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1.
Arch. argent. pediatr ; 119(6): e600-e609, dic. 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1343032

ABSTRACT

El frenillo lingual corto, o anquiloglosia, puede generar problemas durante la lactancia con repercusión en el desarrollo del lactante, daño en el pezón de la madre y abandono precoz de la lactancia. Actualmente no existe homogeneidad en los criterios diagnósticos, lo que ocasiona tanto sobrediagnóstico como infradiagnóstico de esta alteración, con las consecuencias clínicas que ello conlleva. La dificultad en el abordaje radica en saber cuándo se trata de variantes anatómicas normales o de un frenillo lingual sin repercusión funcional, y cuándo los problemas de lactancia, que clásicamente se le atribuyen se deben realmente al frenillo. Alrededor del 50 % de los niños con frenillo lingual corto no presenta problemas de lactancia o estos se resuelven con apoyo y asesoramiento. En el resto de casos se puede recurrir a tratamiento quirúrgico. En este artículo se ha realizado una actualización de la clasificación y tratamiento de la anquiloglosia que permitirá a los profesionales un manejo adecuado de estos pacientes


Short frenulum, or ankyloglossia, may lead to breastfeeding problems, with an impact on infant development, nipple damage, and early abandonment of breastfeeding. There are currently no homogeneous diagnostic criteria, thus leading to both overdiagnosis and underdiagnosis and associated clinical consequences. The challenge to approach this condition lies in establishing whether it is a normal anatomical variation or a lingual frenulum without a functional impact and when breastfeeding difficulties which are typically attributed to it are actually caused by the frenulum. Approximately 50 % of ankyloglossia cases do not result in breastfeeding problems or these can be resolved with support and advice. Surgery may be proposed for the rest of the cases. This article offers an update on the classification and treatment of ankyloglossia, which will help health care providers to provide an adequate management to these patients


Subject(s)
Humans , Infant , Ankyloglossia/diagnosis , Ankyloglossia/therapy , Lingual Frenum/surgery , Breast Feeding , Health Personnel , Nipples/injuries
2.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(1): 151-159, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1250680

ABSTRACT

Abstract Objectives: to measure the micro-cost of local laser therapy (LL) and transcutaneous laser therapy application by Irradiation Laser Intravascular of Blood (ILIB) to treat nipple trauma and compare the most effective and efficient alternative treatment. Methods: a cross-sectional analytical and quantitative study with analysis on the micro absorption cost, implemented as a clipping, from a randomized clinical trial that used two types of laser therapy to treat nipple trauma due to breastfeeding. The sample consisted of 101 nipple lesions. Patients were randomized into three groups (Control - CG, Local Laser -LLG and ILIB-ILIBG). Materials used, direct labor (DL) and laser equipment were predictors of costs. The delta calculation (effect size) was the indicator for measuring effectiveness and efficiency. Results: after three sessions, the average final cost was R$ 40.04for CG, R$ 53.55for LLG and R$ 67.29for ILIBG. After three sessions of treatment, ILIBG showed a great reduction in the lesion area, but with a higher cost (p<0.05). Conclusions: ILIBG had a better effect on healing the nipple trauma when compared to CG and LLG, even though it is more expensive, it suggests a positive cost-benefit and the most effective and efficient alternative treatment.


Resumo Objetivos: mensurar o microcusteio da aplicação de Laserterapia Local (LL) e trans-cutânea por Irradiation Laser Intravascular of Blood (ILIB) no tratamento de traumas mamilares e comparar a alternativa de tratamento mais eficaz e eficiente. Métodos: estudo transversal analítico do tipo quantitativo com análise de microcusteio de procedimento por absorção, implementado como recorte, de um ensaio clínico rando-mizado que utilizou duas modalidades de laserterapia para tratamento de traumas mamilares ocasionados pela amamentação. A amostra foi composta de 101 lesões mamilares. As pacientes foram aleatorizadas em três grupos (Controle - GG, Laser Local - GLL e ILIB -GILIB). Foram preditores de custos os materiais consumidos, Mão de obra Direta (MoD) e o equipamentos de laser O cálculo Delta (tamanho do efeito) foi o indicador para a medida da eficácia e eficiência. Resultados: após três sessões, a média do custo final foi de R$ 40,04 para o GC, R$ 53,55 para o GLL e R$ 67,29 para o GILIB. Após três sessões de tratamento, GILIB apresentou maior redução da área da lesão, contudo custo mais elevado (p<0,05). Conclusão: o GILIB teve efeito melhor na cicatrização dos traumas mamilares quando comparado com o GC e GLL, mesmo sendo mais caro sugere um custo benefício positivo e a alternativa de tratamento mais eficaz eficiente.


