Da superfície para a profundidade: Curva de aprendizado em lifting facial profundo estendido - meus primeiros 100 casos / From Surface to Depth: Learning Curve in Extended Deep Facelift ­ my First 100 Cases

Introdução: O envelhecimento facial é um processo gradual, complexo e multifatorial. É o resultado de mudanças na qualidade, volume e posicionamento dos tecidos. Cirurgiões plásticos têm modificado sua abordagem na cirurgia do rejuvenescimento facial optando pelo plano subaponeurótico (SMAS). O objetivo deste estudo é analisar 100 casos de pacientes operados pela técnica de SMAS profundo, avaliando sua aplicabilidade e eficácia. Método: Foram avaliados 100 pacientes, submetidos a cirurgia plástica facial pela técnica de SMAS profundo - "Deep Smas", e acompanhados por 6 meses. Observou-se a satisfação dos pacientes, número de complicações, número de reoperações, riscos e vantagens da técnica. Resultados: Foram operados 100 pacientes, num período de 3 anos. A idade variou de 41 a 79 anos, sendo 95% sexo feminino. As complicações foram 8 casos (8%) de lesões de ramos do nervo facial, sendo: 4 casos lesão do zigomático, 3 casos de lesão do mandibular e 1 caso de lesão do bucal; houve 1 caso (1%) de queloide retroauricular; 1 caso (1%) de hematoma. Em relação às revisões cirúrgicas, houve 8 casos (8%) de complementação cirúrgica por insatisfação das pacientes. Houve 15% de lesões nervosas entre a 1ª e a 40ª cirurgia, 5% entre a 41ª e a 80ª, e nenhuma lesão entre o 81º e o 100º paciente. Conclusão: O lifting facial profundo ou subSMAS mostrou ser efetivo, proporcionando bons resultados estéticos. Apresenta baixa taxa de recidiva e baixa taxa de morbidade, porém, necessita de uma longa curva de aprendizagem.

Introduction: Facial aging is a gradual, complex, and multifactorial process. It is the result of changes in the quality, volume, and positioning of tissues. Plastic surgeons have modified their approach to facial rejuvenation surgery, opting for the subaponeurotic plane (SMAS). The objective of this study is to analyze 100 cases of patients operated on using the deep SMAS technique, evaluating its applicability and effectiveness. Method: 100 patients were evaluated, undergoing facial plastic surgery using the deep SMAS technique - "Deep Smas", and followed up for 6 months. Patient satisfaction, number of complications, number of reoperations, risks, and advantages of the technique were observed. Results: 100 patients were operated on over 3 years. Age ranged from 41 to 79 years, with 95% being female. The complications were 8 cases (8%) of injuries to branches of the facial nerve, of which 4 cases of zygomatic injury, 3 cases of mandibular injury, and 1 case of buccal injury; there was 1 case (1%) of post-auricular keloid; 1 case (1%) of hematoma. Regarding surgical revisions, there were 8 cases (8%) of surgical completion due to patient dissatisfaction. There were 15% of nerve injuries between the 1st and 40th surgery, 5% between the 41st and 80th, and no injuries between the 81st and 100th patient. Conclusion: Deep facial lifting or subSMAS has proven to be effective, providing good aesthetic results. It has a low recurrence rate and low morbidity rate; however, it requires a long learning curve.

Fratura de mandíbula: análise de 50 casos cirúrgicos em um hospital escola / Jaw fracture: analysis of 50 surgical cases in a teaching hospital

Introdução: A mandíbula é o maior e mais forte dos ossos da face. Em razão de sua topografia, apresenta vulnerabilidade nos traumas. A análise de dados sobre as fraturas de mandíbula se mostram fundamentais para auxiliar no tratamento e em políticas de saúde pública. O objetivo desse estudo é realizar um levantamento epidemiológico de fraturas mandibulares tratadas cirurgicamente. Método: Triagem através do sistema de informação hospitalar, buscando pacientes submetidos a cirurgia para fratura de mandíbula realizadas em um hospital escola pela equipe de cirurgia plástica, em Campinas-SP, de abril de 2015 a abril de 2020. Foram, então, coletados dados por meio da análise de prontuários. Resultados: Foram incluídos 50 pacientes, sendo 90% do sexo masculino. A média de idade foi 30,7 anos. A etiologia predominante foi acidente automotivo e a região mais fraturada na mandíbula foi a parassínfise. A mediana de tempo entre o trauma e cirurgia foi de 19 dias. Onze (22%) pacientes apresentavam alguma comorbidade. Quatorze pacientes (28%) foram internados em Unidade de Terapia Intensiva (UTI) e 42% operaram com outra especialidade além da Cirurgia Plástica. Dez (20%) pacientes apresentaram alguma complicação da cirurgia, sendo a mais comum a deiscência de ferida operatória. Conclusão: Houve predominância entre homens jovens e de acidentes de trânsito como etiologia. As fraturas foram localizadas preferencialmente na região da parassínfise e foram tratadas por meio de fixação interna rígida. Os elevados índices de internação em UTI, lesões associadas e realizações de procedimentos cirúrgicos por outras especialidades evidenciam a gravidade dos pacientes assistidos no serviço.

Introduction: The mandible is the largest and strongest of the bones in the face. Due to its topography, it is vulnerable to trauma. Data analysis on mandible fractures is fundamental for treatment and public health policies. This study aims to conduct an epidemiological survey of surgically treated mandibular fractures. Method: Screening through the hospital information system, seeking patients undergoing surgery for jaw fracture performed at a teaching hospital by the plastic surgery team in Campinas-SP from April 2015 to April 2020. Data were then collected through analysis of medical records. Results: 50 patients were included, 90% male. The average age was 30.7 years. The predominant etiology was an automobile accident, and the most fractured region in the mandible was the parasymphysis. The median time between trauma and surgery was 19 days. Eleven (22%) patients had some comorbidity. Fourteen patients (28%) were admitted to the Intensive Care Unit (ICU), and 42% underwent surgery with another specialty besides Plastic Surgery. Ten (20%) patients had some complication of the surgery, the most common being surgical wound dehiscence. Conclusion: There was a predominance among young men and traffic accidents as etiology. Fractures were preferably located in the parasymphysis region and were treated using rigid internal fixation. The high rates of ICU admission, associated injuries, and surgical procedures carried out by other specialties demonstrate the severity of the patients assisted in the service.

