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1.
Ann Plast Surg ; 90(2): 128-132, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36688855

RESUMO

BACKGROUND: The expanded forehead flap pedicled with superficial temporal vessel(s) is a common method to treat facial scar deformity. However, local bulkiness and hair retention have limited the use of this flap. METHODS: Five cadavers were used for anatomy to confirm the forehead "safety zone." A retrospective study was performed on 15 patients with facial scar deformity who were undergoing the expanded forehead superthin flap (without the expanded capsule, frontalis muscle, and with less hair follicles) pedicled with superficial temporal vessel(s) to transfer and repair the deformity. RESULTS: Through cadaver anatomy, the range where the subdermal vascular network laid superficial to the hair follicle level was named the "safety zone," whose average distance between the bilateral penetrating points was 10.2 cm (8.7-11.6 cm). Fifteen patients with facial scar deformity were treated with the superthin flap technique. The trimming size of the safety zone flap was (6-10) × (12-20) cm. The median time of thinning the safety zone was 35 minutes (range, 25-40 minutes). All flaps healed well. The median residual ratio of the hair follicle was 39.8% (29.9%-50.5%). All patients were satisfied with the contour of the flap. CONCLUSION: We firstly proposed a concept of forehead safety zone and used the superthin flap without the frontalis muscle and less hair follicles to treat facial scar deformity, and obtained an improved therapeutic effect. We think this is an appealing technique that can manifest facial concave and convex in the fine part, improve compliance of the flap, and reduce the times of laser hair removal.


Assuntos
Humanos , Testa/cirurgia , Folículo Piloso , Cicatriz/cirurgia , Estudos Retrospectivos , Transplante de Pele
2.
J Drugs Dermatol ; 22(1): 94-97, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36607749

RESUMO

Linear lichen planus pigmentosus (LPP) of the face is a rare variant of lichen planus, with only a few cases published in the literature.1 It is an inflammatory condition with unknown etiology, characterized by blue-gray hyperpigmented macules, and tends to affect sun-exposed areas of the head and neck.1-4 The pathophysiology of linear lichen pigmentosus is poorly understood, though it is postulated to be caused by T-lymphocyte autoimmunity against keratinocytes.5-7 LPP more frequently affects middle age woman and skin phototypes III-VI.1,3 Treatment for linear LPP is difficult and there is no established first-line therapy; however, tacrolimus ointment, topical corticosteroids, and various systemic agents have shown to be effective in improving the appearance.3,8,9 Prior reports have characterized linear LPP that follows the lines of Blashko as more commonly affecting the trunk.1 We present three cases of linear lichen planus pigmentosus (LPP) of the forehead, a unique novel presentation of linear LPP of the face. One of our cases also provides supporting evidence for tacrolimus to be used as a preferred therapy to treat linear LPP of the face; however, more research is needed to support this claim. To our knowledge, this case series is the largest case series of linear lichen planus pigmentosus (LPP) of the forehead to be reported. J Drugs Dermatol. 2023;22(1):94-97. doi:10.36849/JDD.7200.


Assuntos
Hiperpigmentação , Líquen Plano , Pessoa de Meia-Idade , Feminino , Humanos , Testa , Tacrolimo/uso terapêutico , Líquen Plano/diagnóstico , Líquen Plano/tratamento farmacológico , Hiperpigmentação/diagnóstico , Hiperpigmentação/tratamento farmacológico , Pele
3.
Dermatol Surg ; 49(1): 60-65, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36533798