Subject(s)
Humans , Female , Pregnancy , Breast Feeding/adverse effects , Treatment Outcome , Costs and Cost Analysis , Low-Level Light Therapy/instrumentation , Nipples/injuries , Cross-Sectional Studies
3.
Article in English | WPRIM | ID: wpr-921877

ABSTRACT

Objective To analyze the reasons of misdiagnosis of primary syphilitic chancre and strengthen the understanding of atypical features of this disease. Methods A case series of twenty-seven challenging primary syphilis patients who were not immediately recognized as chancre was included in our study. The clinical data including the patients' age, sex, skin lesions, HIV status, syphilis serologic test results, treatment, and follow-up results were collected. Hematoxylin-eosin and immunohistochemistry staining of skin biopsy sections were reviewed. Results Four female cases with extragenital chancres presenting as erythema or erosive skin lesions on the nipple were misdiagnosed as Paget's disease or eczema. The disorder of missed or misdiagnosed male cases manifested as syphilitic balanitis or multiple chancres on the penis root and adjacent pubis rather than coronal sulcus or frenum. Patients with nonreactive nontreponemal tests at initial presentation were also easily missed or misdiagnosed. Conclusion Primary syphilis presenting as multiple lesions rather than a single chancre, at atypical locations, or with a nonreactive nontreponemal test result, tends to be missed or misdiagnosed.


Subject(s)
Chancre/diagnosis , Female , Humans , Male , Nipples , Skin , Syphilis/diagnosis
4.
Chinese Medical Journal ; (24): 806-813, 2021.
Article in English | WPRIM | ID: wpr-878036

ABSTRACT

BACKGROUND@#Mastectomy techniques have been extended to nipple-sparing mastectomy (NSM). This study aimed to assess the actual application of NSM in China and identify the factors influencing postoperative complications.@*METHODS@#The clinical data of 615 patients (641 surgeries) undergoing NSM from January 1st, 2018 to December 31st, 2018 at 28 centers nationwide were retrospectively analyzed to obtain the rate of NSM and investigate factors related to NSM surgery.@*RESULTS@#The proportion of NSM surgery performed in this study was 2.67% (17/641). Malignant breast tumors accounted for the majority of NSM surgery (559/641, 87.2%). A total of 475 (77.3%) patients underwent NSM combined with reconstructive surgery. The rate of reconstruction decreased with age in our study, and implants were the most common option (344/641, 53.7%) in reconstruction. Radial incision was the most selected method regardless of reconstruction. However, for those who underwent reconstruction surgery, 18.4% (85/462) of cases also chose curvilinear incision, while in the simple NSM surgery group, more patients chose circumareolar incision (26/136, 19.1%). The tumor-to-nipple distance (TND) influenced postoperative complications (P = 0.004). There were no relationships between postoperative complications and tumor size, tumor location, histologic grade, molecular subtype, nipple discharge, and axillary lymph nodes.@*CONCLUSIONS@#NSM surgery is feasible and only TND influenced postoperative complications of NSM surgery. But the proportion of NSM surgery performed is still low in nationwide centers of China. The selection criteria for appropriate surgical methods are important for NSM in clinical practice. To optimize clinical applications of NSM, further multicenter prospective randomized controlled studies are needed.@*TRIAL REGISTRATION@#ChiCTR.org.cn, ChiCTR1900027423; http://www.chictr.org.cn/showprojen.aspx?proj=38739.


Subject(s)
Breast Neoplasms/surgery , China , Humans , Mammaplasty , Mastectomy , Nipples/surgery , Prospective Studies , Retrospective Studies
5.
Audiol., Commun. res ; 26: e2471, 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1350149

ABSTRACT

RESUMO Objetivos Identificar e analisar os estudos que avaliaram as dificuldades enfrentadas pelas puérperas para implementação do aleitamento materno exclusivo até 72 horas após o parto, durante o período em que permaneceram no alojamento conjunto. Estratégia de pesquisa Foi realizada busca de artigos nas plataformas PubMed, BVS e SciELO. Critérios de seleção Foram selecionados artigos originais, com resumo disponível, publicados entre os anos de 2010 e 2020, em português, inglês ou espanhol, que investigaram as dificuldades observadas no aleitamento materno exclusivo durante o período em que a díade mãe/bebê permaneceu no alojamento conjunto. Resultados A amostra final consistiu em 11 artigos publicados entre os anos de 2010 e 2019, sendo o Brasil o país com maior número de publicações. O tamanho das amostras nos estudos variou de 40 a 1.691 puérperas, com faixas etárias entre 13 e 46 anos. Observou-se prevalência de amamentação na primeira hora após o nascimento entre 43,9% e 77,3%. Conclusão A maioria dos artigos indicou que a principal dificuldade no aleitamento materno no período pós-parto se refere aos traumas mamilares. Os traumas mamilares são ocasionados por características do aleitamento, da mulher, da mama, da gestação, do parto e da rede de apoio da puérpera.