Anatomical Conditions in Simultaneous Orthognathic Surgery and Structural Rhinoplasty. A Clinical Series / Condiciones Anatómicas en Cirugía Ortognática y Rinoplastia Estructural Simultanea. Una Seria Clínica

SUMMARY: Orthognathic surgery and rhinoplasty show synergy in terms of function and aesthetic results. The aim of this research is to analyze variables related to simultaneous orthognathic surgery and rhinoplasty and to discuss the surgical sequence. Male and female subjects between 18 and 45 years old were included in this research. Diagnosis related to nasal morphology (nasal tip bifid, rotate, square and others as well as the alae morphology and columella), facial deformity (sagittal and vertical deformity), type of surgery (rhinoplasty techniques and orthognathic techniques) and complications were included. The minimum follow-up was 12 months; Chi- Square and t test were used to define correlations, considering a value of p<0.05 for statistical significance. Class III facial deformity was observed in 40 % of subjects and class II facial deformity was present in 43 %. For the nasal deformities, the tip and nasal bridge were most prevalent; primary nasal deformity was observed in the 83 % of subjects and was significant more than secondary nasal deformity (p=0.042). Bimaxillary surgery was performed in 31 cases (88 %). In 10 cases a change of the original plan for rhinoplasty due to previous maxillary surgery was realized, mainly in class III facial deformity, with no statistical differences. Revision rhinoplasty was realized in 5 cases (14 %) and was not related to surgical variables; revision for orthognathic surgery was not necessary in this series. Rhinoplasty and orthognathic surgery simultaneously show low complications and predictable results. We can conclude that maxillary mandibular osteotomies and rhinoplasty could be performed safely. However, larger studies are necessary to understand the best choice and variables involved in simultaneous procedures and soft tissue response.

La cirugía ortognática y la rinoplastia muestran sinergia en términos de resultados funcionales y estéticos. EL objetivo de esta investigación es analizar variables relacionadas con la cirugía ortognática y rinoplastia ejecutada de forma simultanea. Fueron incluidos hombres y mujeres entre 18 y 45 años de edad. EL diagnóstico fue en base a la morfología nasal (punta bífida, rotada, cuadrada u otras así como alteraciones del ala nasal y columela), deformidad facial (deformidad sagital y vertical), tipo de cirugía (técnica de rinoplastia y cirugía ortognática) y complicaciones asociadas. El seguimiento mínimo fue de 12 meses; se utilizo las prueba t test y chi cuadrado para definir relaciones estadísticas considerando un valor de p< 0,05 para obtener diferencias significativas. La deformidad clase III fue observada en el 40 % de los sujetos y la deformidad facial de clase II se presento en el 43 %. Para la deformidad nasal, las alteraciones de a punta nasal y nasal fueron mas prevalentes; la deformidad nasal primaria se presentó en el 83 % de los sujetos y fue significativamente mayor que la deformidad nasal secundaria (p=0,042). La cirugía bimaxilar se realizó en 31 casos (88 %); en 10 casos se realizó el cambio del plan quirúrgico inicial de la rinoplastia debido a cambios generados en la cirugía maxilar previa, mayormente en deformidad facial de clase III, sin presentar diferencias significativas. La rinoplastia de revisión fue realizada en 5 casos (14 %) y no fue relacionada con ninguna variable de tipo quirúrgica; la revisión de cirugía ortognática no fue realizada en ningún caso de esta serie. La rinoplastia y la cirugía ortognática simultanea mostraron bajas complicaciones y resultados predecibles. Se puede concluir que la osteotomía maxilo mandibular y la rinoplastia son seguras; sin embargo, estudios de mayor volumen son necesarios para entender la mejor opción y variables relacionadas con procedimientos simultáneos y la respuesta de tejidos blandos faciales.

Facial anatomy applied to live models / Anatomia facial aplicada em modelos vivos

Introduction: Anatomy is one of the foundations in medicine, and choosing a practical and dynamic teaching method is essential for better retention of your learning. The objective is to use facial anatomy applied to live models as an innovative teaching strategy and to evaluate the experience of the learning experience of students assigned to the method. Method: The work analyzes the experience with body painting of 51 students from Instituto Boggio assigned this method (or instructed to use this method) during their classes. Different planes and anatomical structures were represented on live models' faces to simulate and teach the main injectable cosmetic procedures; syringes, needles, cannulas, and ultrasound gel stained with food inks were used. Overlapping latex layers were used for the anatomical study of the temple, middle third of the face, and nose, allowing the reproduction of fillers and biostimulators in these regions. The main muscle groups were represented for the discussion of high-precision botulinum toxin. After the entire demonstration, the students answered a questionnaire via "Google Forms" evaluating the methodology used. Results: According to the answers to the questionnaires, most students considered body painting an innovative methodology that contributed to learning anatomical content and satisfactorily illustrating the demonstrated cosmetic procedures. Conclusion: Practical learning through live models makes this new teaching method something innovative and unique that, in an enjoyable way, enables the study of anatomy and appropriately trains clinical skills.

Introdução: A anatomia é um dos principais alicerces no exercício da medicina e a escolha de um método de ensino prático e dinâmico é fundamental para melhor retenção do seu aprendizado. O objetivo é utilizar a anatomia facial aplicada em modelos vivos como estratégia inovadora de ensino e avaliar a experiência do processo de aprendizagem dos alunos submetidos ao método. Método: O trabalho analisa a experiência vivida com a pintura corporal por 51 alunos do Instituto Boggio submetidos ao método durante as aulas ministradas. Diferentes planos e estruturas anatômicas foram representados nas faces de modelos vivos. Para simulação e ensino dos principais procedimentos cosmiátricos injetáveis, seringas, agulhas, cânulas e gel de ultrassom corado com tintas alimentícias foram utilizados. Camadas de látex sobrepostas foram utilizadas para estudo anatômico da têmpora, terço médio da face e nariz, possibilitando a reprodução do uso de preenchedores e bioestimuladores nestas regiões. Os principais grupamentos musculares foram representados para discussão sobre toxina botulínica de alta precisão. Após toda a demonstração, os alunos responderam a um questionário via "Formulários Google" avaliando a metodologia utilizada. Resultados: De acordo com as respostas dos questionários, a maioria dos alunos considerou a pintura corporal como uma metodologia inovadora e que contribui no aprendizado do conteúdo anatômico, bem como ilustra satisfatoriamente os procedimentos cosmiátricos demonstrados. Conclusão: A aprendizagem prática por meio dos modelos vivos faz deste novo método de ensino algo inovador e único que, de maneira lúdica, possibilita o estudo da anatomia e o treinamento de habilidades clínicas adequadamente.

