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1.
Ann R Coll Surg Engl ; 102(8): 594-597, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32538104

RESUMO

INTRODUCTION: The National Bowel Cancer Screening Programme guidelines advocate the use of endoscopic tattooing for suspected malignant lesions to assist identification and to facilitate laparoscopic resections. However, endoscopic tattooing practices are variable in endoscopic units, resulting in repeat endoscopy and delay in patient management. The aim of this study was to assess the adherence to tattoo protocol for significant colonic lesions at an endoscopy unit in a large district general hospital. MATERIALS AND METHODS: Prospectively collected data were analysed for 252 patients with significant colonic lesions between January 2017 and December 2018. Data were collected through reviewing patient's notes, histopathology findings and endoscopy reports. Data on lesions, complications, number and site of tattoo placed, and any repeat endoscopy for a tattoo were collected. RESULTS: Of the 252 patients, 88% (n = 222) had malignant and 12% (n = 30) had benign lesions. Only 58.7% (n = 148) of those patients who had colonoscopy had tattoo placement reported. Of these 148 cases, the report stated the distance of tattoo in relation to the lesion in only 46% (n = 68) of patients. Unfortunately, 14.3% (n = 36) of patients required repeat endoscopy to tattoo the lesions prior to surgery. CONCLUSIONS: Our study highlights the lack of uniformity of tattoo practice among endoscopists. Despite the National Bowel Cancer Screening Programme guidelines, a significant proportion of colorectal lesions are still not tattooed during their first endoscopy. Some patients had to have repeat endoscopy just for the purpose of tattooing. Active involvement and participation of all endoscopists in the colorectal and the complex polyp multidisciplinary teams may help to improve the tattoo service.


Assuntos
Colonoscopia/métodos , Neoplasias Colorretais/cirurgia , Laparoscopia/métodos , Tatuagem/métodos , Idoso , Idoso de 80 Anos ou mais , Carbono/uso terapêutico , Colo/patologia , Colo/cirurgia , Neoplasias Colorretais/patologia , Humanos , Pessoa de Meia-Idade , Reoperação , Estudos Retrospectivos
2.
Cir. plást. ibero-latinoam ; 46(2): 233-240, abr.-jun. 2020. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-194728

RESUMO

INTRODUCCIÓN Y OBJETIVO: La micropigmentación de cejas es un conocido procedimiento para mejorar las cejas envejecidas y las jóvenes y también para crearles una forma estética. A pesar de la evolución de la aparatología y de las rutinas para llevar a cabo este procedimiento, existe una carencia de productos que favorezcan la cicatrización y protección tanto de la piel como para el uso de nuevos pigmentos. Durante muchos años el empleo de dermocosméticos comunes con vitamina C en este procedimiento no ha estado indicado por la posibilidad de blanqueamiento y decoloración, a pesar de sus reconocidas propiedades antioxidantes y de cicatrización. En este estudio nos proponemos investigar si es posible adicionar vitamina C nanoencapsulada en el procedimiento de micropigmentación de las cejas para obtener ventaja de sus propiedades y mejorar los resultados, y si su forma nanoencapsulada puede obtener mejores resultados sin el blanqueamiento o la decoloración que parecen provocar otros dermocosméticos comunes con vitamina C. MATERIAL Y MÉTODO: Realizamos un estudio prospectivo y randomizado que incluyó 31 pacientes sometidas a micropigmentación bilateral de cejas utilizando el mismo procedimiento de rutina y el mismo aparato de micropigmentación. Bajo su consentimiento, las pacientes fueron sus propios controles y recibieron vitamina C nanoencaspulada en una ceja y rutina de micropigmentación normal en la otra. RESULTADOS: La evaluación se realizó mediante documentación fotográfica y análisis visual, valorando si hubo o no pérdida del color. La ceja derecha, tratada con vitamina C nanoencapsulada, mostró mejores resultados que el control, manteniendo los pigmentos y la forma con resultados claramente superiores (70.97%). La ceja izquierda, no tratada, mostró mejores resultados en solo el 22.58% de las pacientes. CONCLUSIONES: Los resultados fueron satisfactorios y abren una nueva visión sobre el papel de la vitamina C nanoencapsulada en la cicatrización y protección de la piel en el procedimiento de micropigmentación de las cejas