ABSTRACT Purpose Identify and analyze the studies that evaluated the difficulties faced by the puerperal women to implement exclusive breastfeeding up to 72 hours after delivery during the period in which they stayed in the rooming-in. Research strategy The search for articles was carried out on the PubMed, BVS, and SciELO platforms. Selection criteria Original articles were selected, with an available summary, published between 2010 and 2020 in Portuguese, English or Spanish that investigated the difficulties observed in exclusive breastfeeding during which the mother-baby dyad stayed in the period of Rooming-in Care. Results The final sample of this study consisted of 11 articles published between the years 2010 and 2019, having Brazil being the country with the largest number of publications. The sample sizes in the studies ranged from 40 to 1,691 puerperal women, having ages between 13 and 46 years. It was observed a prevalence of breastfeeding in the first hour after birth between 43.9% and 77.3%. Conclusion Most articles pointed out that the main difficulty in relation to breastfeeding in the postpartum period refers to nipple trauma. Nipple trauma is caused by characteristics of breastfeeding, women, breast, pregnancy, childbirth and the postpartum support network.


Subject(s)
Humans , Female , Infant, Newborn , Rooming-in Care , Weaning , Breast Feeding , Postpartum Period , Nipples/injuries
6.
An. bras. dermatol ; 95(6): 751-753, Nov.-Dec. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1142116

ABSTRACT

Abstract Paget's disease is a rare disorder of the nipple and/or the areola that is characterized by an erythematosquamous lesion and is often associated with in situ or invasive breast carcinoma. The authors present an atypical, exuberant case that had evolved over eight years, emphasizing the importance of early diagnosis.


Subject(s)
Humans , Breast Neoplasms/diagnosis , Paget's Disease, Mammary , Thorax/diagnostic imaging , Ulcer , Nipples
7.
Rev. cir. (Impr.) ; 72(5): 418-426, oct. 2020. tab, graf, ilus
Article in Spanish | LILACS | ID: biblio-1138733

ABSTRACT

Resumen Objetivo: Se presenta experiencia realizada en Servicio de Salud Talcahuano, de masculinización mamaria en el proceso de reasignación sexual, de transexuales masculinos. En Chile se estima que habrían 754 mujeres transexuales. Materiales y Método: Estudio de 47 individuos, intervenidos en Hospital Las Higueras de Talcahuano, entre 2006 y 2019, sometidos a masculinización mamaria mediante mastectomía subcutánea y reconstrucción del complejo areolomamilar. Resultados: Se intervinieron pacientes de todo el país; 59% corresponde a octava región; 42,5% operados entre los años 2017 y 2018. Un 36% rango de edad de 18 a 22 años. Un 68% IMC entre 24 y 30. Según el tamaño de las mamas, 57% copa B, 31% C, 12% D y 12% de gigantomastía. Un 29%, peso promedio de la mastectomía fue de 600 g; un 29% de 300 gramos y en 9% más de 800 g por lado. En 68% se utilizó abordaje submamario e injerto de piel total del complejo aréola pezón (CAP); otras tecnicas fueron periareolar, incisión en T y liposucción. La complicación más frecuente fue la colección. Biopsia normal en un 100%. Discusión: Experiencia pionera en Chile, realizada en un Hospital Público, en el difícil proceso de reasignación de género, en la población transexual de Chile. Individuos muy estigmatizados de parte de la comunidad, que encontraron en el Servicio de Salud de Talcahuano, una mano amiga, que les extendió su apoyo desinteresado y calificado, logrando excelentes resultados finales.


