RESUMO
PURPOSE: The study investigated the effect of a non-thermal cooling agent, L-menthol, on exercise at a fixed subjective rating of perceived exertion (RPE) in a hot environment. METHOD: Eight male participants completed two trials at an exercise intensity between 'hard' and 'very hard', equating to 16 on the RPE scale at ~35 °C. Participants were instructed to continually adjust their power output to maintain an RPE of 16 throughout the exercise trial, stopping once power output had fallen by 30%. In a randomized crossover design, either L-menthol or placebo mouthwash was administered prior to exercise and at 10 min intervals. Power output, [Formula: see text]O2, heart rate, core and skin temperature was monitored, alongside thermal sensation and thermal comfort. Isokinetic peak power sprints were conducted prior to and immediately after the fixed RPE trial. RESULTS: Exercise time was greater (23:23 ± 3:36 vs. 21:44 ± 2:32 min; P = 0.049) and average power output increased (173 ± 24 vs. 167 ± 24 W; P = 0.044) in the L-menthol condition. Peak isokinetic sprint power declined from pre-post trial in the L-menthol l (9.0%; P = 0.015) but not in the placebo condition (3.4%; P = 0.275). Thermal sensation was lower in the L-menthol condition (P = 0.036), despite no changes in skin or core temperature (P > 0.05). CONCLUSION: These results indicate that a non-thermal cooling mouth rinse lowered thermal sensation, resulting in an elevated work rate, which extended exercise time in the heat at a fixed RPE.
Assuntos
Exercício Físico , Mentol/farmacologia , Percepção/efeitos dos fármacos , Esforço Físico/efeitos dos fármacos , Temperatura Cutânea , Adulto , Metabolismo Energético , Temperatura Alta , Humanos , Masculino , Mentol/administração & dosagem , Antissépticos BucaisRESUMO
Free tissue transfer has revolutionised reconstruction of the head and neck and there are currently few local factors that preclude its use. These include a lack of suitable recipient vessels in the area for microvascular anastomosis. We describe the use of a Corlett loop in which a temporary arteriovenous fistula (AVF) is created with a transposed cephalic vein to enable reconstruction of a mandibular defect with a fibular free flap.
Assuntos
Derivação Arteriovenosa Cirúrgica/métodos , Veias Braquiocefálicas/cirurgia , Artéria Carótida Externa/cirurgia , Pescoço/irrigação sanguínea , Retalhos Cirúrgicos/irrigação sanguínea , Transplante Ósseo/métodos , Feminino , Humanos , Mandíbula/cirurgia , Neoplasias Mandibulares/reabilitação , Pessoa de Meia-Idade , Rádio (Anatomia)/transplante , Procedimentos de Cirurgia Plástica/métodosRESUMO
Penetrating orbital foreign bodies must be removed in a safe and controlled manner. Adequate access is necessary so that there is no further damage to the orbital structures and to allow haemostasis. We describe a case of a wooden foreign body that penetrated the left orbit and its subsequent removal using an inferior orbitotomy. To our knowledge, this technique has not been previously described for removal of a foreign body.
Assuntos
Corpos Estranhos/cirurgia , Órbita/lesões , Madeira , Ferimentos Penetrantes/cirurgia , Adulto , Ciclismo/lesões , Feminino , Seguimentos , Corpos Estranhos/etiologia , Hemostasia Cirúrgica , Humanos , Lacerações/etiologia , Lacerações/cirurgia , Órbita/cirurgia , Osteotomia/métodos , Tomografia Computadorizada por Raios X , Ferimentos Penetrantes/complicaçõesRESUMO
Ectomesenchymal chondromyxoid tumour is a recently described rare entity found almost exclusively in the anterior dorsum of the tongue. We report an additional case, review the pertinent literature and explore the histogenesis of the lesion. The lesion has no discriminating clinical features and diagnosis is only established following histopathological examination including immunohistochemical assessment. The histogenesis of the lesion remains speculative and our study seems to discount myoepithelial cells as a potential source.
Assuntos
Neoplasias de Tecido Conjuntivo/patologia , Neoplasias da Língua/patologia , Biomarcadores Tumorais/metabolismo , Células Epiteliais/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Proteínas de Neoplasias/metabolismo , Neoplasias de Tecido Conjuntivo/metabolismo , Neoplasias da Língua/metabolismoRESUMO
Malignant tumours of the nose occasionally require rhinectomy. Implant retained prostheses can give good aesthetic results. Predictable biomechanical retention of nasal prostheses can be achieved using osseointegrated implants and Brånemark intra-oral and craniofacial implants have been used previously. Zygomaticus implants are traditionally used for dental rehabilitation of the partially edentulous maxilla with severe bone resorption. We describe two patients in whom zygomaticus implants have been used to aid salvage in prosthetic reconstruction of the nose.