BACKGROUND AND OBJECTIVE: Eyebrows micropigmentation is a popular procedure to enhance the aged and youth eyebrows and to create an aesthetic shape to them. Despite the devices evolution and routines for this procedure there is a lack of wound healing and protection products both to skin and the new pigments. For many years, the use of regular Vitamin C dermocosmetics in this procedure has been non indicated, because the possibility of whitening and discoloration, despite its recognized wound healing and antioxidants properties. Our propose in this paper is to investigate if it's possible to add nanoencapsulated vitamin C in eyebrows micropigmentation procedure in order to take advantage of its properties, to enhance the procedure results, and if the nanoencapsulated vitamin C can get better results in eyebrows micropigmentation, without whitening and discoloration METHODS: A prospective randomized study was developed including 31 patients who underwent bilateral eyebrows micropigmentation using the same procedure routine and device. Under their consent, patients served as their own control and received nanoencapsulated vitamin C to one eyebrow and none product to the other side. RESULTS: The evaluation was carried out using photographic documentation and visual analysis, assessing whether or not there was color loss. The right eyebrow, treated with nanoencapsulated vitamin C showed better results than the control, maintaining pigments and shape with clearly superior results (70.97%). The untreated left eyebrow showed better results in only 22.58% of patients. CONCLUSIONS: The results were satisfactory and open a new vision on the role of nanoencapsulated vitamin C in the healing and protection of the skin in the micropigmentation procedure of the eyebrows


Assuntos
Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Nanocápsulas/administração & dosagem , Ácido Ascórbico/administração & dosagem , Sobrancelhas , Tatuagem/métodos , Pigmentação da Pele , Cicatriz/terapia , Procedimentos Cirúrgicos Dermatológicos/métodos , Cicatrização/efeitos dos fármacos , Estudos Prospectivos
3.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(1): 56-64, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-31958932