Aim: Describe the experience in Talcahuano Helath Service, of mammary masculinization in the sexual reassignment process, of male transsexuals. In Chile it is estimated that there will be 754 transsexual women. Materials and Method: Study of 47 individuals, operated at Las Higueras Hospital in Talcahuano, between 2006 and 2019, subjected to breast masculinization by subcutaneous mastectomy and reconstruction of the areolomamilar complex. Results: Patients from all over the country were operated; 59% corresponds to the Bio-Bio province; 42.5% operated between 2017 and 2018. A 36% range of ages from 18 to 22 years. 68% BMI between 24 and 30. According to the size of the breasts, 57% B cup, 31% C, 12% D and 12% gigantomasty. At 29%, the average weight of the mastectomy was 600 grams; 29% of 300 grams and 9% more than 800 grams per side. In 68%, the submammary approach and total skin graft of the CAP were used; Other techniques were periareolar, incision in T and liposuction. The most frequent complication was the collection. 100% normal biopsy. Discussion: Pioneering experience in Chile, carried out in a public hospital, in the difficult process of gender reassignment, in the transsexual population of Chile. Individuals very stigmatized by the community, who found in the Health Service of Talcahuano, a helping hand, which extended their selfless and qualified support, achieving excellent final results.


Subject(s)
Humans , Male , Female , Mastectomy, Subcutaneous/methods , Transgender Persons , Nipples/surgery , Age Distribution , Reconstructive Surgical Procedures
8.
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(3): 695-703, July-Sept. 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136449

ABSTRACT

Abstract Objectives: to evaluate the effect of an intervention on the incidence of nipple trauma and the quality of breastfeeding technique in the first month of postpartum. Methods: this is a quasi-randomized intervention study with 180 puerperal women equally distributed between experimental and control groups. The intervention was performed at a maternity and consisted of an educational session on breastfeeding technique. A descrip-tive analysis of the groups' characteristics was performed, comparing the frequencies of unfa-vorable parameters related to breastfeeding technique between groups. Pearson's chi-square test and Fisher's test were used, and p≤0.05 was adopted as the critical level of significance. Results: at 30 days, 64% and 15% of the mothers used the technique correctly, respec-tively, in the experimental and control groups with RR=4.87 (CI95%=2.93-8.34); NNT=1.96 (CI95% =1.61-2.72); p<0.001. In the experimental group, a decrease was observed in the unfavorable parameters of the breastfeeding technique (p≤0.05). The incidence of nipple trauma was 30% in the experimental group and 38.9% in the control group (p=0.21). Conclusions: the intervention was insufficient to prevent nipple trauma in the experi-mental group, but significantly improved the quality in the breastfeeding technique.


Resumo Objetivos: avaliar o efeito de uma intervenção na incidência de traumas mamilares e na qualidade da técnica de amamentar no primeiro mês pós-parto. Métodos: trata-se de um estudo de intervenção quasi randomizado com 180 puérperas distribuídas entre os grupos experimental e controle. A intervenção foi realizada na mater-nidade e consistiu de sessão educativa sobre a técnica de amamentar. Foi realizada análise descritiva das características dos grupos, comparadas as frequências dos parâmetros desfa-voráveis da técnica de amamentar. O teste do qui-quadrado de Pearson e teste de Fisher foram utilizados, sendo adotado p≤ 0,05 como nível crítico de significância. Resultados: aos 30 dias, 64% e 15%, das mães apresentaram técnica correta, respectiva-mente, nos grupos experimental e controle com RR= 4,87 (IC95%=2,93-8,34); NNT= 1,96 (IC95%=1,61-2,72); p<0,001.No grupo experimental percebeu-se que houve diminuição dos parâmetros desfavoráveis da técnica de amamentar (p≤0,05). A incidência de trauma mamilar foi de 30% no grupo experimental e 38,9% no grupo controle (p=0,21). Conclusão: no grupo experimental a intervenção realizada não foi suficiente para prevenir a ocorrência de traumas mamilares, porém melhorou significantemente a qualidade da técnica de amamentar.


Subject(s)
Humans , Female , Pregnancy , Breast Feeding/methods , Health Education , Postpartum Period , Nipples/injuries , Chi-Square Distribution
9.
Rev. Bras. Saúde Mater. Infant. (Online) ; 20(2): 333-345, Apr.-June 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136440

ABSTRACT

Abstract Objectives: to analyze the effectiveness on health education to prevent nipple trauma in breastfeeding compared to other interventions. Methods: systematic literature review was carried out in January 2019, according to PRISMA recommendations. The searches were conducted in Cinahl, PubMed, Web of Science, Scopus, and in the references cited in the selected articles. The studies were assessed for quality and level of evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results: twelve studies were selected, all conducted at the maternities. The interventions were classified in two categories: health education on breastfeeding and the use of nipple covers. Health education on breastfeeding presents a moderate level of evidence on the prevention of nipple trauma. There is a moderate to high level of evidence on the positive effects of guaiazulene, gel or peppermint water applied in the postpartum period to prevent nipple trauma. Conclusion: health education on breastfeeding with clinical demonstration is an important strategy to prevent nipple trauma and requires more than one educational approach. The use of nipple covers requires some consideration, since they must be removed prior to breastfeeding. All interventions were conducted in the postpartum period, which points out for the necessity of clinical research to prevent nipple trauma in prenatal care.