Faceta Direta de Resina Composta utilizando Pigmentos Opacificadores para Reabilitação Estética Anterior de Dente Escurecido: Relato de Caso / Direct Composite Resin Veneer using Opacifying Pigments for Anterior Aesthetic Rehabilitation of Discolored Teeth: Case Report

O tratamento estético de dentes com alteração de cor é um grande desafio na Odontologia Restauradora. Nesse sentido, a utilização de técnicas de estratificação com resina composta associada ao uso de pigmentos opacificadores permite que seja possível restaurar por meio de uma técnica direta, que resulta em um menor desgaste da estrutura dental durante o preparo. Dessa forma, o presente trabalho apresenta um caso clínico de faceta direta de resina composta utilizando associação de três pigmentos opacificadores. Paciente do sexo masculino, 54 anos, procurou atendimento apresentando alteração de cor severa do dente 21, relato de trauma dental, tratamento endodôntico e contraindicação de novo protocolo de clareamento interno, sendo sugerido, como plano de tratamento, a restauração direta com resina composta. Para a confecção da faceta direta de resina, foi utilizada uma mistura de três opacificadores na consistência fluida. Para verificar o valor da camada aplicada da mistura, foram feitas fotografias em preto e branco. A estratificação prosseguiu com camadas de resina translúcida para a base palatina, resina opaca de dentina e resina acromática translúcida para o esmalte. Como resultado, constatou-se a função e eficácia do uso da associação de pigmentos opacificadores na resolução do caso, em seguida, foi realizada uma reavaliação após 30 dias e 7 meses do procedimento restaurador, quando verificou-se a estabilidade de cor da restauração. Concluiu-se, portanto, que a utilização da técnica de estratificação de resinas compostas associada a utilização de pigmentos opacificadores traz resultados estéticos satisfatórios e favoráveis por meio de uma técnica direta, realizada em sessão clínica única e com alta previsibilidade.

The esthetic treatment of teeth with discoloration is a major challenge in restorative dentistry. In this sense, the use of composite resin veneering techniques associated with the use of opacifying stains allows restorations to be made using a direct technique, which results in less wear to the tooth structure during preparation. Thus, the present study presents a clinical case of a direct composite resin veneer using an association of three opacifying pigments. A 54-year-old male patient presented with severe color change on the central upper left incisor, a report of dental trauma, endodontic treatment, and contraindication for a new internal bleaching protocol. In order to make the direct resin veneer, a mixture of three opacifiers in a fluid consistency was used. To check the value of the applied layer of the mixture, black and white photographs were taken. Layering proceeded with translucent resin layers for the palatal base, opaque dentin resin and translucent achromatic resin for the enamel. As a result, the function and efficacy of the use of the association of opacifying pigments was verified in the resolution of the case. A reevaluation was performed 30 days and 7 months after the restorative procedure, when the color stability of the restoration was verified. This case allows to conclude that using composite resin layering technique associated with the use of opacifying pigments brings satisfactory and favorable aesthetic results through a direct technique, performed in a single clinical session and with high predictability.

Consideraciones didácticas acerca de la modalidad no presencial en las universidades / Didactic Considerations about the Non-Face-to-Face Modality in Universities

Introducción: La modalidad no presencial del proceso de enseñanza-aprendizaje se incrementó como respuesta a las condiciones creadas por la COVID-19, sin la necesaria preparación y experiencia de los docentes para implementarla. Objetivo: Proponer algunas consideraciones didácticas que tributan al adecuado manejo del docente de los componentes del proceso de enseñanza-aprendizaje en la implementación de la modalidad no presencial. Posicionamiento de los autores: La exitosa implementación de cualquier variante de modalidad no presencial dependerá de la preparación del docente, particularmente en Didáctica, al asumir las tecnologías de la información y las comunicaciones como medios de enseñanza en la misión de hacer que sus estudiantes aprendan. Conclusiones: La no presencialidad en el proceso de enseñanza-aprendizaje se considera una alternativa viable en circunstancias de pandemia u otras equivalentes, y debe ser una modalidad complementaria en la etapa posCOVID-19. Así que los profesores tendrán que replantear el proceso en todos sus componentes, en un contexto digital que ya no tiene vuelta atrás(AU)

Introduction: Within the teaching-learning process, the non-face-to-face modality was increased as a response to the conditions created by COVID-19, but without the necessary preparation and experience for professors to implement it. Objective: To propose some didactic considerations that contribute to the professor's adequate management of the components of the teaching-learning process in the implementation of the non-face-to-face modality. Authors' position: The successful implementation of any variant of the non-face-to-face modality will depend on the professor's preparation, particularly in didactics, when assuming information and communication technologies as teaching means in the mission of making their students learn. Conclusions: Within the teaching-learning process, the non-face-to-face condition is considered a viable alternative in pandemic, or other equivalent, circumstances; it should be a complementary modality in the post-COVID-19 stage. Thus, professors will have to rethink the process focusing on all its components, within a digital context that has no turning back(AU)

The Role of E-learning in Medical Education during the COVID-19 Pandemic: A Cross-Sectional Study of Student Perception

