, the vertical design of the paramedian forehead flap can intrude into the scalp, thus incorporating hair into the nasal reconstruction. The inadequate length of the forehead flap or shift to an oblique design may result in eyebrow elevation and asymmetry. Therefore, laser hair removal (epilation) on the forehead flap has been proposed to improve esthetic results. An alexandrite laser (755 nm, 10 to 20 ms, 18-mm spot size) with a Dynamic Cooling Device™ (DCD™) cooling system was used for hair removal in 22 patients (16 male and 6 female patients) after nasal reconstructions using forehead flaps from December 2011 to September 2016. All patients received cryogen spray cooling laser treatment (CSC-LT). The mean follow-up period was 24 months, with a range between 18 and 50 months. The average duration of treatment was 1.8 months (range, 1-5 months). The energy density ranged from 14 to 18 J/cm2 with an average of 17.2 J/cm2. The number of treatments ranged from 2 to 4 (mean 2.8). Patients had satisfactory esthetic results over 11.1 months (range, 8-18 months). Residual white hairs were observed in 3 patients, and 4 patients had tiny black residual hairs without deteriorating cosmesis. Using an alexandrite laser to remove hair on the forehead is safe and reliable in nasal reconstruction with superior recipient site cosmesis.


Assuntos
Testa/cirurgia , Remoção de Cabelo , Lasers de Estado Sólido , Nariz/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Retalhos Cirúrgicos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Lasers Med Sci ; 35(4): 797-806, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31919681

RESUMO

Using light sources in phototherapy has presented promising results regarding several types of facial and body skin affections for centuries. The neodymium-doped yttrium aluminum garnet (ND:YAG) 1064 nm laser has become a standard treatment in dermatology for dermatological disturbances related to the pilous follicle and the structures surrounding it. Despite the reports of its clinical benefits, few scientific studies show its actual safety and efficacy. To substantiate the effects, benefits, and safety of applying an ND:YAG 1064 laser in the epilation process during esthetic treatment, a systematic review was carried out between October 2018 and January 2019, on studies published in the last 20 years. Randomized clinical trials in humans were considered that evaluated the efficacy, safety, and benefits of ND:YAG laser application at 1064 nm wavelengths for hair removal. A total of 198 articles were identified; 58 articles remained after their titles and abstracts were read; and 21 articles were selected after the removal of duplicates. After the integral reading, 13 of these articles were included in the systematic review (734 patients). The ND:YAG 1064 nm laser presents safety and promising, beneficial effects in epilation. However, further scientific studies with better methodologic quality are necessary to better standardize ND:YAG laser therapy and clarify its parameters for photoepilation.


Assuntos
Remoção de Cabelo/métodos , Lasers de Estado Sólido/efeitos adversos , Humanos , Pele/efeitos da radiação , Resultado do Tratamento
7.
J Pediatr Surg ; 55(4): 761-766, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31126689

RESUMO

PURPOSE: This study aimed to standardize the technique of pediatric endoscopic pilonidal sinus treatment (PEPSiT) associated with laser epilation. METHODS: All pediatric patients presenting with acute or chronic pilonidal sinus disease (PSD) who underwent PEPSiT in our institution over a 36-month period (July 2015-July 2018), were included in the study. Pre- and postoperative management, recurrence rate, postoperative pain, hospital stay, analgesic requirements, and patient satisfaction levels were evaluated. RESULTS: A total of 59 patients (23 girls and 36 boys) underwent PEPSiT during the study period. Ten/59 patients (16.9%) had recurrent PSD after open repair, and 4/59 (6.7%) presented a concomitant pilonidal cyst. All children underwent laser epilation pre- and postoperatively over the last 15 months. The average length of surgery was 27.5 min (range 20-45). The average pain score during the first 48 postoperative hours was 2.7 (range 2-5), and the average analgesic requirement was 20 h (range 16-24). The average hospitalization was 22.4 h (range 18-36). At 1 month postoperatively, external openings were healed in all patients. During follow-up, 1 recurrence (1.6%) was recorded and successfully re-treated with PEPSiT. CONCLUSIONS: We believe that PEPSiT represents the technique of choice for treatment of PSD in the pediatric population. It is crucial to standardize the technique consisting of pre- and postoperative laser epilation, PEPSiT, and accurate postoperative wound management with eosin and sulfadiazine spray. LEVEL OF EVIDENCE: Treatment study - Level IV.