Resumo Objetivos: analisar a eficácia da educação em saúde para a prevenção do trauma mamilar na amamentação comparado a outras intervenções. Métodos: revisão sistemática realizada em janeiro de 2019, segundo recomendações PRISMA. As buscas foram realizadas na Cinahl, PubMed, Web of Science, Scopus e referências citadas nos artigos selecionados. Os estudos foram avaliados quanto à qualidade e nível de evidência conforme o sistema Grading of Recommendations, Assessment, Development and Evaluation. Resultados: foram selecionados 12 estudos, todos executados em maternidades. As intervenções foram representadas em duas categorias: educação em saúde sobre amamentação e uso de coberturas mamilares. A educação em saúde sobre amamentação apresenta moderada evidência na prevenção do trauma mamilar. As coberturas de gel ou água de hortelã-pimenta, de guaiazulene, aplicadas no pós-parto, têm efeito positivo na prevenção do trauma mamilar, com moderada a alta evidência. Conclusão: a educação em saúde sobre amamentação, com demonstração clínica, configura-se importante estratégia para prevenção do trauma mamilar, devendo ser realizada mais de uma abordagem educativa. A implementação de coberturas mamilares precisa ser ponderada, pois todas exigiram remoção antes da mamada. Todas as intervenções foram conduzidas no pós-parto, o que aponta para a necessidade de pesquisas clínicas sobre a prevenção do trauma mamilar no pré-natal.


Subject(s)
Humans , Female , Pregnancy , Breast Feeding , Health Education , Nipple Protectors , Nipples/injuries , Postpartum Period
10.
Rev. bras. cir. plást ; 34(4): 477-484, oct.-dec. 2019. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1047906

ABSTRACT

Introdução: Sabe-se que o câncer de mama é hoje a segunda neoplasia mais frequente entre as mulheres, as quais são submetidas desde a tratamentos clínicos até cirúrgicos mutilantes da mama. Ter mamas bonitas e harmoniosas é um direito legítimo, sendo assim o conceito de reconstrução mamária e do complexo areolo papilar se torna importante na reinserção social feminina. Este estudo visa apresentar uma técnica eficaz de reconstrução areolar, utilizando enxerto cutâneo livre palpebral bilateral, demonstrando sua eficácia através de resultados fotográficos, comparação com outras técnicas já descritas e questionários de satisfação dos pacientes. Resultados: Foram avaliados, retrospectivamente, 50 pacientes operados de reconstrução areolar com enxerto de pele palpebral e outras técnicas já descritas, operados por um único cirurgião sênior. O grupo de pacientes operados com pele palpebral não obtiveram diferenças significativas dentro da análise de resultados, comparados com outras técnicas de reconstrução. Houve boa satisfação por parte dos pacientes, quanto ao resultado das cirurgias das aréolas. Conclusão: O estudo obteve baixos índices de complicações, apresentando-se como boa opção terapêutica, dentro do arsenal cirúrgico de reconstrução areolar.


Introduction: Breast cancer is currently the second most common neoplasm among women who undergo clinical treatments and breast-mutilating surgeries. Having beautiful and harmonious breasts is a legitimate right, so the concept of reconstructing the breast and nipple-areolar complex becomes important in female social reinsertion. This study aimed to present an effective technique of areolar reconstruction using free bilateral eyelid skin grafts and demonstrate its effectiveness through photographic results, comparison with previously described techniques, and patient satisfaction questionnaires. Results: The authors retrospectively evaluated 50 patients who underwent areolar reconstruction with eyelid skin grafts and other techniques performed by a single senior surgeon. Patients who underwent eyelid skin graft surgery did not achieve significantly different results from those who underwent other reconstruction techniques. Patients who underwent areola surgeries reported good satisfaction. Conclusion: The study revealed low complication rates and demonstrated that the use of eyelid skin is a good therapeutic option for areolar reconstruction.