Background: In march 2020, with the declaration of COVID-19 as a global pandemic, the schools, colleges, and universities of the highly contagious areas of the world were instantaneously closed to mitigate the deleterious effects of COVID-19. Moreover, as a result of social distancing, the most effective preventative strategy since the emergence of COVID-19, medical education has been profoundly disturbed. In light of the prevailing pandemic, an abrupt shifting of the educational system was made from face-to-face learning to online methodologies to provide uninterrupted education to the students of the affected countries. By and large, traditional education was replaced by various forms of e-learning. The aim of this study was to evaluate the perception of e-learning in undergraduate medical students at Medical Colleges during covid pandemic. Material & Methods: This was a cross-sectional questionnaire-based study and was conducted from December, 2020 to February, 2021 in the CARe Medical College, Dhaka, Bangladesh. In the present study we included 270 undergraduate medical students as our participants and students who were not willing to participate were excluded from our study. Results: In our study we found the mean age of the respondents was 23.05 ± 1.28 years and majority of our students were female (68%) compared to male (32%). Most of the students (67%) had moderate grade of IT skills. We found major advantage of e-learning was the ability to record classes 67% and the disadvantage was poor internet speed (68.9%). Among all students, 51.1% & 6.7% students were able to increase knowledge, 62.6% & 3% were able to increase clinical skill and 37.8% & 7.4% were able to increase social skill via conventional & e-learning methods respectively. Majority (88.1%) students preferred face-to face learning method and 11.9% preferred e-learning method. Conclusion: In our study, we evaluated the student’s perception of e-learning and its associated advantages and disadvantages in terms of learning outcomes. While comparing e-learning and face-to-face learning among undergraduate medical students,we found face-to-face learning was considered the most effective way of learning to increase knowledge, practical skills and social skills. Therefore, most of our students preferred the face-to-face learning method compared to e-learning.

Knowledge, intention, and practice of wearing face mask by common people to ensure protection against COVID-19 during pandemic

Background: Since the outbreak of global pandemic, wearing face mask not only protects the individual but also limits the spread of corona virus infection in the community. However, certain sociocultural and personal factors have created hinderance in wearing face mask by general people against COVID-19 virus. Aims and Objectives: The aim and objective of this study is to assess the knowledge, intension, and practice of wearing face mask among common people. Materials and Methods: It was a cross-sectional study conducted among general people in a part of Western Odisha after ethical approval. A total of 1050 adults above 18 years participated in this study. The data were collected from different locality of the town using a pretested self-administered questionnaire by all authors and research assistants of this project. The period of study was from July 2021 to December 2021. The results were tabulated, processed, and analyzed using SPSS-20. Results: Regarding knowledge score, we observed that 57% had average, 18% had poor, and 25% had good knowledge. Furthermore, we found 42% participants had positive intention and 58% had negative intention. Again we assessed that 35% of participants were practicing face mask appropriately and 65% practicing inappropriately. Conclusion: In this study, the score of knowledge, intention, and also the practice of wearing face mask against COVID-19 was lower than the average as compared to previous researches. Hence, health authorities should promote the people to wear mask and encourage awareness programs for the benefit of the society.

A face vitimada: morbidade entre mulheres atendidas em serviços sentinelas no brasil / The face victimized: morbidity between women incoming in sentinel service in Brazil / El rostro victimizado: morbilidad entre mujeres atendidas en servicios de centinela en Brasil

Introdução:Mulheres têm sido subjugadas pela violência em prol da identidade machista e domínio viril do homem. Objetivo: analisar os atendimentos de emergência em mulheres vítimas de violência na região de cabeça e pescoço. Metodologia:Análise de dados do inquérito de Vigilância e Acidentes em 25 capitais e no Distrito Federal no ano de 2011 por meio de amostra de 351 atendimentos de mulheres entre 15 e 49 anos em relação à ocorrência de violência na região de cabeça e pescoço. Resultados:A ocorrência da violência foi predominante em mulheres pretas (70,8%),jovens (68,3% 20-29 anos)e com pouca escolaridade (< 8 anos de estudo), sendo mais frequentes no domicílio (45,5%), cometida de forma intencional (86,9%) por um agressor do sexo masculino (77,4%), identificado como parceiro ou ex-parceiro íntimo (44,5%), sendo aface (87,0%) a região de cabeça/pescoço mais atingida. Conclusões:A violência contra a mulher perpassa a discussão das desigualdades de gênero, interseccionalidade e capital social. O importante não é o gênero em si, mas a junção do gênero, raça e classe socioeconômica. Isto requer políticas públicas intersetoriais e mobilização social em prol do capital social. Para tanto, o modelo de Redes de Atenção, com a consequente multiprofissionalidade, intersetorialidade e transdisciplinaridadeé fundamental. Isto pressupõe, inclusive, a maior inserção do cirurgião-dentista na identificação e acolhimento das vítimas para posteriores encaminhamentos (AU).

Introduction:Women have been subjugated by violence in favor of the male identity and virile dominance of men. Objective:to analyze emergency care for women victims of violence in the head and neck region. Methodology:Analysis of data from the Surveillance and Accident Survey in 25 state capitals and the Federal District in 2011 througha sample of 351 visits to women between 15 and 49 years old regarding the occurrence of violence in the head and neck region. Results:The occurrence of violence was predominant in black women (70.8%), young (68.3% 20-29 years) and with little schooling (< 8 years of study), being more frequent at home (45.5 %), committed intentionally (86.9%) by a male aggressor (77.4%), identified as a partner or former intimate partner (44.5%), with the face (87.0%) the most affected head/neck region. Conclusions:Violence against women permeates the discussion of gender inequalities, intersectionality and social capital. What is important is not gender per se, but the combination of gender, race and socioeconomic class. This requires intersectoral public policies and social mobilization in favor of social capital. Therefore, the model of Care Networks, with the consequent multiprofessionality, intersectoriality and transdisciplinarity is fundamental. This presupposes, including, greater involvement of the dental surgeon in the identification and reception of victims for subsequent referrals (AU).

Introducción:Las mujeres han sido subyugadas por la violencia a favor de la identidad masculina y el dominio viril de los hombres. Objetivo:analizar la atención de emergencia a mujeres víctimas de violencia en la región de cabeza y cuello. Metodología:Análisis de datos de la Encuesta de Vigilancia y Accidentalidad en 25 capitales de estado y Distrito Federal en 2011 a través de una muestra de 351 visitas a mujeres entre 15 y 49 años sobre la ocurrencia de violencia en la región de cabeza y cuello. Resultados: Predominó la ocurrencia de violencia en mujeres negras (70,8 %), jóvenes (68,3 % 20-29 años) y con poca educación(< 8 años de estudio), siendo más frecuente en el hogar (45,5 %), cometida intencionalmente (86,9%) por un agresor masculino (77,4%), identificado como pareja o ex pareja íntima (44,5%), siendo el rostro (87,0%) la región de cabeza/cuello más afectada. Conclusiones:La violencia contra las mujeres permea la discusión sobre las desigualdades de género, la interseccionalidad y el capital social. Lo importante no es el género per se, sino la combinación de género, raza y clase socioeconómica. Esto requiere políticas públicas intersectoriales y movilización social a favor del capital social. Por ello, es fundamental el modelo de Redes de Atención, con la consiguiente multiprofesionalidad, intersectorialidad y transdisciplinariedad. Esto presupone incluso una mayor inserción del cirujano dentista en la identificación y recepción de las víctimas para su posterior derivación (AU).