Assuntos
Endoscopia/métodos , Seio Pilonidal/cirurgia , Adolescente , Analgésicos/uso terapêutico , Endoscopia/efeitos adversos , Feminino , Remoção de Cabelo/efeitos adversos , Remoção de Cabelo/métodos , Humanos , Terapia a Laser/efeitos adversos , Tempo de Internação , Masculino , Duração da Cirurgia , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Satisfação do Paciente , Recidiva , Resultado do Tratamento , Cicatrização
8.
Lasers Med Sci ; 35(2): 373-378, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31278429

RESUMO

The aim of this study was to compare the efficacy and safety of a novel diode system emitting 755 nm wavelength with conventional 755 nm alexandrite laser in skin types III and IV. It was a randomized, right-left comparison, assessor-blind, clinical study. Sixteen female volunteers age 29.52 ± 9.52 were randomly assigned to receive six treatment sessions using 755 nm diode laser on one axilla and 755 nm alexandrite on the opposite axilla. Efficacy was assessed by counting of hairs per square centimeter, 6 months after the last treatment. Treatment outcome was also evaluated by blind reviewing of before and after pictures, using Physician Global Assessment scale (GAS). Subject satisfaction was assessed using visual analogue scale (VAS), pain level and adverse effects were recorded. Skin biophysical parameters (transepidermal water loss, skin sebum, and erythema index) were also measured. Significant reduction in hair count was observed, 6 months after the last treatment session, for both devices (- 33% for 755 nm diode and - 35% for 755 nm alexandrite; p value = 0.85). The mean GAS score was 2.66 for alexandrite treated side vs. 2.00 for diode treated side (p value = 0.036). No severe adverse events were reported. The subject satisfaction score was significantly higher after treatment with alexandrite laser. No significant changes were detected in none of skin biophysical parameters. 755 nm diode laser is suitable for hair removal procedures and it is as effective and safe as the 755 nm alexandrite laser in skin types III-IV.


Assuntos
Axila/efeitos da radiação , Remoção de Cabelo/efeitos adversos , Lasers Semicondutores/efeitos adversos , Lasers Semicondutores/uso terapêutico , Lasers de Estado Sólido/efeitos adversos , Lasers de Estado Sólido/uso terapêutico , Adulto , Feminino , Humanos , Dor/etiologia , Pele/efeitos da radiação , Resultado do Tratamento , Escala Visual Analógica
9.
Asian J Androl ; 22(1): 28-33, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31489848

RESUMO

Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction. One of the major complications associated with these prostheses is infections, which ultimately require device explanation and placement of a new device. Over the past several decades, significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient morbidity. This article reviews the current state of knowledge surrounding penile prosthesis infections, with attention to the evidence for methods to prevent infection and best practices for device reimplantation.


Assuntos
Disfunção Erétil/cirurgia , Implante Peniano/métodos , Prótese de Pênis , Infecções Relacionadas à Prótese/prevenção & controle , Infecção da Ferida Cirúrgica/prevenção & controle , Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Antibioticoprofilaxia/métodos , Bandagens , Portador Sadio/diagnóstico , Portador Sadio/tratamento farmacológico , Clorexidina/uso terapêutico , Materiais Revestidos Biocompatíveis , Remoção de Dispositivo , Diabetes Mellitus/epidemiologia , Disfunção Erétil/epidemiologia , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Negativas/imunologia , Infecções por Bactérias Gram-Negativas/prevenção & controle , Infecções por Bactérias Gram-Negativas/terapia , Remoção de Cabelo/métodos , Humanos , Hospedeiro Imunocomprometido/imunologia , Masculino , Cuidados Pré-Operatórios/métodos , Infecções Relacionadas à Prótese/epidemiologia , Infecções Relacionadas à Prótese/imunologia , Infecções Relacionadas à Prótese/terapia , Reoperação , Fatores de Risco , Traumatismos da Medula Espinal/epidemiologia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/imunologia , Infecções Estafilocócicas/prevenção & controle , Infecções Estafilocócicas/terapia , Staphylococcus aureus , Staphylococcus epidermidis , Campos Cirúrgicos , Instrumentos Cirúrgicos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/imunologia , Infecção da Ferida Cirúrgica/terapia
12.
J Dtsch Dermatol Ges ; 18(1): 27-32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31671255