RESUMO

BACKGROUND: Simultaneous treatment of moderate-to-severe upper facial lines is reflective of real-world clinical practice. OBJECTIVE: To evaluate the efficacy and safety of daxibotulinumtoxinA-lanm for injection (DAXI) for simultaneous treatment of glabellar, forehead, and lateral canthal (LC) lines. METHODS: In this open-label, single-arm Phase 2 study, patients (48 enrolled, 94% completed, follow-up 24-36 weeks) received DAXI 40U (glabellar), 32U (forehead), and 48U (LC) lines. Key efficacy endpoints: percentages of patients achieving none/mild wrinkle severity (investigator-rated) for each upper facial line scale at Week 4. RESULTS: At Week 4, most patients achieved none/mild wrinkle severity (investigator-rated): glabellar (96%), forehead (96%), and LC (92%). Median times to loss of none/mild response (investigator- and patient-rated) among all patients were: 24.6 (glabellar), 20.9 (forehead), and 24.9 (LC) weeks; and 25.0, 24.0, and 28.1 weeks, respectively, among Week-4 responders. At Week 4, most patients reported improvements (Global Aesthetic Improvement Scale: 96%-98%) and high satisfaction rates (85%-98%). Five patients experienced treatment-related adverse events: injection-site erythema (3 patients/7 events), facial discomfort (2 patients/2 events), and headache (1 patient/1 event). No patients experienced eyebrow or eyelid ptosis. CONCLUSION: Simultaneous treatment of upper facial lines with DAXI was well tolerated and demonstrated high response rates, extended duration, and high patient satisfaction. CLINICAL TRIAL REGISTRY: https://clinicaltrials.gov/ct2/show/NCT04259086.


Assuntos
Toxinas Botulínicas Tipo A , Fármacos Neuromusculares , Envelhecimento da Pele , Humanos , Testa , Face , Injeções , Resultado do Tratamento , Método Duplo-Cego
5.
Artigo em Inglês | MEDLINE | ID: mdl-36497956

RESUMO

When the ambient temperature, in which a person is situated, fluctuates, the body's surface temperature will alter proportionally. However, the body's core temperature will remain relatively steady. Consequently, using body surface temperature to characterize the core body temperature of the human body in varied situations is still highly inaccurate. This research aims to investigate and establish the link between human body surface temperature and core body temperature in a variety of ambient conditions, as well as the associated conversion curves. METHODS: Plan an experiment to measure temperature over a thousand times in order to get the corresponding data for human forehead, axillary, and oral temperatures at varying ambient temperatures (14-32 °C). Utilize the axillary and oral temperatures as the core body temperature standards or the control group to investigate the new approach's accuracy, sensitivity, and specificity for detecting fever/non-fever conditions and the forehead temperature as the experimental group. Analyze the statistical connection, data correlation, and agreement between the forehead temperature and the core body temperature. RESULTS: A total of 1080 tests measuring body temperature were conducted on healthy adults. The average axillary temperature was (36.7 ± 0.41) °C, the average oral temperature was (36.7 ± 0.33) °C, and the average forehead temperature was (36.2 ± 0.30) °C as a result of the shift in ambient temperature. The forehead temperature was 0.5 °C lower than the average of the axillary and oral temperatures. The Pearson correlation coefficient between axillary and oral temperatures was 0.41 (95% CI, 0.28-0.52), between axillary and forehead temperatures was 0.07 (95% CI, -0.07-0.22), and between oral and forehead temperatures was 0.26 (95% CI, 0.11-0.39). The mean differences between the axillary temperature and the oral temperature, the oral temperature and the forehead temperature, and the axillary temperature and the forehead temperature were -0.08 °C, 0.49 °C, and 0.42 °C, respectively, according to a Bland-Altman analysis. Finally, the regression analysis revealed that there was a linear association between the axillary temperature and the forehead temperature, as well as the oral temperature and the forehead temperature due to the change in ambient temperature. CONCLUSION: The changes in ambient temperature have a substantial impact on the temperature of the forehead. There are significant differences between the forehead and axillary temperatures, as well as the forehead and oral temperatures, when the ambient temperature is low. As the ambient temperature rises, the forehead temperature tends to progressively converge with the axillary and oral temperatures. In clinical or daily applications, it is not advised to utilize the forehead temperature derived from an uncorrected infrared thermometer as the foundation for a body temperature screening in public venues such as hospital outpatient clinics, shopping malls, airports, and train stations.