Conduta dos cirurgiões-dentistas frente à violência contra a mulher: uma revisão integrativa / Attitudes of dental surgeons towards violence against women: an integrative review / Conductasde los cirujanos dentistas frente a la violencia contra la mujer: una revisión integradora

Introdução:A violência doméstica, um fenômenoconstante na vida de muitas mulheres, possui dimensões globais. Esse infortúnio que assombra o sistema de saúde se intensificou ainda mais com as medidas de restrição social e o confinamento das vítimas com seus agressores por um longo período, no cenário de pandemia da Covid-19. Objetivo:Essa pesquisa teve por objetivo identificar a conduta dos cirurgiões-dentistas frente à violência contra a mulher, por meio de uma revisão integrativa.Metodologia:A busca dos estudos foi realizada nas plataformas de bancos de dados da Biblioteca Virtual de Saúde e da National Library of Medicine. Foram selecionados os textos completos, disponíveis em português, referentes aos últimos cinco anos (2017-2022) e utilizando os descritores "Violência contra as mulheres", "Saúde bucal", "Autoimagem" e "Traumatismos da Face", combinados com o operador booleano "and". Resultados:Foram recuperados 51 estudos, dos quais utilizaram-se 13, pois esses satisfizeram os critérios de inclusão e exclusão, demonstrando que o tema de maior destaque foi a violência contra a mulher associada com a autoestima, autoimagem e predominantemente estudos transversais. Observou-se que o impacto emocional ultrapassa os danos físicos provenientes da violência contra a mulher. A face, principalmente a boca, é a área mais afetada pela violência doméstica. O uso do álcool e de drogas pelos agressores aumentam as chances de violência contra a mulher. Ainda, os dados encontrados não contemplaram completamente a indagação sobre o papel do cirurgião-dentista diante do acolhimento das vítimas da violência doméstica. Conclusões:Os cirurgiões-dentistas como profissionais de saúde, inseridos diariamente no manejo das lesões de cabeça e pescoço, fazem parte do acolhimento das vítimas de violência doméstica e devem estarcapacitadosno cuidado integral à saúdepara lidar com as demandas necessárias (AU).

Introduction:Domestic violence, a constant phenomenonin the lives of many women, has global dimensions. Social distancing measures and house confinement of victims with their aggressors for long periods in the scenario of the Covid-19 pandemic has further escalated this misfortune with which the health systemhas to deal. Objective:This study sought to identify the attitudes of dental surgeons towards violence against women through an integrative review.Methodology:A search of studies was conducted in the Virtual Health Library and National Library of Medicine databases. The descriptors "Violence against women", "Oral health", "Self-image" and "Facial trauma" were used, combined with the Boolean operator "AND". Full texts available in Portuguese published in the last five years (2017-2022) were selected.Results:Fifty-one studies were retrieved and 13 were selected after application of inclusion and exclusion criteria. They were predominantly cross-sectional studies and showed that the most prominent theme was violence against women associated with self-esteem andself-image. It was observed that the emotional impact goes beyond the physical damage resulting from violence against women. The face, especially the mouth, is the area most affected by domestic violence. The use of alcohol and drugs by aggressors increases the chances of violence against women. The data found did not fully cover the question about the role of dental surgeons in the support for victims of domestic violence. Conclusions:As health professionals involved with daily management of cases of head and neck injuries, dental surgeons have a role in the care and support for victims of domestic violence and must be trained in comprehensive health care to deal with the necessary demands (AU).

Introducción: La violencia doméstica, un fenómeno constante en la vida de muchas mujeres, tiene dimensiones globales. Esta desgracia que acecha al sistema de salud se ha recrudecido aún más con las medidas de restricción social y el confinamiento de las víctimas con sus agresores durante un largo periodo en el escenario de la pandemia del Covid-19. Objetivo: Esta investigación tuvo como objetivo identificar el comportamiento de los odontólogos frente a la violencia contra la mujer. Metodología: La búsqueda de estudios se realizó en las plataformas de bases de datos de la Biblioteca Virtual en Salud y la Biblioteca Nacional de Medicina. Fueron seleccionados textos completos, disponibles en portugués, referidos a los últimos cinco años (2017-2022) y utilizando los descriptores "Violencia contra la mujer", "Salud bucal", "Autoimagen" y "Trauma facial", combinado con el operador booleano "AND". Resultados: Fueron recuperados 51 estudios, de los cuales 13 fueron utilizados, ya que cumplieron con los criterios de inclusión y exclusión, demostrando que el tema más destacado fue la violencia contra la mujer asociada a la autoestima, la autoimagen y estudios predominantemente transversales. Se observó que el impacto emocional va más allá del daño físico derivado de la violencia contra las mujeres. La cara, especialmente la boca, es la zona más afectada por la violencia doméstica. El uso de alcohol y drogas por parte de los agresores aumenta las posibilidades de violencia contra las mujeres. Aun así, los datos encontrados no contemplaron en su totalidad la pregunta sobre el papel del odontólogo en la acogida de víctimas de violencia doméstica.Conclusiones: Los cirujanos dentistas como profesionales de la salud, insertos cotidianamente en el manejo de traumatismos de cabeza y cuello, forman parte del cuidado de víctimas de violencia doméstica y deben estar capacitados en atención integral de salud para hacer frente a las demandas necesarias (AU).