RESUMO

Objective: To explore the application of endoscopic tattooing with carbon nanoparticles in the treatment of advanced colorectal cancer (ACRC). Methods: A randomized controlled study was used. Inclusion criteria: (1) age more than 18 years old, and colorectal cancer was found for the first time and confirmed by colonoscopy and biopsy; (2) advanced colorectal cancer (preoperative TNM stage of T3/N1 or above, local unresectable lesion, M1 stage and simultaneously resectable metastatic lesion), and patients agreed to receive neoadjuvant therapy; (3) advanced colorectal cancer (TNM stage of T3/N1 or above) with simultaneous unresectable metastatic lesion, and patients refused operation and consented to chemoradiotherapy. Patients with previous abdominal surgery history, radiotherapy and chemotherapy history, urgent need for surgery or endoscopic stent placement and those with severe allergic constitution were excluded. Based on the above criteria, 120 patients diagnosed with ACRC in No.900 Hospital of the Joint Logistics Team from January 2016 to December 2017 were prospectively enrolled and randomly divided into tattoo group and non-tattoo group by random number table method. Tattoo group were tattooed within 1-7 days before chemoradiotherapy. The labeling location of the lesions: (1) if the colonoscopy could pass smoothly, 4 points were injected into the intestinal wall of the both opposite sides 1 cm cephalad and caudad of the tumor; (2) if the colorectal cavity was severely narrow and the colonoscopy could not pass, only 4 points were injected in 4 quadrants at 1 cm caudad of the tumor. Each injection point was injected with 0.1 ml carbon nanoparticles, and the size of the tumor was measured according to the range of carbon nanoparticles staining. The efficacy was evaluated after 8 weeks of chemoradiotherapy. Patients who were defined to be suitable for operation underwent operation 6 weeks after chemoradiotherapy. The following parameters were compared between two groups: lesion identification time, operation time, blood loss, distance from lesion to distal margin, the rate of first positive margin and the rate of anal sphincter preservation (rectal cancer). Among patients who had been evaluated as having no indication for surgery, those who were effective in chemoradiotherapy continued to receive chemotherapy in the original regimen; if the treatment failed, the chemotherapy regimen was replaced, and the efficacy was finally evaluated after six months [referring to the revised RECIST guidelines (version 1.1)]. Results: Three patients withdrew from this study, and 117 patients were enrolled in this study finally, including 59 cases in tattoo group and 58 cases in the non-tattoo group. There were no significant differences in baseline data between two groups (all P>0.05). All the patients had slight adverse reactions of radiotherapy and chemotherapy before operation, and could tolerate after symptomatic management without interruption of treatment. All the patients in the tattoo group had no discomfort such as fever, abdominal pain, abdominal distention, hematochezia, etc. and the intestinal mucosa could be seen clearly with black staining after being tattooed. A total of 77 patients were evaluated with surgical indications, including 39 cases in the tattoo group (tattoo-operable) and 38 cases in the non-tattoo group (non-tattoo-operatable). There were no significant differences in baseline data between the two groups (all P>0.05). Forty patients without operation indications continued chemoradiotherapy, including 20 cases in tattoo group (tattoo-inoperable) and 20 cases in non-tattoo group (non-tattoo-inoperable), whose differences in baseline data between the two groups were not significant as well (all P>0.05). No obvious edema, necrosis or abscess were found in the tattooed segments and the black spots could be seen quickly and clearly on the serosa of rectum in tattoo-operable patients. As compared to non-tattoo group, tattoo group had significantly shorter lesion identification time [(3.4±1.4) minutes vs. (11.8±3.4) minutes, t=-14.07,P<0.001], shorter operation time [(155.7±44.5) minutes vs. (177.2±30.2) minutes, t=-2.48,P=0.015], less blood loss [(101.3±36.7) ml vs.(120.2±38.2) ml, t=-2.22,P=0.029], shorter distance from lesion to distal margin [(3.7±1.0) cm vs. (4.6±1.7) cm, t=-2.20, P=0.034], while tattoo group had slightly higher rate of anal sphincter preservation [66.7%(16/24) vs. 45.5%(10/22), χ(2)=2.10,P=0.234] and lower rate of first positive resection margin [0 vs. 4.5%(1/22), χ(2)=0.62,P=0.480], but their differences were not significant. There were no significant differences in the degree of tumor differentiation and TNM stage between two groups. Patients without operative indication were evaluated for efficacy of chemoradiotherapy again after half a year. One case of complete response (CR), 8 of partial response (PR), 10 of stable disease (SD) and 1 of progressive disease (PD) were found and the improvement rate was 45.0% (9/20) in tattoo-inoperable patients. No case of CR, 6 of PR, 11 of SD and 3 of PD were found and the improvement rate was 30.0% (6/20) in non-tattoo-inoperable patients. There was no significant difference in the improvement rate between the two groups (P=0.514). Conclusions: Endoscopic tattooing with carbon nanoparticles injection is safe and reliable for colorectal tumor positioning. It can assist rapid detection of lesions during surgery after neoadjuvant treatment, perform accurate resection, significantly shorten the operation time and reduce surgical trauma; can assist colonoscopy accurately to measure the size of the lesions before and after chemoradiotherapy, and increase the means of assessing the efficacy to guide the follow-up treatment plan. This technique is worth clinical promotion and application.


Assuntos
Carbono/administração & dosagem , Neoplasias do Colo/terapia , Nanopartículas/administração & dosagem , Neoplasias Retais/terapia , Tatuagem/métodos , Adolescente , Quimiorradioterapia Adjuvante , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Colonoscopia , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Neoplasias Colorretais/terapia , Terapia Combinada , Humanos , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
4.
Dermatology ; 236(3): 208-215, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31499492

RESUMO

BACKGROUND: Tattooist-related technical failures of tattooing were hitherto unstudied and related to clinical complications. Tattooing requires talent, training and experience. Amateurism is a challenge in popular tattoo industry with no formal education and certification of the tattooists. OBJECTIVE: To study technical tattoo failures causing disease in a consecutive hospital material of tattoo complications. MATERIAL: 574 patients with 702 tattoo complications referred to the "Tattoo Clinic" (a subspecialised dermatological clinic) were enrolled. Patients were examined clinically and classified with respect to the cause of complication. RESULTS: 147 (21%) tattooist and tattoo studio-related complications were recorded, i.e. excessive pigment installed in the dermis with "pigment overload" in 64 (9%), tattoo "needle trauma" with "overworked tattoos" in 43 (6%), contaminated ink causing infection in 20 (3%), and other sources of infections related to tattooing in 20 (3%). Pain and discomfort were particularly common as well as long-term complications including scarring induced by "needle trauma." "Pigment overload" with black pigment carried a special risk of granulomatous inflammation and sarcoid granuloma and was observed in 12/35 (34%) of punch biopsies taken from tattoos with "pigment overload." Keratoacanthoma associated with trauma was observed in 1 case. 82% of complications were related to professional tattooists working in a tattoo studio and 18% to amateurs. CONCLUSION: Technical failures of tattooing are associated with medical tattoo complications. "Needle trauma" with major skin damage, e.g. "overworked tattoo," and installation of excessive pigment, e.g. "pigment overload," and (re)use of contaminated tattoo ink bottles are identified failures calling for preventive intervention.