Assuntos
Temperatura Corporal , Termômetros , Adulto , Humanos , Testa , Axila , Raios Infravermelhos , Temperatura
6.
Artigo em Inglês | MEDLINE | ID: mdl-36554922

RESUMO

Chronic pain impacts one in five Americans and is difficult to manage, costing ~USD 600 billion annually. The subjective experience of pain is a complex processing of central nervous system input. Recent advances in magnetic resonance imaging revealed the prefrontal cortex as vital to the perception of pain and that changes in the cerebral hemodynamics can be used to detect painful sensations. Current pain monitoring is dependent on the subjective rating provided by patients and is limited to a single time point. We have developed a biomarker for the objective, real-time and continuous chronic pain assessment using proprietary algorithms termed ROPA and cerebral optical spectrometry. Using a forehead sensor, the cerebral optical spectrometry data were collected in two clinical sites from 41 patients (19 and 22, respectively, from sites 1 and 2), who elected to receive an epidural steroid injection for the treatment of chronic pain. Patients rated their pain on a numeric rating scale, ranging from 0-10, which were used to validate the ROPA objective pain scoring. Multiple time points, including pre- and post-procedure were recorded. The steroid injection was performed per standard medical practice. There was a significant correlation between the patient's reported numeric rating scale and ROPA, for both clinical sites (Overall ~0.81). Holding the subjective pain ratings on a numeric rating scale as ground truth, we determined that the area under the receiver operator curves for both sites revealed at least good (AUC: 64%) to excellent (AUC > 98%) distinctions between clinically meaningful pain severity differentiations (no/mild/moderate/severe). The objective measure of chronic pain (ROPA) determined using cerebral optical spectrometry significantly correlated with the subjective pain scores reported by the subjects. This technology may provide a useful method of detection for the objective and continuous monitoring and treatment of patients with chronic pain, particularly in clinical circumstances where direct assessment is not available, or to complement the patient-reported pain scores.


Assuntos
Dor Crônica , Dispositivos Eletrônicos Vestíveis , Humanos , Dor Crônica/diagnóstico , Dor Crônica/tratamento farmacológico , Testa , Percepção da Dor , Esteroides
7.
Arch. argent. pediatr ; 120(6): e278-e282, dic. 2022. tab, ilus
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1399732

RESUMO

La displasia frontometafisaria 2 (DFM2) es una enfermedad rara causada por una mutación en el gen MAP3K7. En este artículo, se informa sobre un paciente de 7 años con DFM2 causada por una variante nueva de corte y empalme en MAP3K7. El paciente presenta las características frecuentes de la DFM2, pero algunas nunca antes informadas. No se dispone de una descripción sistemática de las características de las imágenes tomográficas de la DFM2. Describimos ciertas diferencias en las características de la DFM2, la bibliografía publicada y las manifestaciones imagenológicas generales de la DFM2. Este caso resalta la importancia del valor clínico de la tomografía computada (TC) y la renderización de volúmenes (VR) en el diagnóstico de la DFM2. Las características de la DFM2 pueden observarse claramente en los estudios tomográficos, lo que señala la gran importancia de la TC para el diagnóstico y el tratamiento precoces de los pacientes con DFM2.


Frontometaphyseal dysplasia 2 (FMD2) is a rare disease caused by MAP3K7 gene mutation. We report a 7-year-old sporadic patient with FMD2 due to a de novo splicing variant in MAP3K7. He has the common characteristics of FMD2 but also has some characteristics that have never been reported, which increases the clinical phenotype of FMD2. Moreover, no systematic description of the imaging characteristics of FMD2 in computed tomography (CT) is available. In the present work, we found some different features of FMD2, reviewed previous literature, and summarized the general imaging manifestations of FMD2. This case emphasizes the important clinical value of CT and VR in the diagnosis of FMD2. We can clearly find the characteristics of FMD2 by CT examination, indicating its great significance for the prompt diagnosis and treatment of FMD2 patients.