Assuntos
Nariz , Próteses e Implantes , Zigoma/cirurgia , Idoso , Carcinoma de Células Escamosas/cirurgia , Estética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Osseointegração/fisiologia , Desenho de Prótese , Terapia de SalvaçãoRESUMO
Psychosis is an uncommon but well-recognised complication of short-term corticosteroid administration. We report a case of steroid-induced psychosis subsequent to a bimaxillary osteotomy.
Assuntos
Anti-Inflamatórios/efeitos adversos , Metilprednisolona/efeitos adversos , Osteotomia de Le Fort , Psicoses Induzidas por Substâncias/psicologia , Adolescente , Antipsicóticos/uso terapêutico , Clorpromazina/uso terapêutico , Feminino , Alucinações/induzido quimicamente , Alucinações/psicologia , Humanos , Psicoses Induzidas por Substâncias/tratamento farmacológicoRESUMO
Tongue piercing is associated with significant morbidity. We report on a patient with a bifid tongue defect following insertion of a tongue ornament. This abnormality resulted in severe emotional disturbance.
Assuntos
Piercing Corporal/efeitos adversos , Língua/lesões , Adolescente , Glossectomia , Humanos , Masculino , Língua/patologia , Língua/cirurgiaRESUMO
Twenty-five patients undergoing routine incision and drainage of dento-alveolar abscesses were screened for bacteraemia during the procedure. In 13 patients, the abscesses were aspirated with a needle prior to incision and drainage, while needle aspiration was omitted in the remaining 12. A blood sample was taken from all individuals immediately before the surgical procedures and at one-minute intervals for a period of 5 minutes after surgery. Needle aspiration of pus resulted in a significant reduction (P less than 0.05) in the bacteraemic episodes (0 out of 13) during subsequent surgery as compared with incision and drainage, without aspiration (3 out of 12). Bacteraemia appeared to be transient, although in one case it was detected at 5 minutes. It is concluded that bacteraemic episodes occur during incision and drainage of dento-alveolar abscesses and this may be reduced by aspiration of the abscess contents prior to incision and drainage. In addition, the aspirates could serve as excellent microbiological samples, uncontaminated with salivary flora. The need for antibiotic cover in at risk patients, however, needs to be established by further studies.
Assuntos
Abscesso Periodontal/cirurgia , Periodontite/cirurgia , Sepse/etiologia , Bactérias/isolamento & purificação , Drenagem , Feminino , Humanos , Masculino , Abscesso Periodontal/microbiologia , Sepse/microbiologia , Infecções Estreptocócicas , SucçãoRESUMO
A case is reported of a foreign body in the left parotid gland, which presented in an unusual manner following a trivial injury and posed a difficult diagnostic problem, trismus being the most prominent clinical feature. The importance of having a high index of suspicion for retained foreign bodies is stressed.
Assuntos
Corpos Estranhos/diagnóstico , Glândula Parótida , Trismo/diagnóstico , Pré-Escolar , Feminino , Corpos Estranhos/etiologia , Humanos , Masculino , Recidiva , Trismo/etiologiaRESUMO
A simple technique for the fixation of maxillary fractures using premaxillary pins is described. Three case reports have been used to illustrate the technique which is recommended when maxillary fractures occur in conjunction with craniofacial or multiple injuries and when conventional methods of fixation are difficult to apply.
Assuntos
Pinos Ortopédicos , Fixação de Fratura/métodos , Fraturas Maxilares/cirurgia , Adolescente , Adulto , Idoso , Ossos Faciais/lesões , Humanos , Masculino , Fraturas Cranianas/cirurgiaRESUMO
A case of a man with an otherwise simple facial fracture which was complicated by mediastinal emphysema is reported. A review of the literature indicating the pathogenesis, clinical and radiographic features and management of this condition is given.
Assuntos
Enfisema Mediastínico/etiologia , Osso Nasal/lesões , Fraturas Cranianas/complicações , Fraturas Zigomáticas/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
An unusual case of a large rhinolith, which initially presented as an oronasal fistula, is reported. The surgical removal of the rhinolith through a maxillary osteotomy at the Le Fort I level with immediate direct fixation using 'Champy' plates is described. This approach provided excellent access for removal of the mass and repair of the oronasal fistula.
Assuntos
Cálculos/complicações , Fístula/etiologia , Cavidade Nasal/patologia , Palato/patologia , Adulto , Feminino , Humanos , Doenças Maxilares/etiologia , Doenças Nasais/complicaçõesRESUMO
Predictable biomechanical retention of nasal prostheses can now be achieved using Brånemark osseointegrated implants. These prostheses are tissue compatible, simple in design and easy to place, can be worn independently of spectacles and can in the majority of cases be provided soon after surgical excision. We have treated 14 patients (30 implants) 8 of whom had the implants placed at the time of surgical excision of the tumour. The longest survival so far has been 62 months (mean 38 months). Craniofacial osseointegration changes patients' perceptions of a nasal prosthesis and improves quality of life. Initial reconstructive surgery after radical nasal excision should be limited to reconstruction of the upper lip and preparation of the surgical defect for an implant-retained prosthesis.