Evaluation of distance and face-to-face anatomy education from the perspective of students during the COVID-19 pandemic period / Evaluación de la educación anatomía a distancia y presencial desde la perspectiva de los estudiantes durante el período de pandemia del COVID-19

SUMMARY: During the COVID-19 pandemic, a questionnaire was administered to the students who took anatomy courses through distance education in the Faculties of Medicine and Dentistry. Through the questionnaire, the aim was to figure out whether the infrastructure of Firat University was ready and adequate for distance education, how efficient the distance theoretical and practical anatomy classes were, and in what proportions the students would prefer to take face-to-face and distance anatomy classes when the pandemic is over. A questionnaire of 35 questions was applied to 555 students studying at the Medicine and Dentistry Faculties of Firat University. The students widely accepted the opinion that Firat University successfully implemented the distance education system, and distance education offered the opportunity to receive the lessons repeatedly regardless of time and place. In addition, it has been determined as a common opinion that anatomy classes given via distance education were equally beneficial as face-to-face education in terms of duration, content, and efficiency. Despite these advantages, the lack of face-to-face interaction and weak information permanence were reported as the negative aspects of distance education. The students emphasized that applied anatomy classes and especially cadaver studies should be conducted face to face. Anatomy education is quite substantial in the acquisition and development of professional skills. It is considered that distance anatomy education will be inadequate to provide this gain. The high demand for face-to-face practical classes by students also backs this up.

Durante la pandemia de COVID-19, se administró un cuestionario a los estudiantes que cursaban asignaturas de anatomía a distancia en las Facultades de Medicina y Odontología. A través del cuestionario, se pretendía conocer si la infraestructura de la Universidad de Firat estaba preparada y era adecuada para la educación a distancia, ¿qué tan eficientes eran las clases teóricas y prácticas de anatomía a distancia? y ¿en qué proporciones los estudiantes preferirían tomar clases presenciales? y clases de anatomía a distancia cuando termine la pandemia. Se aplicó un cuestionario de 35 preguntas a 555 estudiantes de las Facultades de Medicina y Odontología de la Universidad de Firat. Los estudiantes aceptaron ampliamente la opinión de que la Universidad de Firat implementó con éxito el sistema de educación a distancia, y la esta manera de enseñar ofreció la oportunidad de recibir lecciones repetidamente, independientemente de la hora y el lugar. Además, se ha determinado como opinión común que las clases de anatomía impartidas a distancia fueron igualmente beneficiosas que las presenciales en términos de duración, contenido y eficiencia. A pesar de estas ventajas, la falta de interacción cara a cara y la débil permanencia de la información fueron reportadas como los aspectos negativos de la educación a distancia. Los estudiantes enfatizaron que las clases de anatomía aplicada y en especial los estudios de cadáver deben ser presenciales. La educación en anatomía es bastante sustancial en la adquisición y desarrollo de habilidades profesionales. Se considera que la educación anatómica a distancia será inadecuada para proporcionar esta ganancia. La alta demanda de clases prácticas presenciales por parte de los estudiantes también lo avala.

Estrés académico en estudiantes de Medicina diagnosticados en la Unidad de Orientación Estudiantil / Academic stress in Medicine students diagnosed in the Student Direction Unit i: en

Introducción: La educación universitaria constituye un proceso generador de muchas tensiones para los estudiantes de todo el mundo, que se ha asociado a altos niveles de estrés, ansiedad y depresión. Objetivo: Describir las manifestaciones de estrés académico en estudiantes del tercer año de la carrera de Medicina. Métodos: Se realizó un estudio descriptivo, transversal y retrospectivo de 10 estudiantes de la Facultad de Medicina No. 1 de Santiago de Cuba, diagnosticados con estrés académico en la Unidad de Orientación Estudiantil, desde enero hasta junio de 2022. Resultados: Predominó el estrés moderado en 70,0 % de los alumnos, con una primacía del sexo femenino (50,0 %). La frecuencia de intensidad de la preocupación fue expresada en el valor categorial mucho (70,0 %). Entre los principales factores estresores identificados figuraron: sobrecarga de tareas y trabajos, evaluaciones de los profesores y participación en clase, que en su totalidad forman parte de la dinámica del proceso formativo de la carrera. También prevaleció la diversidad de estrategias de afrontamiento a dicho estrés. Conclusiones: El estrés académico se presentó mayormente en las esferas afectiva y conductual de los estudiantes y se asoció a sucesos vivenciales como factores estresores.

Introduction: University education constitutes a process that generates many tensions for the students from all over the world, which has been associated with high stress levels, anxiety and depression. Objective: To describe the manifestations of academic stress in students from the third year of Medicine. Methods: A descriptive, cross-sectional and retrospective study of 10 students from the Medicine Faculty No. 1 was carried out in Santiago de Cuba, diagnosed with academic stress in the Student Direction Unit, from January to June, 2022. Results: The moderated stress prevailed in 70.0 % of the students, with a primacy of female sex (50.0 %). The frequency of intensity of the concern was expressed in the categorical value (70.0 %) as many. Among the main identified factors that cause stress we can mention: excess of tasks and works, professors evaluations and participation in class that are part of the dynamics in the training process of the career. Also, the diversity of strategies to face this stress prevailed. Conclusions: The academic stress was mostly present in the affective and behavioral spheres of the students and was associated with events experienced as factors that cause stress.

Preoperative clinical management of patients who are candidates for facial transplantation / Manejo clínico pré-operatório de pacientes candidatos ao transplante facial

Introduction: Face transplantation has gained recognition, changing the clinicalsurgical scenario for restoring complex facial defects, as it attributes functional and aesthetic recovery to patients who have suffered serious accidents. At the time of writing this article, in official publications, 43 patients had already undergone facial transplantation worldwide. Face transplantation has numerous pieces of evidence that can irrefutably provide improvements to the patient. For this, preoperative care for the patient must be carefully established so that there is good surgical performance. Case Report: Male patient, 46 years old, reports that, at the age of 6, he had burns due to exposure to gasoline, with 72% of his body surface burned, showing sequelae of burns and surgical reconstructions on the face, with redundant and ptotic skin flap on the left cheek, absence of upper and lower lip and exposure of lower teeth. Conclusion: It is important to publicize this innovative procedure in different medical specialties and preoperative care through a thorough investigation, which attributes better surgical effectiveness, allowing the rescue of their facial identity, once stigmatized.