Assuntos
Dermatopatias/diagnóstico , Tatuagem/efeitos adversos , Corantes/efeitos adversos , Humanos , Dermatopatias/etiologia , Tatuagem/métodos , Tatuagem/normas
5.
Plast Reconstr Surg ; 145(1): 38-42, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31881601

RESUMO

Medical tattooing is a critical reconstructive component in women following mastectomy. Recently, novel three-dimensional tattooing techniques mimicking depth by using light and shadow principles have allowed for aesthetically superior results. However, results are variable between providers, and professionals skilled in tattooing are often inaccessible to patients. To assess the need and obtain more background information regarding current practices, the authors recorded survey results from 753 plastic and reconstructive surgery offices. Results showed that 23 percent of facilities that offer reconstruction do not perform or refer for nipple-areola complex tattooing, leaving the patients to seek the service on their own. In this article, the authors present the nipple-by-number device, a three-dimensionally-printed stencil to ensure an accurate, consistent, and personalized aesthetic result during three-dimensional nipple-areola complex tattooing. The nipple-by-number device permits the plastic surgeon or supervised treating specialist to inexpensively, efficiently, and expeditiously perform the three-dimensional nipple-areola complex tattooing in their office. Furthermore, the device gives the patients the option of having their premorbid nipple-areola complex anatomy restored through preoperative photographs or choosing a different nipple-areola complex from a catalogue of designs. The device can be applied on any reconstructed breast mound whether or not a nipple projection procedure has been performed.


Assuntos
Neoplasias da Mama/cirurgia , Mamoplastia/métodos , Mamilos/cirurgia , Tatuagem/métodos , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente
6.
J Clin Pathol ; 73(5): 267-272, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31690565

RESUMO

AIMS: To describe the clinical utility of lymph node retrieval and prognostic value of tattooing in rectal cancer (RC) patients undergoing neoadjuvant concurrent chemoradiotherapy (CCRT). METHODS: A total 97 RC patients underwent preoperative CCRT, and 38 patients had preoperative endoscopic tattooing. Surgical intervention was performed after CCRT and the specimens were sampled as standard protocol in all patients. Other clinicopathological parameters correlated with lymph node retrieval status were also analysed. RESULTS: Fifteen patients (39.5%) of 38 RC patients in the tattooing group (TG) had adequate lymph node retrieval (>12) compared with 12 (20.3%) of 59 in the non-tattooing group. Higher lymph node retrieval rate was noted in the TG (p=0.04). In multivariable analysis, it showed tattooing was an independent predictive factor for higher lymph node retrieval in RC patients after CCRT (p=0.024) by logistic regression modelling. Besides histological grade, positive lymphovascular invasion, presence of lymph node metastasis, poor CCRT response and advanced pathological stage, inadequate lymph node retrieval was significantly associated with poor survival (all p<0.05) by Kaplan-Meier analysis. In multivariable analyses, the results revealed that lymph node retrieval (p=0.005), pathological stage (p=0.001) and tumour progression grade (p=0.02) were independent prognostic markers in RC patients receiving CCRT. CONCLUSION: Preoperative endoscopic tattooing is a useful technique for RC patient receiving neoadjuvant CCRT. It can improve lymph node retrieval and provide an adequate diagnosis for proper treatment and prognosis.