Assuntos
Humanos , Masculino , Criança , Osteocondrodisplasias/complicações , Osteocondrodisplasias/diagnóstico , Osteocondrodisplasias/genética , Hipertensão Arterial Pulmonar , Fenótipo , Testa
8.
Arch Argent Pediatr ; 120(6): e278-e282, 2022 12.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36374066

RESUMO

Frontometaphyseal dysplasia 2 (FMD2) is a rare disease caused by MAP3K7 gene mutation. We report a 7-year-old sporadic patient with FMD2 due to a de novo splicing variant in MAP3K7. He has the common characteristics of FMD2 but also has some characteristics that have never been reported, which increases the clinical phenotype of FMD2. Moreover, no systematic description of the imaging characteristics of FMD2 in computed tomography (CT) is available. In the present work, we found some different features of FMD2, reviewed previous literature, and summarized the general imaging manifestations of FMD2. This case emphasizes the important clinical value of CT and VR in the diagnosis of FMD2. We can clearly find the characteristics of FMD2 by CT examination, indicating its great significance for the prompt diagnosis and treatment of FMD2 patients.


La displasia frontometafisaria 2 (DFM2) es una enfermedad rara causada por una mutación en el gen MAP3K7. En este artículo, se informa sobre un paciente de 7 años con DFM2 causada por una variante nueva de corte y empalme en MAP3K7. El paciente presenta las características frecuentes de la DFM2, pero algunas nunca antes informadas. No se dispone de una descripción sistemática de las características de las imágenes tomográficas de la DFM2. Describimos ciertas diferencias en las características de la DFM2, la bibliografía publicada y las manifestaciones imagenológicas generales de la DFM2. Este caso resalta la importancia del valor clínico de la tomografía computada (TC) y la renderización de volúmenes (VR) en el diagnóstico de la DFM2. Las características de la DFM2 pueden observarse claramente en los estudios tomográficos, lo que señala la gran importancia de la TC para el diagnóstico y el tratamiento precoces de los pacientes con DFM2.


Assuntos
Osteocondrodisplasias , Hipertensão Arterial Pulmonar , Masculino , Humanos , Osteocondrodisplasias/complicações , Osteocondrodisplasias/diagnóstico , Osteocondrodisplasias/genética , Fenótipo , Testa
9.
Plast Reconstr Surg ; 150(6): 1326e-1339e, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36445760

RESUMO

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Understand the cardinal principles in the management of postburn deformities in the face and neck. 2. Understand reconstruction of specific subsites in the face and neck affected by burn contracture. 3. Acquire knowledge about the various techniques of burn reconstruction of the face and neck. 4. Grasp technical nuances and select appropriate surgical options for individual cases. SUMMARY: Postburn contractures in the face and neck region are multifactorial in origin and difficult to prevent in extensive burns. Facial burns lead to distortion of anatomical landmarks, causing aesthetic, functional, and psychological problems. Each subunit of the face is unique in structure; thus, the surgeon needs to adjust the timing of surgery and the technique according to region and the severity of contracture. Contracture of one unit, especially that of the neck and forehead, can exaggerate the contracture in neighboring subunits. The role of these extrinsic influences must be considered while sequencing surgical procedures. The burn surgeon must be adept in all reconstructive surgery techniques from skin grafting to tissue expanders to microsurgery to obtain the best outcomes. Surgery must be followed up with long-term physical therapy and psychological rehabilitation to help burn survivors with head and neck contractures to integrate back into society.


Assuntos
Contratura , Traumatismos Faciais , Humanos , Pescoço/cirurgia , Contratura/etiologia , Contratura/cirurgia , Transplante de Pele , Traumatismos Faciais/complicações , Traumatismos Faciais/cirurgia , Testa
10.
Ann Plast Surg ; 89(6): 652-655, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36416692