Introdução: O transplante de face adquiriu reconhecimento, alterando o panorama clínico-cirúrgico para a restauração de defeitos faciais complexos, visto que atribui recuperação funcional e estética a pacientes que sofreram acidentes graves. Até o momento da redação deste artigo, em publicações oficiais, 43 pacientes já haviam realizado o transplante facial em todo mundo. O transplante de face possui inúmeras evidências que podem fornecer melhorias ao paciente de forma irrefutável. Para isso, cuidados pré-operatórios ao paciente devem ser cuidadosamente estabelecidos para que haja um bom desempenho cirúrgico. Relato de Caso: Paciente sexo masculino, 46 anos, relata que, aos 6 anos de idade, teve queimadura por exposição à gasolina, com 72% de superfície corporal queimada, apresentando sequelas de queimaduras e reconstruções cirúrgicas na face, com retalho cutâneo redundante e ptótico em bochecha esquerda, ausência de lábio superior e inferior e exposição dos dentes inferiores. Conclusão: Ressalta-se a importância da divulgação desse procedimento inovador em diferentes especialidades médicas e dos cuidados pré-operatórios através de uma investigação minuciosa, que atribuem uma melhor eficácia cirúrgica, possibilitando o resgate de sua identidade facial, uma vez estigmatizada.

A Single Centre Open Label Non-Randomized Phase-IV Post Marketing Surveillance Study to Evaluate the Efficacy and Safety of Roop Mantra Ayurvedic Medicinal Cream

Objectives: The objective of the study was to evaluate the efficacy and safety of a polyherbal Roop Mantra Ayurvedic Medicinal Cream in subjects with acne, facial scars, pimples, blemishes, dull and dry skin. Methods: This was a 60-day, single-centre, open-labelled, non-randomized phase-IV surveillance study with 120 subjects. Subjects were selected based on the study's inclusion criteria. The study included three scheduled clinical visits on days 0 (screening and baseline visit), 30 (follow-up visit), and 60 (final visit). Following an evaluation of baseline data, all subjects were given Roop Mantra Ayurvedic Medicinal Cream for 60 days. The primary outcome of the study was to assess the efficacy of Roop Mantra Ayurvedic Medicinal Cream based on changes in parameters such as skin texture, skin health, global acne assessment parameters and an investigator assessment scale. The secondary outcome of the study was the determination of local intolerance and adverse effects to Roop Mantra Ayurvedic Medicinal Cream . Results: The study findings revealed that the use of Roop Mantra Ayurvedic Medicinal Cream for 60 days improved skin texture and appearance while significantly reducing acne, pimples, blemishes, and skin dryness. Roop Mantra Ayurvedic Medicinal Cream was likewise dermatologically well tolerated and did not cause any adverse effects during the study period. Conclusion: Roop Mantra Ayurvedic Medicinal Cream showed highly satisfactory results in terms of skin texture, skin appearance and general acne parameters without having any adverse effects on the skin. Given the positive outcomes, Roop Mantra Ayurvedic Medicinal Cream is clinically effective and safe alternative for treating various skin problems.

A Single Centre Open Label Post Marketing Surveillance Study to Evaluate the Efficacy and Safety of Roop Mantra Cucumber Ayurvedic Medicinal Face Wash

The objective of the study was to assess the safety and efficacy of Roop Mantra Cucumber Ayurvedic Medicinal Face Wash in subjects with acne, facial scars, pimples, blemishes, dull skin and dry skin. Methods: This was a single-center, open-label, non-randomized post-marketing surveillance study with 120 subjects. Subjects were selected on the basis of inclusion criteria. The study included three scheduled clinical visits on days 0 (screening and baseline visit), 15 (follow-up visit), and 30 (final visit). Following an assessment of baseline data, all subjects were given Roop Mantra Cucumber Ayurvedic Medicinal Face Wash for 30 days. The efficacy of Roop Matra Cucumber Ayurvedic Medicinal Face Wash was determined by measuring changes in parameters such as skin characteristics, skin appearance, and Global Acne Assessment (GAA) score. Product safety was assessed by determining local intolerance and adverse effects of Roop Mantra Cucumber Ayurvedic Medicinal Face Wash. Results: The results of the study showed that applying Roop Mantra Cucumber Ayurvedic Medicinal Face Wash for 30 days significantly improved skin’s characteristic and appearance. Roop Mantra Cucumber Ayurvedic Medicinal Face Wash was also found to be dermatologically well tolerated and had no negative impacts over the course of the study. Conclusion: The polyherbal Roop Mantra Cucumber Ayurvedic Medicinal Face Wash was found to be very safe and effective in reducing acne, pimples, blemishes, and skin dryness with improved skin texture and appearance. Roop Mantra Cucumber Ayurvedic Medicinal Face Wash is therefore a clinically feasible and safe alternative for treating the aforementioned skin conditions.

Diagnostic procedures in infrared thermography for the human face: a scoping review protocol / Procedimentos diagnósticos em termografia infravermelha para a face humana: um protocolo de revisão de escopo

ABSTRACT Purpose: to present the scoping review protocol that will describe the diagnostic procedures used in infrared thermography to evaluate the human face. Methods: based on the Joanna Briggs Institute and PRISMA-ScR checklist, with the mnemonic: population (P) - human face, concept (C) - infrared thermography, and context (C) - diagnostic procedures in infrared thermography for the human face. The methodological structure will have six stages. The PubMed, LILACS, SciELO, BBO, Web of Science, EMBASE, Scopus, Cochrane Library, and Grey Literature Report databases will be searched, with no restriction on time or language. The review will include qualitative and quantitative studies. Two reviewers will independently select studies and extract data. Results will be analyzed using a variable approach. Conclusion: this scoping review protocol followed the methodological precepts and is apt to be carried out. It will serve as the basis for other scoping reviews. Conducting a scoping review is important and the prior publication of the scoping review protocol is essential to make the review process transparent.