Assuntos
Quimiorradioterapia Adjuvante , Excisão de Linfonodo/métodos , Linfonodos/cirurgia , Cuidados Pré-Operatórios/métodos , Proctoscopia , Neoplasias Retais/terapia , Tatuagem/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Modelos Logísticos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Protectomia , Prognóstico , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/mortalidade , Estudos Retrospectivos , Análise de Sobrevida
7.
Tech Coloproctol ; 23(11): 1073-1078, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31667693

RESUMO

BACKGROUND: Different markers have been used preoperatively to mark colonic lesions, especially India ink. In recent years, another kind of marker has been developed: sterile carbon particle suspension (SCPS). No comparison between these two markers has yet been made. The aim of the present study was to compare the pyrogenic, inflammatory and intraperitoneal effect of these two markers. METHODS: From September 2015 to December 2018, adult patients who were candidates for elective laparoscopic colon resection were randomized to the SCPS or conventional India ink injection group using computer-based randomization. The primary endpoint of the study was the presence of intraoperative adhesions related to the endoscopic tattoo. Secondary endpoints were differences in white blood cell, C-reactive protein, and fibrinogen levels as well as, abdominal pain and body temperature at baseline (before endoscopic tattooing) and 6 and 24 h after colonoscopy. Finally, the visibility of the tattoo during the minimally invasive intervention was assessed. RESULTS: Ninety-four patients were included in the study, 47 for each arm. There were 45/94 females (47.9%) and 49/94 males (52.1%), with a median age of 67.85 ± 9.22 years. No differences were found between groups in WBC, fibrinogen levels, body temperature or VAS scores, but we documented significantly higher CRP values at 6 and 24 h after endoscopic tattooing with India ink injection. There were significantly fewer adhesions in the SCPS Endoscopic Marker group. All the endoscopic tattoos were clearly visible. CONCLUSIONS: SCPS is an effective method for tattooing colonic lesions and has a better safety profile than traditional India ink in terms of post-procedure inflammatory response and intraoperative bowel adhesions. CLINICAL TRIAL REGISTRATION: clinicaltrials.gov (ID: NCT03637933).


Assuntos
Carbono/efeitos adversos , Neoplasias do Colo/cirurgia , Corantes/efeitos adversos , Tatuagem/métodos , Dor Abdominal/etiologia , Idoso , Temperatura Corporal , Proteína C-Reativa/metabolismo , Colonoscopia , Feminino , Fibrinogênio/metabolismo , Humanos , Inflamação/sangue , Inflamação/induzido quimicamente , Injeções , Laparoscopia , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Suspensões
9.
Anal Chim Acta ; 1079: 59-72, 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31387720

RESUMO

This review summarizes the current regulatory status of tattoos in all their versions in the European Union framework, as well as the analytical approaches developed so far to control the safety of this type of products. Publications from the last two decades (2000-2019) have been reviewed in which body-decorating products have become more and more popular. Tattoo inks, permanent make-up, sticker tattoos, and henna-based products are covered. The report highlights that there is no unique regulation for body art products, conforming a complex legislative framework even within the European community. The labelling of tattoo related products is generally non-existent or incorrect. It is therefore very difficult to know their chemical composition in detail. Pigments are ingredients common to all types of tattoos, so they are the most covered compounds in this review, along with their impurities and degradation products, including aromatic amines, metals or PAH. Other types of undesirable compounds are also included, such as plasticizers or para-phenylenediamine. Although the development of methods of analysis has increased in recent times, there is still margin for improvement in the analytical coverage of this topic. The challenge is, indeed, a systematic analytical approach to control body-decorating products, but ideally within a clear and common harmonised regulatory framework. Finally, tattoo-based sensors for biomonitoring have also been included in this review, since although its purpose is not decorative; its clinical importance is very relevant.


Assuntos
Corantes/análise , Tatuagem/legislação & jurisprudência , Europa (Continente) , Humanos , Tatuagem/métodos
10.
Gastrointest Endosc Clin N Am ; 29(4): 687-703, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31445691

RESUMO

Retrieval of lesions after endoscopic polypectomy enables histopathologic analysis and guides future surgical management and endoscopic surveillance intervals. Various techniques and devices have been described with distinct advantages and disadvantages to accomplish retrieval. Appropriate histopathologic analysis depends on lesion handling and preparation. How lesions are handled further depends on size, endoscopic appearance, and removal technique. Endoscopic marking or tattooing is a well-described process that uses dye mediums to leave longstanding marks in the colon. Techniques, dye mediums, and locations within the colon influence tattoo approach.