RESUMO

BACKGROUND: As facial feminization surgery (FFS) continues to grow in access and popularity, the need for secondary FFS can be expected to increase. The purpose of this study was to identify reasons for FFS reoperation and offer recommendations to minimize secondary surgery. METHODS: A retrospective cohort study of patients who underwent FFS from October 2017 to 2021 was performed. Patients who underwent nonstaged secondary surgery were identified and sorted in 2 non-mutually exclusive surgical cohorts: additional surgery, defined as unplanned additional feminization surgery on previously unoperated facial units, and revision surgery, defined as redo surgery on previously operated facial units. Reasons for secondary surgery were examined in the context of the senior author's experience. RESULTS: Of 161 patients who underwent FFS, 41 (25.5%) underwent secondary surgery consisting of additional surgery (n = 32) and/or revision surgery (n = 30). There were no significant differences in clinical or demographic data between the secondary surgery and total FFS cohorts. Among additional surgery patients, facial units that had been previously operated on were as follows: nose (46.3%), trachea (31.7%), forehead/brow (22.0%), chin (12.2%), lips (9.8%), and cheeks (7.3%). Among revision patients, facial units revised were as follows: nose (36.6%), forehead/brow (26.8%), cheeks (17.1%), chin (17.1%), lips (12.5%), and trachea (2.4%). The main indication for revision for all facial units was undercorrection to feminine ideals. CONCLUSIONS: One-quarter of patients who underwent FFS had prior FFS and/or sought revision. Keeping in mind that the dominant indication for revision was undercorrection, FFS surgeons can minimize the need for secondary surgery in the future.


Assuntos
Face , Feminização , Masculino , Humanos , Feminização/cirurgia , Estudos Retrospectivos , Face/cirurgia , Testa/cirurgia , Lábio/cirurgia
11.
Dermatol Surg ; 48(11): 1191-1197, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36342250

RESUMO

BACKGROUND: OnabotulinumtoxinA safety and efficacy are well established for upper facial lines (UFL), including forehead lines (FHL), glabellar lines (GL), and crow's feet lines (CFL). OBJECTIVE: To investigate the association of onabotulinumtoxinA efficacy with patient-reported psychological impacts and satisfaction in UFL. MATERIALS AND METHODS: A pooled analysis of data from 4 pivotal Phase 3 trials (onabotulinumtoxinA vs placebo in FHL ± GL, FHL + GL ± CFL, CFL, and CFL + GL for ≤180 days) evaluated investigator-assessed ≥1-grade severity improvement on the Allergan Facial Wrinkle Scale at Day 30 (responders). Facial Line Outcomes (FLO-11) Questionnaire, Facial Line Satisfaction Questionnaire (FLSQ), and Subject Assessment of Satisfaction of Appearance (SASA) were used to evaluate responder appearance-related psychological impacts and satisfaction. RESULTS: OnabotulinumtoxinA patients, by primary study focus (FHL, GL, or CFL), totaled 921, 921, and 833, respectively; 786 patients received placebo. Most patients were female, White, and aged 45 to 50 years (median). Through 150 days, >42% FHL, >43% GL, and ≥32% CFL patients were onabotulinumtoxinA responders. Responders reported improvements in appearance-related psychological impacts (FLO-11) and high satisfaction (FLSQ and SASA), sustained through ≥150 days. CONCLUSION: A ≥1-grade improvement with onabotulinumtoxinA is a clinically meaningful outcome in UFL, associated with long-lasting improved patient-reported psychological impacts and high satisfaction.


Assuntos
Toxinas Botulínicas Tipo A , Técnicas Cosméticas , Satisfação do Paciente , Envelhecimento da Pele , Feminino , Humanos , Masculino , Toxinas Botulínicas Tipo A/efeitos adversos , Técnicas Cosméticas/psicologia , Testa , Fármacos Neuromusculares/efeitos adversos , Resultado do Tratamento , Ensaios Clínicos Fase III como Assunto , Pessoa de Meia-Idade
12.
Plast Aesthet Nurs (Phila) ; 42(3): 137-142, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36450054

RESUMO

The perceived feminine face is distinctly unique from the perceived masculine face. Facial feminization surgery (FFS) includes a range of surgical procedures designed to change characteristically masculine facial features into feminine ones. FFS encompasses a set of bone and soft-tissue reconstructive procedures including, but not limited to, forehead contouring with or without frontal sinus setback, hairline adjustment, brow lift, rhinoplasty, lip lift, mandibular shaping, genioplasty, and "tracheal" shave, and fat grafting. Some patients choose to undergo one, all, or groupings of the procedures. The surgical decision is tailored to the individual and based on clinical opinion, patient desire, and insurance status or means to pay. FFS improves patient quality of life, has good general aesthetic outcomes, and improves feminine gender appearance (Morrison et al., 2020).