RESUMO

BACKGROUND AND OBJECTIVES: Dermatoscopy may be hindered by body hair, and the development of an automated hair removal algorithm (AuHRA) might improve the diagnostic accuracy. However, the physicians' exact level of hindrance and the clinical benefit attained by AuHRA has not been assessed. The objectives of this study are to quantify the physicians' level of hindrance by body hair and the level of improvement in the visibility of underlying dermatoscopic patterns after application of AuHRA to digital images of hair-covered nevi. PATIENTS AND METHODS: A cross-sectional reader study including 59 sets of dermatoscopic images of benign nevi that were presented to six dermatologists. Each set included three images of one individual nevus (unshaved/physically shaved/digitally shaved with AuHRA), which were compared to each other within each set to assess the level of improvement caused by hair removal. RESULTS: In comparison to unshaved lesions, dermatologists attributed the highest mean level of improvement to a physical shave (+1.36, p < 0.001) followed by AuHRA's digital shave (+0.79, p < 0.001). The majority of dermatologists considered the application of AuHRA as helpful and confirmed a medical need. CONCLUSIONS: The dermatologists in our study confirmed a substantial impairment of the dermatoscopic examination by body hair. We demonstrated a clinical benefit attained by AuHRA in comparison to unshaved or physically shaved lesions.


Assuntos
Algoritmos , Remoção de Cabelo/métodos , Nevo/diagnóstico , Neoplasias Cutâneas/diagnóstico , Estudos Transversais , Dermoscopia/métodos , Diagnóstico Diferencial , Humanos , Exame Físico
14.
J Pediatr Surg ; 55(1): 182-186, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31676078

RESUMO

PURPOSE: The purpose of this study was to evaluate the resource utilization and outcome of a minimally invasive pilonidal protocol (MIPP) versus surgical excision (SE) in adolescents with pilonidal disease. METHODS: Improved hygiene, laser epilation (LE), and sinusectomy were implemented as a minimally invasive pilonidal protocol (MIPP) in March 2016. Following IRB approval, 34 consecutive MIPP patients with moderate and severe disease were compared with a random sample of 17 SE patients treated prior to MIPP implementation. Number of visits, laser epilation (LE) treatments, care duration, operations, operating room (OR) time, charges, and condition at last visit were analyzed. Charges were standardized for 2018. RESULTS: No differences were found in age or body mass index between groups. SE patients underwent an average 1.6 excisions/patient (cumulative 2598 OR minutes) and no LE. MIPP patients underwent an average 1.4 sinusectomies and 3.5 LEs/patient. Six sinusectomies (0.17/patient) were performed in OR (cumulative 258 OR minutes). No differences in number of visits or care duration were found between groups. At last follow-up, 82% of MIPP and 18% of SE patients were healed or asymptomatic (p < 0.01). Average charges were $29,098 for SE versus $8440 for MIPP (p < 0.01). CONCLUSION: A minimally invasive pilonidal protocol reduces charges and improves outcome compared with surgical excision in adolescents. LEVEL OF EVIDENCE: III. TYPE OF STUDY: Retrospective comparative study.