Assuntos
Pólipos do Colo/cirurgia , Colonoscopia/métodos , Neoplasias Colorretais/prevenção & controle , Lesões Pré-Cancerosas/cirurgia , Tatuagem/métodos , Idoso , Pólipos do Colo/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/diagnóstico por imagem , Lesões Pré-Cancerosas/patologia , Sensibilidade e Especificidade , Manejo de Espécimes
11.
Cornea ; 38(11): 1400-1405, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31436635

RESUMO

PURPOSE: To report outcomes of keratopigmentation (KP) with commercial black ink in the treatment of dysphotopsia secondary to laser peripheral iridotomies (LPI) using manual anterior stromal puncture (ASP) and manual lamellar pocket (LP). METHODS: This is a retrospective case series of eyes that underwent KP for treatment of dysphotopsia secondary to LPI. Patients' postoperative symptoms were categorized as resolved, improved, no change, or worse. Any intraoperative and postoperative complications were noted, as well as the need for further treatments. RESULTS: Five eyes in 4 patients underwent ASP, and 14 eyes in 13 patients underwent LP. Only 1 patient had improvement in symptoms in the AK group. Four patients had a complete resolution of symptoms after LP, whereas 7 had symptomatic improvement and 3 did not notice any change. Fifty-five percent of patients in the LP group experienced late-onset depigmentation between 3 and 5 years postoperatively. One patient who underwent 2 LP re-treatments experienced irregular corneal steepening with nonprogressive corneal thinning. Overall, there were no serious adverse reactions to the pigment used. CONCLUSIONS: ASP was not suitable for the treatment of dysphotopsia secondary to LPI. In the short term, LP had good outcomes, but commercial black ink was prone to depigmentation at 3 to 5 years postoperatively. We therefore do not recommend the use of such pigment for long-term management of dysphotopsia secondary to LPI.


Assuntos
Cor de Olho , Tinta , Iridectomia/métodos , Doenças da Íris/cirurgia , Iris/cirurgia , Lasers de Estado Sólido/uso terapêutico , Tatuagem/métodos , Feminino , Seguimentos , Previsões , Humanos , Iris/patologia , Terapia a Laser/métodos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Breast J ; 25(6): 1214-1221, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31321852

RESUMO

Surgical techniques for reconstructing the nipple-areola complex (NAC) pose disadvantages such as areola necrosis, loss of nipple projection, depression or local necrosis, temporary leave from professional activities due to convalescence, and operational costs, all of which are factors that may discourage patients from undergoing them. In this context, dermopigmentation stands out as an emerging nonsurgical option. It is an inexpensive outpatient procedure that mimics the nipple-areola complex by means of defining the areolar contour, Montgomery's tubercles, and a variety of colors that allow for individualization and contralateral symmetry. In this pioneering study, we propose to validate the 3D dermopigmentation technique as a preferential technique in the NAC reconstruction process. We selected 30 women with previous breast cancer who underwent conservative breast surgeries or mastectomy with NAC removal more than 6 months prior to their participating in our study. We employed the dermopigmentation technique, which we evaluated with the aid of questionnaires intended for patients, doctors, and tattooists. Among specialists, results were considered good and excellent with regard to overall esthetics (76.07%) and color (72.5%); whereas among patients, results were considered good and excellent with regard to overall satisfaction (95%) and color (100%); no adverse events were observed. Three-dimensional dermopigmentation proved to be a promising nonsurgical technique for nipple-areola complex reconstruction.


Assuntos
Neoplasias da Mama/cirurgia , Mastectomia/efeitos adversos , Mamilos , Complicações Pós-Operatórias/terapia , Tatuagem/métodos , Adulto , Corantes/farmacologia , Estética , Feminino , Humanos , Mastectomia/métodos , Pessoa de Meia-Idade , Satisfação do Paciente , Complicações Pós-Operatórias/psicologia , Pigmentação da Pele
13.
Nanoscale ; 11(30): 14294-14302, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31318368

RESUMO

Room-temperature printing of conductive traces has the potential to facilitate the direct writing of electronic tattoos and other medical devices onto biological tissue, such as human skin. However, in order to achieve sufficient electrical performance, the vast majority of conductive inks require biologically harmful post-processing techniques. In addition, most printed conductive traces will degrade with bending stresses that occur from everyday movement. In this work, water-based inks consisting of high aspect ratio silver nanowires are shown to enable the printing of conductive traces at low temperatures and without harmful post-processing. Moreover, the traces produced from these inks retain high electrical performance, even while undergoing up to 50% bending strain and cyclic bending strain over a thousand bending cycles. This ink has a rapid dry time of less than 2 minutes, which is imperative for applications requiring the direct writing of electronics on sensitive surfaces. Demonstrations of conductive traces printed onto soft, nonplanar materials, including an apple and a human finger, highlight the utility of these new silver nanowire inks. These mechanically robust films are ideally suited for printing directly on biological substrates and may find potential applications in the direct-write printing of electronic tattoos and other biomedical devices.