Subject(s)
Humans , Female , History, 21st Century , Patients , Skin , Transplantation , Breast , Patient Satisfaction , Reconstructive Surgical Procedures , Esthetics , Eyelids , Nipples , Transplantation/methods , Transplantation/statistics & numerical data , Breast/surgery , Patient Satisfaction/statistics & numerical data , Reconstructive Surgical Procedures/methods , Eyelids/surgery , Nipples/surgery
11.
An. bras. dermatol ; 94(5): 549-552, Sept.-Oct. 2019. tab
Article in English | LILACS | ID: biblio-1054854

ABSTRACT

Abstract Background Nipple eczema is a less common presentation of atopic dermatitis. No studies in the literature have correlated nipple eczema in pregnancy as a manifestation of atopic dermatitis. Objective To evaluate whether nipple eczema presenting in pregnancy is a manifestation of atopic dermatitis. Methods This was a prospective observational study including 100 women who presented with nipple eczema for the first time during pregnancy. The exclusion criteria were any patient with previous history of nipple eczema, those already on oral or topical treatment for atopic dermatitis or nipple eczema, and other disorders mimicking eczema. Patients were divided into two groups ‒ nipple eczema with atopic dermatitis and without atopic dermatitis. Demographic data, clinical features, total leukocyte count, differential leukocyte count, absolute eosinophil counts, and serum IgE levels were compared between the two groups to detect association between nipple eczema in pregnancy and atopic dermatitis. Results Out of 100 patients, 39 were diagnosed with atopic dermatitis, whereas 61 were ruled out to have any features suggestive of atopic dermatitis. There were no statistically significant differences in mean age, mean duration of symptoms, and serum IgE levels. In patients with atopic dermatitis, bilateral symptoms were noted more commonly than in patients without the disease, but this was statistically insignificant. Study limitations Lack of long term follow-up and no large studies in literature to compare results. Conclusion Nipple eczema in pregnancy follows a similar pattern as in other age groups. The clinical profile of patients is similar in cases with and without atopic dermatitis.


Subject(s)
Humans , Female , Pregnancy , Adult , Breast Diseases/pathology , Dermatitis, Atopic/pathology , Eczema/pathology , Nipples/pathology , Pregnancy Complications/pathology , Breast Diseases/diagnosis , Breast Diseases/blood , Immunoglobulin E/blood , Prospective Studies , Dermatitis, Atopic/diagnosis , Dermatitis, Atopic/blood , Eczema/diagnosis , Eczema/blood , India , Leukocyte Count , Neutrophils
12.
Nursing (Säo Paulo) ; 22(256): 3160-3164, set.2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1026022

ABSTRACT

O objetivo desse artigo foi identificar os tratamentos sugeridos na literatura para tratamento de lesão e dor mamilar durante o aleitamento materno. Trata-se de uma Revisão Integrativa de Literatura, realizada na base de dados Pubmed e LILACS, onde foi encontrado oito artigos. A maioria dos estudos adotou a correção da pega associados ao uso de pomadas a base de lanolina para o tratamento da dor e trauma mamilar. Outros tratamentos indicados incluíram o uso leite materno além de medicamentos tópicos e orais, porém observou-se que somente houve evidência estatisticamente significante o uso de lanolina. Conclusão: A correção da pega e o uso da lanolina mostraram serem eficazes para o tratamento da dor e fissura mamária.(AU)


The objective of this article was to identify the treatments suggested in the literature for the treatment of nipple injury and pain during breastfeeding. It is an Integrative Review of Literature, carried out in the Pubmed database and LILACS, where eight articles were found. Most studies have adopted the correction of the handle associated with the use of lanolin-based ointments for the treatment of pain and nipple trauma. Other indicated treatments included the use of breast milk in addition to topical and oral medications, but it was observed that there was only statistically significant use of lanolin. Conclusion: Handle correction and lanolin use have been shown to be effective for the treatment of breast pain and fissure.(AU)


El objetivo de este artículo fue identificar los tratamientos sugeridos en la literatura para el tratamiento de la lesión del pezón y el dolor durante la lactancia. Es una Revisión Integrativa de Literatura, realizada en la base de datos Pubmed y LILACS, donde se encontraron ocho artículos. La mayoría de los estudios han adoptado la corrección del mango asociada con el uso de ungüentos a base de lanolina para el tratamiento del dolor y el traumatismo del pezón. Otros tratamientos indicados incluyeron el uso de leche materna además de medicamentos tópicos y orales, pero se observó que solo había un uso estadísticamente significativo de lanolina. Conclusión: la corrección del mango y el uso de lanolina han demostrado ser efectivos para el tratamiento del dolor y la fisura en los senos.(AU)