Assuntos
Remoção de Cabelo/estatística & dados numéricos , Recursos em Saúde/estatística & dados numéricos , Higiene , Seio Pilonidal/economia , Seio Pilonidal/cirurgia , Adolescente , Honorários e Preços , Feminino , Recursos em Saúde/economia , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos/estatística & dados numéricos , Visita a Consultório Médico/estatística & dados numéricos , Recidiva , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
15.
BMC Womens Health ; 19(1): 164, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31856800

RESUMO

BACKGROUND: Research indicates that young women are being exposed to increasing pressures to remove pubic hair from their bodies, which has the potential for both negative physical and psychological consequences. Women's personal choice and reasoning for partaking in pubic hair removal is influenced by broader social influences; however, there is little theory-based research drawing from established decision-making models investigating the underlying processes that lead young women to engage in pubic hair removal practices. Based on the Theory of Planned Behaviour, it was hypothesised that 1) attitude, subjective norm, and perceived behavioural control would predict intention to remove pubic hair; 2) additional variables (prototype similarity and favourability) from the Prototype Willingness Model would significantly predict intention to remove pubic hair; 3) feminist values would significantly predict decreased intention to remove pubic hair; and 4) intention and perceived behavioural control would predict future self-reported removal of pubic hair. METHOD: The current study included a sample of 270 young women (17-25 years old), who completed an online survey and a follow up survey 4 weeks later (N = 96). RESULTS: Attitudes, perceived behavioural control, and similarity to prototypical pubic hair removers were significant predictors of intention to remove pubic hair. Intention was significantly positively associated and feminist values were significantly negatively associated with actual pubic hair removal. CONCLUSIONS: These findings align with Theory of Planned Behaviour propositions. Furthermore, the expansion of the model highlights how broader social images impact on young women when deciding whether to engage in a behaviour that is intimately associated with their body image.


Assuntos
Imagem Corporal/psicologia , Tomada de Decisões , Remoção de Cabelo/psicologia , Adolescente , Adulto , Atitude , Feminino , Humanos , Intenção , Osso Púbico , Inquéritos e Questionários , Adulto Jovem
16.
Med. UIS ; 32(3): 27-33, Sep.-Dec. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1114974

RESUMO

Abstract Genital hair is one of the secondary sexual traits that marks the beginning of puberty; its removal has been part of human culture since ancient times. This practice may lead to modifications in vaginal microbiome with potential repercussions on skin health and balance. We conducted a narrative review with the purpose of describing normal skin microbiota, its impact under microenvironment changes and genital hair removal. Menses, pathological conditions and pubic hair removal may alter vaginal microbiota, being the latter of special relevance giving the risk of hair microtrauma, irritations and potential spread of infectious agents. MÉD.UIS.2019;32(3):27-33


Resumo O cabelo genital é um dos traços sexuais secundários que marcam o início da puberdade; sua remoção faz parte da cultura humana desde os tempos antigos. Essa prática pode levar a modificações no microbioma vaginal com possíveis repercussões na saúde e equilíbrio da pele. Realizamos uma revisão narrativa com o objetivo de descrever a microbiota normal da pele, seu impacto nas alterações do microambiente e na remoção de pelos genitais. A menstruação, as condições patológicas e a remoção de pelos pubianos podem alterar a microbiota vaginal, sendo esta última de especial relevância dando o risco de microtraumatismo capilar, irritações e potencial disseminação de agentes infecciosos. MÉD.UIS.2019;32(3): 27-33


Resumen El vello genital es uno de los rasgos sexuales secundarios que marca el comienzo de la pubertad; su eliminación ha sido parte de la cultura humana desde la antigüedad. Esta práctica puede conducir a modificaciones en el microbioma vaginal con posibles repercusiones potenciales en la salud y el equilibrio de la piel. Realizamos una revisión narrativa con el propósito de describir la microbiota cutánea normal, su impacto bajo los cambios del microambiente y la depilación genital. La menstruación, las condiciones patológicas y la depilación púbica pueden alterar la microbiota vaginal, siendo esta última de especial relevancia dado el riesgo de microtraumatismos, irritaciones y posible propagación de agentes infecciosos. MÉD.UIS.2019;32(3): 27-33