Assuntos
Nanofios/química , Prata/química , Tatuagem/métodos , Eletrônica , Humanos , Tinta , Tatuagem/instrumentação
14.
South Med J ; 112(4): 222-227, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30943541

RESUMO

OBJECTIVES: Accurate localization of a colonic lesion is crucial to successful resection. Although colonic tattooing is a widely accepted technique to mark lesions for future identification surgery or repeat colonoscopy, no consensus guidelines exist. The objective of this study was to determine whether the current tattooing practice at a tertiary medical center differs from recommendations in the literature and self-reported provider practice. METHODS: The study consisted of an observational retrospective chart review of patients who received colonic tattoos, as well as a provider survey of reported tattooing practices at a tertiary academic medical center. A total of 747 patients older than 18 years of age who underwent colonoscopy with tattoo were included. Forty-four gastroenterologists performing endoscopy were surveyed on tattooing techniques. RESULTS: In the majority of cases, neither the number of tattoos, location of the tattoo nor the distance from the lesion was specified within the report. Following the index procedure, a tattoo was detected in 75% of surgical resections and 73% of endoscopies. At the time of surgery, however, the tattoo and/or the lesion was detected approximately 94% of the time. Twenty-five endoscopists (56.8%) completed the survey. Differences were seen the between the chart review and reported practice. Most providers report placing ≥2 marks (87.2%); however, chart review revealed that only 56.2 % were tattooed with ≥2 marks. CONCLUSIONS: Variation exists between the reported tattooing practice and actual practice. Despite this, most tattoos are identified at the time of surgery or repeat endoscopy. Further research is needed to determine whether a standardized approach to tattooing and reporting could improve localization at repeat endoscopy.


Assuntos
Pólipos do Colo/cirurgia , Colonoscopia/métodos , Neoplasias Colorretais/cirurgia , Documentação/estatística & dados numéricos , Gastroenterologistas , Padrões de Prática Médica/estatística & dados numéricos , Tatuagem/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Pólipos do Colo/diagnóstico , Neoplasias Colorretais/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tatuagem/métodos , Centros de Atenção Terciária , Adulto Jovem
15.
Int J Dermatol ; 58(6): 750-755, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30828798

RESUMO

BACKGROUND: Even though dermatologists often perform drug delivery procedures, it is necessary to assess their safety. OBJECTIVE: Quantify the amount of medication delivered using the MMP drug delivery technique and outline other safety parameters. METHODS: Using a simple and novel technique, we attempted to quantify the amount of medication delivered by weighing human skin samples before and after delivery. RESULTS: In drug delivery done on human skin using a liquid with a density of 1,271,460 µg/ml (the values expressed in this manuscript are in µg), a needling density of 570 perforations/cm2 , and a needling depth of 300 microns, we estimate that 1,175 µg/cm2 were delivered (standard deviation 601 µg/cm2 , standard error 190 µg/cm2 ). LIMITATIONS: This result is only applicable to the protocol proposed in this study for the MMP drug delivery technique. CONCLUSION: The MMP drug delivery technique injects small amounts of medication (1,175 µg/cm2 ) homogeneously into the dermis.