Assuntos
Cirurgia de Readequação Sexual , Cirurgiões , Humanos , Masculino , Feminização , Qualidade de Vida , Testa
13.
Plast Aesthet Nurs (Phila) ; 42(3): 163-166, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36450059

RESUMO

In this report, we discuss the excision of a large congenital nevus covering the nose and face and the reconstruction of the defect using an expanded forehead flap, in a 24-year-old man. We observed that after incorporating specific modifications including tissue expansion, thinning of the distal part of the flap, and placing the pedicle over the cutaneous branch of the supratrochlear artery, we were able to provide excellent aesthetic results using this time-tested paramedian forehead flap for nasal reconstruction. After we inset the flap, there was negligible donor site morbidity during a 33-month follow-up period.


Assuntos
Nevo , Neoplasias Cutâneas , Masculino , Humanos , Adulto Jovem , Adulto , Testa/cirurgia , Nariz/cirurgia , Retalhos Cirúrgicos , Neoplasias Cutâneas/cirurgia
14.
Lima; Perú. Ministerio de Salud; Nov. 2022. 37 p. tab.
Monografia em Espanhol | MINSAPERÚ | ID: biblio-1399990

RESUMO

El documento contiene la estrategia de preparación y respuesta frente a la viruela del mono, para reducir el impacto en la morbilidad y mortalidad por viruela del mono en la población del país. Deroga R.M 421-2022-MINSA.


Assuntos
Morbidade , Mortalidade , Preparação em Desastres , Varíola dos Macacos , Testa
15.
Dermatol Surg ; 48(11): 1198-1202, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36206385

RESUMO

BACKGROUND: AbobotulinumtoxinA (aboBoNT-A) solution is a new ready-to-use formulation developed to reduce preparation time and improve reproducibility of injections. OBJECTIVE: To further evaluate treatment of moderate-to-severe glabellar lines (GLs) using pooled data from 2 Phase III studies. METHODS: Following double-blind treatment with 50 U aboBoNT-A solution (n = 251) or placebo (n = 123), GL severity was assessed by investigators (ILA) and subjects (SSA). Other assessments included subject-reported time to onset, subject satisfaction, FACE-Q, and adverse events. RESULTS: One month after aboBoNT-A solution treatment, 88% had none-or-mild GLs at maximum frown and 93% had ≥1-grade improvement in ILA (similar for SSA), 24% to 27% remaining improved at Month 6. Glabellar lines responder rates remained higher than placebo throughout Month 6 ( p < .001). Almost two-thirds of subjects reported onset within 3 days, nearly a quarter reporting effect by Day 1. Subject satisfaction with GL appearance, and FACE-Q satisfaction with facial appearance overall and psychological well-being were also improved over placebo throughout Month 6, p < .05. Treatment-related adverse events were nonserious and mild or moderate. CONCLUSION: Pooled analysis confirmed a duration of effect on GLs of up to 6 months for aboBoNT-A solution, with onset starting within 24 hours, high subject satisfaction, and improved psychological well-being. The treatment was well tolerated.