Assuntos
Humanos , Feminino , Microbiota , Remoção de Cabelo , Ruptura , Pele , Staphylococcus , Actinomycetales , Humanos , Saúde , Risco , Puberdade , Dermatologia , Genitália Feminina , Cabelo , Infecções , Menstruação , Noxas
17.
Rom J Ophthalmol ; 63(3): 281-286, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687633

RESUMO

Objective: To describe the chronological features of choroidal neovascular membrane (CNV) development subsequent to accidental firing of diode laser into the eye of a young female during hair epilation. Methods: Descriptive case report. Results: The patient presented one week after the laser injury to a local ophthalmologist complaining of RE (right eye) blurred central vision. Snellen's visual acuity (VA) was 6/ 7.5. Optical coherence tomography (OCT) showed focal disruption of the ellipsoid and the interdigitation zones. Four weeks later, she presented with worsening symptoms and RE VA 6/ 15. Funduscopy revealed a perifoveal grayish lesion with adjacent retinal hemorrhage, which, on fluorescein angiography, was leaking, compatible with CNV. OCT showed a dome-shaped sub-retinal pigment epithelium lesion with extension into the subretinal space and little subretinal fluid. The patient was treated with one intravitreal bevacizumab injection. There was rapid regression of the CNV and improvement of VA to 6/ 7.5 at one-month visit and to 6/ 6 at 6-month visit. Conclusion: All the laser procedures should be conducted with intensive care for both the patient and the laser surgeon since inadvertent effects are constantly being reported due to lack of adherence to safety measures.


Assuntos
Neovascularização de Coroide/etiologia , Remoção de Cabelo/efeitos adversos , Terapia a Laser/efeitos adversos , Acuidade Visual , Adulto , Inibidores da Angiogênese/administração & dosagem , Bevacizumab/administração & dosagem , Neovascularização de Coroide/diagnóstico , Feminino , Remoção de Cabelo/métodos , Humanos , Injeções Intravítreas , Receptores de Fatores de Crescimento do Endotélio Vascular/antagonistas & inibidores , Tomografia de Coerência Óptica
18.
PLoS Negl Trop Dis ; 13(10): e0007637, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31589610

RESUMO

IMPORTANCE: Trichiasis surgery programs globally have faced high rates of poor surgical outcomes. Identifying correctable risk factors for improving long-term outcomes is essential for countries targeting elimination of trachoma as a public health problem. OBJECTIVE: To determine whether the location of trichiatic eyelashes prior to surgery influences development of post-operative trichiasis (PTT) within two years after surgery. DESIGN: Secondary data analysis of four randomized clinical trials evaluating methods to improve trichiasis surgery outcomes. These include the Surgery for Trichiasis, Antibiotics for Recurrence (STAR) trial, Partnership for Rapid Elimination of Trachoma (PRET-Surgery), absorbable versus silk sutures trial, and epilation versus surgery for minor trichiasis trial. SETTING: Primary trials were conducted in rural areas of Ethiopia and Tanzania. INTERVENTIONS OR EXPOSURES: Trichiasis surgery performed with either the bilamellar tarsal rotation procedure or posterior lamellar rotation procedure. MAIN OUTCOMES: Prevalence of PTT within two years after surgery, location of trichiatic eyelashes pre-operatively and post-operatively. RESULTS: 6,747 eyelids that underwent first-time trichiasis surgery were included. PTT rates varied by study, ranging from 10-40%. PTT was less severe (based on number of trichiatic eyelashes) than initial trichiasis for 72% of those developing PTT, and only 2% of eyelids were worse at follow up than pre-operatively. Eyelids with central only-trichiasis pre-operatively had lower rates of PTT than eyelids with peripheral only trichiasis in each of the three trials that included severe TT cases. 10% of eyelids with peripheral trichiasis pre-operatively that develop PTT have central TT post-operatively. CONCLUSIONS AND RELEVANCE: Pre-operative central trichiasis is less likely than peripheral trichiasis to be associated with subsequent PTT. Regardless of type of surgery, surgeon skill levels, or pre-operative trichiasis severity, the presence of peripheral trichiasis pre-operatively is associated with higher rates of PTT. Making an incision that extends the length of the eyelid and adequately rotating the nasal and temporal aspects of the eyelid when suturing may help to minimize the chance of developing peripheral PTT. TRIAL REGISTRATION: ClinicalTrials.gov PRET: NCT00886015; Suture: NCT005228560; Epilation: NCT00522912.