RESUMO Objetivo: apresentar um protocolo de revisão de escopo para identificar os procedimentos diagnósticos utilizados na termografia infravermelha para a avaliação da face humana. Métodos: baseado no The Joanna Briggs Institute e no checklist PRISMA-ScR, com o mnemônico: população (P) - face humana, conceito (C) - termografia infravermelha e contexto (C) - procedimentos diagnósticos na termografia infravermelha para a região da face humana. A estrutura metodológica consistirá em seis etapas. As bases de dados consultadas serão o PubMed, LILACS, SciELO, BBO, Web of Science, Embase, Scopus, Cochrane Library e Grey Literature Report. A busca será realizada sem delimitação temporal ou restrição de idioma. A revisão incluirá estudos qualitativos e quantitativos. Dois revisores selecionarão os estudos independentemente e extrairão os dados. Os resultados serão analisados utilizando uma abordagem variável. Conclusão: este protocolo de revisão de escopo seguiu os preceitos metodológicos e se encontra em condições de execução, servindo também como base para outras revisões de escopo. A realização de uma revisão de escopo é importante e a prévia publicação do protocolo de revisão de escopo fundamental, pois tem a finalidade de trazer transparência ao processo a ser realizado.

External compression headache during Covid-19 pandemic: a neglected entity / Cefaléia por compressão externa durante a pandemia de Covid-19: uma entidade negligenciada

Introduction: Personal Protective Equipment (PPE) is part of the work routine of health professionals, especially during pandemics. During the Covid-19 pandemic, the use of PPE became constant for long working hours, resulting in adverse effects on the health of professionals, especially headache. Objective: In this review, we explore the scientific literature on headache associated with prolonged use of PPE during the coronavirus pandemic. Method: This is a narrative literature review conducted through the PubMed and Web of Science databases according to the following MeSH descriptors: "Face shield", "Headache" and "Covid-19". Articles that analyzed the presence of headache and other adverse events in health professionals in prolonged use of PPE were included. Results: The included studies point to headache as the most prevalent adverse event, which may be a new headache or the worsening of a previous headache. Other effects were also found, such as pressure marks on the skin, hyperemia in contact areas; suffocation; reduced concentration and excessive sweating. Conclusion: The use of PPE for long periods can cause headaches due to external pressure, in addition to other unwanted events.These effects reveal the importance of studies to make PPE more efficient, ensuring protection for the individual without causing discomfort.

Introdução: Os Equipamentos de Proteção Individual (EPI) fazem parte da rotina de trabalho dos profissionais de saúde, principalmente durante as pandemias. Durante a pandemia da Covid-19, o uso de EPI tornou-se constante durante longas jornadas de trabalho, resultando em efeitos adversos à saúde dos profissionais, principalmente cefaleia. Objetivo: Nesta revisão, exploramos a literatura científica sobre cefaleia associada ao uso prolongado de EPI durante a pandemia do coronavírus. Método: Trata-se de uma revisão narrativa da literatura realizada por meio das bases de dados PubMed e Web of Science segundo os seguintes descritores MeSH: "Face Shield", "Headache" e "Covid-19". Foram incluídos artigos que analisaram a presença de cefaleia e outros eventos adversos em profissionais de saúde em uso prolongado de EPI. Resultados: Os estudos incluídos apontam a cefaleia como o evento adverso mais prevalente, podendo ser uma nova cefaleia ou o agravamento de uma cefaleia anterior. Também foram encontrados outros efeitos, como marcas de pressão na pele, hiperemia nas áreas de contato; asfixia; concentração reduzida e transpiração excessiva. Conclusão: O uso de EPI por longos períodos pode causar dores de cabeça por pressão externa, além de outros eventos indesejados. Esses efeitos revelam a importância de estudos para tornar os EPI mais eficientes, garantindo proteção ao indivíduo sem causar desconforto.

AI Rudi's Experience in Differentiating and Treating Facial Hormone-dependent Dermatitis by Stages Using the method of Clearing Heat and Protecting Yin / 中医杂志

This paper summarized the clinical experience of AI Rudi in the treatment facial hormone-dependent dermatitis with the method of clearing heat and protecting yin. It is believed that the key pathogenesis is the heat toxin accumulation， yin depletion and collaterals obstruction. The clinical treatment should focus on “heat exuberance” and “yin depletion”. It is advocated that “half treatment is from heat and half from yin” is the general principle， and the treatment is staged. In the acute phase， the treatment is half from cooling blood and dispersing wind to dispel heat pathogen， and half from protecting fluid and moisturizing skin to strengthen yin； and the modified Liangxue Xiaofeng Powder （凉血消风散） could be used. In the chronic phase， half treatment is from clearing residual toxin to eliminate heat pathogen， and half from nourishing yin and unblocking collaterals to strengthen yin， for which Xuanmai Ganju Decoction and Erzhi Pills （玄麦甘桔汤合二至丸） can be used and modified according to the symptoms. At the same time， we should pay attention to the simultaneous internal and external treatment， and emphasize the importance of daily protection in the treatment of the disease.

Readiness of clients in returning to face-to-face therapy in an outpatient rehabilitation clinic: a preliminary study

BACKGROUND@#The Clinic for the Therapy Services (CTS) has considered reverting to face-to-face service delivery due to the downward trend in COVID-19 cases in the Philippines. However, the clinic has yet to investigate the willingness of the clients to this mode as a basis for its effective implementation.@*OBJECTIVES@#The study described the readiness of CTS clients in returning to face-to-face therapy amidst the pandemic. It also discussed the factors affecting readiness based on a survey.@*METHODOLOGY@#Fifty-five screened survey responses on the readiness of clients in returning to face-to-face therapy were gathered from January 30 to February 28, 2021. These underwent retrospective data analysis. Eight prospective online key informant interviews were conducted for clarifications in May 2022. This study utilized a descriptive analysis of quantitative categorical variables and a thematic content analysis of qualitative data.@*RESULTS@#The majority of the respondents (35) stated readiness to attend face-to-face therapy followed by those who answered “No” (11), “Maybe” (5), and others (4). Factors that may have affected readiness included travel, characteristics of face-to-face therapy, health conditions, vaccine, and COVID-19 concerns. Frequently preferred health and safety strategies were the provision of hygiene products, disinfection, limited people inside the clinic, separate therapy areas, and ventilation.@*CONCLUSION@#Most of the respondents expressed willingness to receive face-to-face therapy in April or May of 2021. Feasibility of travel and decreased number of COVID-19 cases may have encouraged willingness to attend. Those who were hesitant reported concerns with traveling, characteristics of face-to-face therapy, health conditions, the COVID-19 situation, and the vaccine.