Assuntos
Toxinas Botulínicas Tipo A , Fármacos Neuromusculares , Envelhecimento da Pele , Humanos , Método Duplo-Cego , Testa , Reprodutibilidade dos Testes , Resultado do Tratamento , Ensaios Clínicos Controlados Aleatórios como Assunto , Ensaios Clínicos Fase III como Assunto
16.
J Dtsch Dermatol Ges ; 20(11): 1455-1461, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36314592

RESUMO

BACKGROUND AND OBJECTIVES: The paramedian forehead flap is an interpolated flap, consisting of the transfer of tissue from the forehead region to the nasal area, irrigated by the supratrochlear artery. Traditionally, the vascular pedicle is divided at between 14 and 21 days. However, this time could be overestimated. Our objective is to demonstrate that the paramedian forehead flap can be divided before that set out in the literature and to demonstrate the usefulness of cutaneous ultrasound to determine the optimal time for division. PATIENTS AND METHODS: A prospective observational study, including patients who required nasal defect reconstruction with a paramedian forehead flap, was designed. The inclusion criteria were: nasal tip, dorsum or alar skin defects following oncological surgery, larger than 2 cm. Twelve patients were included. A retrospective cohort was used to perform a cost reduction analysis. RESULTS: The average time to flow, measured by ultrasound, was 6.6 days. The average number of days to division of the pedicle was 6.9 days. No serious complications were reported. CONCLUSIONS: The paramedian forehead flap can be divided before the traditional reported time. Ultrasound is a reliable and cost-effective technique to determine and individualize pedicle division time.


Assuntos
Rinoplastia , Humanos , Testa/diagnóstico por imagem , Testa/cirurgia , Testa/irrigação sanguínea , Estudos Retrospectivos , Retalhos Cirúrgicos/cirurgia , Nariz , Rinoplastia/métodos
18.
Dermatol Online J ; 28(4)2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-36259860

RESUMO

A 72-year-old man with a history of squamous cell carcinoma presented to the Portland VA with forehead discoloration. He was initially diagnosed with actinic damage and prescribed topical treatment. However, he returned to clinic months later with a large, violaceous forehead plaque. Upon biopsy, he was diagnosed with blastic plasmacytoid dendritic cell neoplasm (BPDCN), a rare hematological malignancy. This case report illustrates the importance of keeping BPDCN in the differential diagnosis for ecchymotic plaques that fail to respond to first line therapy.


Assuntos
Neoplasias Hematológicas , Neoplasias Cutâneas , Masculino , Humanos , Idoso , Testa/patologia , Células Dendríticas/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Neoplasias Hematológicas/patologia , Biópsia
19.
Cutis ; 110(2): E18-E20, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-36219634

Assuntos
Face , Testa , Bochecha , Humanos , Pele
20.
F1000Res ; 11: 13, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36071710

RESUMO

Background: Sublingual temperature measurement is a quick and accurate representation of oral temperature and corresponds closely with core temperature. Sub-lingual temperature measurement using non-contact infrared thermometers has not been studied for this purpose and if accurate they would be a reliable and convenient way of recording temperature of a patient very quickly. The aim of the study was to evaluate the utility of recording sublingual temperature using an infrared non-contact thermometer and establish its accuracy by comparing the readings with tympanic thermometer recordings. Methods: This cross-sectional study was carried out in 29 patients (328 paired recordings from sublingual and tympanic sites simultaneously). Subjects were requested to keep their mouth closed for five minutes before recording the temperature. Sublingual recordings were performed for each patient at different times of the day using an infrared thermometer. The infrared thermometer was quickly brought 1cm away from the sublingual part of the tongue and the recordings were then done immediately. Readings were compared with the corresponding tympanic temperature. Results: The non-contact sublingual temperature correlated very closely with tympanic temperature (r=0.86, p<0.001). The mean difference between the infrared sublingual and tympanic temperature was 0.21°C (standard deviation [SD]:0.48°C, 95% confidence interval [CI] of 0.16-0.27). The intra-class correlation co-efficient (ICC) between core and sublingual temperatures was 0.830 (95% CI: 0.794 to 0.861) p<0.001. The sensitivity of sublingual IR (infrared) temperature of 37.65°C was 90% and specificity was 89% for core temperature >38°C. Conclusions: This innovative modification of using the forehead infrared thermometer to measure the sublingual temperature offers an accurate, rapid and non-contact estimation of core temperature.


Assuntos
Testa , Termômetros , Estudos Transversais , Humanos , Sensibilidade e Especificidade , Temperatura
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