Assuntos
Neoplasias Nasais/reabilitação , Nariz/cirurgia , Próteses e Implantes , Feminino , Humanos , Lábio/cirurgia , Masculino , Neoplasias Nasais/cirurgia , Osseointegração , SobreviventesRESUMO
Removal of tumours from the parapharyngeal space is often difficult because of limited surgical access. Mandibulotomy has proved useful for improving access but may cause damage to the inferior dental and lingual nerves. Use of the inverted 'L' osteotomy provides excellent access avoiding damage to the nerves and the technique is illustrated with three surgical cases.
Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Mandíbula/cirurgia , Osteotomia/métodos , Neoplasias Faríngeas/cirurgia , Adenoma Pleomorfo/cirurgia , Idoso , Idoso de 80 Anos ou mais , Placas Ósseas , Doenças das Artérias Carótidas/cirurgia , Artéria Carótida Interna/patologia , Humanos , Fixadores Internos , Masculino , Músculo Masseter/cirurgia , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/cirurgia , Osteotomia/instrumentação , Paraganglioma/cirurgia , Neoplasias Parotídeas/cirurgia , Faringe/anatomia & histologiaRESUMO
A case is reported of a papillary cystadenocarcinoma of the sublingual gland which presented as a ranula. This is both rare in site and mode of presentation.
Assuntos
Cistadenocarcinoma/diagnóstico , Soalho Bucal/patologia , Rânula/diagnóstico , Neoplasias da Glândula Sublingual/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , MasculinoRESUMO
Osteosarcoma is a highly malignant tumour which despite modern surgery and chemotherapy still retains a relatively poor prognosis. This prognosis is, however, much better in the rare variant known as juxtacortical osteosarcoma. Both types of osteosarcoma mainly affect the long bones but the juxtacortical variant may be treated less aggressively and has a much better survival rate. The authors report four cases of juxtacortical osteosarcoma affecting the jaws and discuss these unusual tumours and their management.
Assuntos
Neoplasias Maxilomandibulares/patologia , Osteossarcoma/patologia , Adulto , Terapia Combinada , Feminino , Humanos , Neoplasias Maxilomandibulares/terapia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Osteossarcoma/terapiaRESUMO
A retrospective audit was undertaken of the value of routine cross-matching of blood for patients undergoing orthognathic surgery at Canniesburn Hospital, Glasgow. Overall, routine cross-matching of blood was wasteful of resources for all but the more major types of osteotomy procedure: Le Fort III, Le Fort II, malar osteotomies requiring a bicoronal flap and bimaxillary osteotomies. The study has financial implications regarding the proper use of cross-matching in selected patients undergoing elective orthognathic surgery. A blood ordering tariff has been suggested for the various procedures studied.
Assuntos
Tipagem e Reações Cruzadas Sanguíneas , Unidade Hospitalar de Odontologia , Auditoria Médica , Osteotomia/métodos , Transfusão de Sangue/estatística & dados numéricos , Queixo/cirurgia , Unidade Hospitalar de Odontologia/estatística & dados numéricos , Humanos , Cuidados Intraoperatórios , Mandíbula/cirurgia , Maxila/cirurgia , Cuidados Pós-Operatórios , Probabilidade , Estudos Retrospectivos , Cirurgia BucalRESUMO
OBJECTIVE: To find out if giving steroids reduces postoperative swelling in orbital surgery. DESIGN: Prospective, randomized, double-blind trial. SETTING: Regional unit, teaching hospital, UK. SUBJECTS AND INTERVENTIONS: 20 patients who require orbital floor exploration after injuries. Patients were given methylprednisolone 250 mg (or placebo identically packaged) at induction of anaesthesia, with a further three doses at 6-hourly intervals postoperatively. MAIN OUTCOME MEASURE: Differences in interpalpebral width before and after operation. RESULTS: Those given steroids (n=11) had a significantly increased interpalpebral width compared with placebo (n=9) postoperatively (P < 0.01, 95% confidence intervals of the difference = 1 mm-6 mm). CONCLUSION: Short courses of steroids therapy should be considered in orbital surgery for appropriate patients. There is an advantage in being able to assess the globe postoperatively.
Assuntos
Pálpebras/efeitos dos fármacos , Glucocorticoides/administração & dosagem , Metilprednisolona/administração & dosagem , Órbita/cirurgia , Cuidados Pós-Operatórios , Adolescente , Adulto , Antibioticoprofilaxia , Blefaroplastia , Intervalos de Confiança , Pálpebras/fisiopatologia , Humanos , Pessoa de Meia-Idade , Fraturas Orbitárias/fisiopatologia , Fraturas Orbitárias/cirurgia , Cuidados Pós-Operatórios/estatística & dados numéricos , Estudos Prospectivos , Estatísticas não ParamétricasRESUMO
A case is reported of a central acinic cell carcinoma of the mandible. This is an unusual site for this rare tumour and to our knowledge only three cases have been previously reported in the literature.