Assuntos
Fármacos Dermatológicos/administração & dosagem , Sistemas de Liberação de Medicamentos/instrumentação , Tatuagem/instrumentação , Sistemas de Liberação de Medicamentos/métodos , Humanos , Injeções Subcutâneas/instrumentação , Injeções Subcutâneas/métodos , Pele , Absorção Cutânea , Tatuagem/métodos
16.
Clin Breast Cancer ; 19(3): 208-215, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30922804

RESUMO

INTRODUCTION: Targeted axillary dissection (TAD) is an alternative to axillary dissection for breast cancer patients who presented as cN+ before neoadjuvant chemotherapy (NAC) and became cN0 after treatment. TAD is defined as the removal of sentinel lymph nodes (SLNs) along with the pre-NAC marked positive nodes. Tattooing is an option to mark positive nodes. In this study we aimed to investigate the identification rate of tattooed nodes during surgery, correspondence between tattooed nodes and SLNs, and difficulties and pitfalls of the method. PATIENTS AND METHODS: In 75 patients who were cN+, with axillary lymph nodes known to have or suspected to have disease were tattooed pre-NAC with a sterile carbon suspension (Spot). After NAC completion all patients became cN0 and underwent TAD as an axillary staging procedure. RESULTS: SLNs were identified successfully in 70 of 75 patients (93.3%). All tattooed nodes were identified successfully intraoperatively in 71 of 75 patients (94.6%). Retrieval of all tattooed nodes in surgical specimens was achieved in 74 patients (98.6%). Correspondence between tattooed nodes and SLNs was observed in 53 of 70 patients (75.3%). In 34 patients (45.3%) the number of pigmented nodes in pathological examination was greater than the number of initially tattooed nodes, indicating the possibility of tattoo ink migration. CONCLUSION: Tattoo of axillary lymph nodes is a feasible, accurate, and low-cost method of positive node marking pre-NAC. Pathological confirmation of black pigment in the lymph nodes excised is not by itself warranty of retrieval of all marked node because of tattoo ink migration from one node to another. Intraoperative identification using visual inspection is essential.


Assuntos
Neoplasias da Mama/cirurgia , Excisão de Linfonodo/métodos , Linfonodos/patologia , Linfonodos/cirurgia , Tatuagem/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Axila , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Receptor ErbB-2/metabolismo , Receptores Estrogênicos/metabolismo , Receptores de Progesterona/metabolismo , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
20.
PLoS One ; 14(1): e0209853, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30629615

RESUMO

INTRODUCTION: Tattooing especially gains popularity among both men and women in adulthood from the wide range of socioeconomic groups and is noted as a risk taking behaviour in adults. Especially when tattooing does not perform to the highest standards, it can potentially be the hazardous practice. Myanmar has a paucity of evidence-based information on the estimated prevalence of tattoos and awareness of potential disease transmission from tattooing under insanitary conditions as well as the infection risk. The present research was undertaken to help identify the self-reported prevalence of tattooing among adults (18-35 years) and their knowledge of transmission risk of blood-borne infections and its determinants. METHODS: A community-based cross-sectional study focused on residents aged 18-35 years was carried out in two urban and two rural areas in Mandalay district, Mandalay Region during 2015. Trained interviewers used a pre-tested structured questionnaire for face-to-face interviews with one eligible participant per selected household (n = 401). Bivariate analysis and multivariable analysis using binary logistic regression were done to ascertain the relevant explanatory variables. RESULTS: The overall self-reported prevalence of tattooing was 19.5% (78/401) (95% CI = 16-24). Nearly 80% of participants (318/401) knew at least one blood-borne viral infection that could be transmitted from tattooing. The persons who had high formal education, manual laborers and those who lived with their families were significantly more likely to cite at least one blood-borne viral infection. Their perceived possibility to remove tattoo independently influenced the practice of tattooing (aOR = 1.91, 95% CI = 1.06-3.45; p = 0.03) compared with participants who reported no perceived possibility. Tattooing was more common in male (aOR = 13.07, 95% CI = 6.25-27.33; p<0.001) compared to female which was independently significant. CONCLUSIONS: This study ascertained the tattoo prevalence as two in ten adults of working age especially among male in central part of Myanmar in the context of lack of registration system for tattoo parlours and the issuance of safety guidelines. Findings have suggested the target groups and risk factors to be included in future health promotion programs. Future research directions should focus on perspectives of tattooists to create and sustain the sanitary practices to reduce the chance of transmission of blood-borne viral infections.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde/etnologia , Tatuagem/efeitos adversos , Tatuagem/psicologia , Adolescente , Adulto , Patógenos Transmitidos pelo Sangue , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Mianmar/etnologia , Prevalência , Fatores de Risco , Autorrelato , Inquéritos e Questionários , Tatuagem/métodos , Viroses/etiologia
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