Subject(s)
Humans , Female , Pain , Wounds and Injuries , Breast Feeding , Nipples , Maternal-Child Health Services , Maternal Health
13.
Article in English | WPRIM | ID: wpr-761391

ABSTRACT

Adenomyoepithelioma (AME) is a rare breast lesion with balanced proliferation of both epithelial and myoepithelial cells. Patients usually present with a solitary mass without pain and nipple discharge. Although the tumor is generally considered benign, it has potential for local recurrence, metastasis, or malignant change. Approximately 150 cases have been reported in the medical literature, of which 40 cases were malignant or potentially malignant. But among them, elastographic findings have been reported in only two cases and still remain unclear. Herein, we now present a case of breast AME with emphasis on elastography.


Subject(s)
Adenomyoepithelioma , Breast Neoplasms , Breast , Elasticity Imaging Techniques , Humans , Neoplasm Metastasis , Nipples , Recurrence , Ultrasonography
14.
Ultrasonography ; : 83-91, 2019.
Article in English | WPRIM | ID: wpr-731037

ABSTRACT

Three-dimensional automated breast ultrasonography (ABUS) has been approved for screening Epub ahead of print studies as an adjunct to mammography. ABUS provides proper orientation and documentation, resulting in better reproducibility. Optimal image quality is essential for a proper diagnosis, and high-quality images should be ensured when ABUS is used in clinical settings. Image quality in ABUS is highly dependent on the acquisition procedure. Artifacts can interfere with the visibility of abnormalities, reduce the overall image quality, and introduce clinical and technical problems. Nipple shadow and reverberation artifacts are some of the artifacts frequently encountered in ABUS. Radiologists should be familiar with proper image acquisition techniques and possible artifacts in order to acquire high-quality images.


Subject(s)
Artifacts , Breast , Diagnosis , Early Detection of Cancer , Mammography , Mass Screening , Nipples , Ultrasonography, Mammary
16.
Article in English | WPRIM | ID: wpr-739172

ABSTRACT

BACKGROUND: It remains unknown whether perfusion mapping using the SPY system can predict mastectomy skin flap necrosis in each type of breast surgery. We analyzed intraoperative indocyanine green (ICG) angiography images of breast cancer patients who underwent nipple-sparing mastectomy (NSM) with implant-based breast reconstruction, and evaluated the perfusion of the nipple-areolar complex (NAC) with the SPY Elite system to predict NAC necrosis with a single quantitative value. METHODS: We analyzed nipple perfusion in 30 patients from October 2016 to November 2018. After NSM, ICG injection and SPY angiography were performed to characterize NAC perfusion before immediate reconstruction. The nipple perfusion rate was measured by analyzing fluorescence at the central point of the nipple, and the presence of NAC necrosis was evaluated at 5 days and 1 month postoperatively. RESULTS: Three of the 30 patients developed NAC necrosis that secondarily healed within 1 month, and five developed NAC necrosis and underwent surgical debridement within 1 month. Seven of eight patients with a perfusion rate < 13% developed NAC necrosis, and all four patients with a perfusion rate < 10% needed partial surgical debridement or total NAC excision. CONCLUSIONS: The nipple perfusion rate could be useful for predicting NAC necrosis before immediate reconstruction. For patients at a high risk for NAC necrosis, tissue expander insertion rather than a direct-to-implant procedure may be considered, and close follow-up with thorough wound management should be done to reduce complications.


Subject(s)
Angiography , Breast Neoplasms , Breast , Debridement , Female , Fluorescence , Follow-Up Studies , Humans , Indocyanine Green , Mammaplasty , Mastectomy , Necrosis , Nipples , Perfusion , Skin , Tissue Expansion Devices , Wounds and Injuries
17.
Article in English | WPRIM | ID: wpr-759809

ABSTRACT

Mammary Paget's disease is clinically defined as skin inflammation of the nipple area and is an adenocarcinoma of the epidermis of the nipple. The pathogenesis of mammary Paget's disease is relatively unknown; nonetheless, there are two popular theories that support the underlying carcinoma and de novo carcinogenesis. For the attending medical practitioner, mammary Paget's disease poses a diagnostic and therapeutic dilemma, especially in the absence of a clinically palpable breast mass. We report a rare case of a 48-year-old Malay woman who presented at Hospital Universiti Sains Malaysia, Kelantan, Malaysia with the symptom of skin erosion on the left nipple and unresponsiveness to multiple topical treatments. A full evaluation and assessment of the patient were conducted, and mammary Paget's disease was diagnosed.