Assuntos
Pestanas , Complicações Cognitivas Pós-Operatórias/epidemiologia , Tracoma/epidemiologia , Triquíase/epidemiologia , Triquíase/cirurgia , Idoso , Antibacterianos/uso terapêutico , Etiópia/epidemiologia , Pálpebras/cirurgia , Feminino , Remoção de Cabelo , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Recidiva , Fatores de Risco , Tanzânia/epidemiologia , Tracoma/cirurgia , Triquíase/tratamento farmacológico
19.
Am J Emerg Med ; 37(11): 2119.e1-2119.e2, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31477356

RESUMO

This is the case of a 23-year-old female with a past medical history of ADHD and Depression who was evaluated in the emergency department for perioral cyanosis and hypoxia after application of the eutectic mixture of lidocaine and prilocaine (EMLA) local anesthetic prior to a laser-assisted hair removal procedure. This report illustrates a case of methemoglobinemia which is a rare but significant complication of topical anesthetic use.


Assuntos
Anestésicos Locais/efeitos adversos , Remoção de Cabelo , Combinação Lidocaína e Prilocaína/efeitos adversos , Metemoglobinemia/induzido quimicamente , Feminino , Remoção de Cabelo/métodos , Humanos , Metemoglobinemia/diagnóstico , Adulto Jovem
20.
PLoS One ; 14(9): e0221303, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31483828

RESUMO

Recent findings have suggested an association between pubic hair grooming and self-reported history of sexually transmitted infection (STI), specifically gonococcal infection (GC), chlamydial infection (CT), or human immunodeficiency virus (HIV). We evaluated the association between self-reported extreme grooming and laboratory-confirmed prevalence of GC/CT. Between April 2017 and April 2018, we enrolled English-speaking, adult, female students at a large, Midwestern university who presented on-campus for STI testing. Participants completed a questionnaire on demographics and sexual and grooming behaviors, which was linked to their GC/CT test results based on nucleic acid amplification testing. We defined extreme grooming as removal of all pubic hair either at least weekly in the past 12 months or ≥6 times in the past 30 days. We used two separate logistic regression models to determine whether odds of GC/CT varied by extreme groomer status for either time interval. In the study sample of 214 women, prevalence of GC/CT was 9.8%. Nearly all participants (98.1%) reported ever grooming; 53.6% were extreme groomers in the past year and 18% in the past month. Extreme grooming was not associated with prevalent GC/CT in the past year (odds ratio [OR] = 0.8; 95% confidence interval [CI]: 0.3-1.9; adjusted OR = 0.7; 95% CI: 0.3-2.0) or in the past month (OR = 0.5; 95% CI: 0.1-2.0; aOR = 0.4; 95% CI: 0.1-1.9). Pubic hair grooming was common among female university students attending for STI testing. Findings do not support pubic hair grooming as an STI risk factor in this population.


Assuntos
Remoção de Cabelo , Doenças Sexualmente Transmissíveis/diagnóstico , Estudantes/psicologia , Adulto , Infecções por Chlamydiaceae/diagnóstico , Infecções por Chlamydiaceae/epidemiologia , Feminino , Gonorreia/diagnóstico , Gonorreia/epidemiologia , Humanos , Modelos Logísticos , Prevalência , Autorrelato , Doenças Sexualmente Transmissíveis/epidemiologia , Inquéritos e Questionários , Adulto Jovem
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