Subject(s)
Adenocarcinoma , Breast , Breast Neoplasms , Carcinogenesis , Eczema , Epidermis , Female , Humans , Inflammation , Malaysia , Middle Aged , Nipples , Paget's Disease, Mammary , Skin
18.
Article in Korean | WPRIM | ID: wpr-758472

ABSTRACT

OBJECTIVE: Focused assessment with sonography for trauma (FAST) is used routinely for evaluating patients with major trauma. After a primary survey, the existence of hemoperitoneum or hemopericardium must be searched using FAST. Traditionally, hemopericardium can be assessed through the subcostal approach with the curved probe for the abdomen. On the other hand, satisfactory images (four chamber view) are difficult to obtain with this approach. METHODS: This was a prospective, single-center pilot study of an academic tertiary medical center. When FAST is performed on the patients, traditional FAST (subcostal approach with the curved probe) is generally conducted. During a FAST examination, the time consumed, numeric rating scale (NRS) for pain, and success rate of satisfactory images are recorded. After the traditional FAST was used, we used the curved probe like echo probe. The curved probe was positioned beside the left nipple with the probe marker opposite-sided (modified FAST) like the parasternal long-axis view of echocardiography. Finally, the existence of hemopericardium is confirmed using an echo probe. In this study, the consumed time, NRS, and success rate of satisfactory images were compared. RESULTS: The consumed time was shorter (57.4 vs. 71.2 seconds, P<0.001) and the pain score was lower (0.1 vs. 1.8, P<0.001) with the modified FAST compared to the traditional FAST. Satisfactory images were obtained in 23 cases (51%) with traditional FAST, whereas satisfactory images were obtained in 37 cases (82%) using modified FAST. CONCLUSION: Mvodified FAST is more accurate for the detection of hemopericardium than traditional FAST. The pain is less severe and the time consumed is shorter.


Subject(s)
Abdomen , Advanced Trauma Life Support Care , Echocardiography , Hand , Hemoperitoneum , Humans , Nipples , Pericardial Effusion , Pilot Projects , Prospective Studies , Ultrasonography
19.
Article in English | WPRIM | ID: wpr-762847

ABSTRACT

BACKGROUND: Multiple approaches for nipple reconstruction exist, and none is considered superior to all others. The star flap is one of the most popular methods for nipple reconstruction, but gradual height loss is a major concern. We present a new modification of the star flap that incorporates a de-epithelialized dermal flap, along with the associated surgical results. METHODS: We reviewed the medical records of patients who underwent nipple reconstruction using the modified star flap method. The design was different from the conventional star flap in that the lateral wings were changed into a trapezoidal shape and de-epithelialized dermal flaps were added. The patients were followed up at 2, 4, 6, and 12 months postoperatively, and nipple height was measured. The postoperative nipple height achieved using the modified method was compared with that obtained using the traditional method. RESULTS: From February 2013 to June 2017, 32 patients received surgery using the modified star flap, and 18 patients who underwent nipple reconstruction before 2013 comprised the conventional method group. All patients had undergone breast reconstruction with an abdominal tissue-based flap. The mean follow-up period was 14.4 months in the modified method group and 17.3 months in the conventional method group. The mean maintenance of projection at 12 months postoperatively was 56.28%±18.58% in the modified method group, and 44.23%±14.15% in the conventional method group. This difference was statistically significant (P<0.05). CONCLUSIONS: The modified method using a de-epithelialized dermal flap provides reliable maintenance of projection in patients who have undergone abdominal tissue-based breast reconstruction.


Subject(s)
Female , Follow-Up Studies , Humans , Mammaplasty , Medical Records , Methods , Nipples , Surgical Flaps
20.
Article in English | WPRIM | ID: wpr-762819

ABSTRACT

A combined cartilage holder and crusher is described that allows the surgeon to hold, crush, morselize, and suture a single piece or stack of cartilage graft without letting it slip. The customized slit-shaped jaws allow adequate room for the suture needle, while the serrated surfaces hold the cartilage firmly. The use of this instrument is advocated primarily in rhinoplasty for manipulating and suturing a small cartilage graft or a stack of grafts. The use of this instrument may be extended to aesthetic or reconstructive cases where cartilage grafts need to be sutured or shaped, as in eyelid, ear, and nipple reconstruction.


Subject(s)
Cartilage , Ear , Eyelids , Jaw , Linear Energy Transfer , Needles , Nipples , Rhinoplasty , Sutures , Transplants
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