Percepção tátil e visual no aumento de radix com cartilagem fragmentada livre na rinoplastia / Tactile and visual perception in radix augmentation with free fragmented cartilage in rhinoplasty

Introdução: A correção da relação radix dorso nasal é realizada há vários anos utilizando as mais variadas técnicas como enxerto de cartilagem auricular, septal ou costal, preenchimento com ácido hialurônico, uso de fáscia e enxertos e uso de cartilagem picada em cubo, silicone e ácido hialurônico. O uso de cartilagem fragmentada é descrito na literatura e tem ganhado adeptos nos últimos anos, pela facilidade em ser realizado. O objetivo neste estudo é descrever nossa experiência com a utilização do enxerto de cartilagem fragmentado no aumento do radix comparando a percepção visual e tátil do paciente e sua satisfação. Método: Estudo observacional em pacientes submetidos a rinoplastia no período de janeiro 2018 a junho de 2022, em cirurgias nas quais ocorreu o aumento de radix com o uso de enxerto de cartilagem picada. Resultados: Dos 47 pacientes, a maioria era do sexo feminino (35, 74,4%), com média de idade de 34,6 anos (18-44). Quanto ao tipo de pele, Fitzpatrick tipo 3 (n=28, 59,5%) foi o principal, sendo encontrado frequentemente pacientes com pele de média espessura (n=23, 48,9%). Complicações presentes foram infecção (1 caso), migração de cartilagem picada (3 casos), e reabsorção parcial (1 caso). Na avaliação da percepção tátil 42 pacientes (89,3%) percebiam, à palpação, as proeminências cartilaginosas e na visual apenas 2 (4%). A satisfação foi elevada em 45 (96%) pacientes. Conclusão: A cartilagem picada livre pode ser utilizada na região do radix com resultados satisfatórios.

Introduction: Correction of the nasal radix dorsum relationship has been carried out for several years using the most varied techniques such as auricular, septal, or costal cartilage grafts, filling with hyaluronic acid, use of fascia and grafts and the use of diced cartilage, silicone, and hyaluronic acid. The use of fragmented cartilage is described in the literature and has gained popularity in recent years, due to its ease of use. The objective of this study is to describe our experience with the use of fragmented cartilage graft in radix augmentation, comparing the patient's visual and tactile perception and satisfaction. Method: Observational study in patients undergoing rhinoplasty from January 2018 to June 2022, in surgeries in which the radix was increased with the use of minced cartilage graft. Results: Of the 47 patients, the majority were female (35, 74.4%), with a mean age of 34.6 years (18-44). As for skin type, Fitzpatrick type 3 (n=28, 59.5%) was the main one, with patients with medium-thickness skin being frequently found (n=23, 48.9%). Complications present were infection (1 case), migration of chopped cartilage (3 cases), and partial resorption (1 case). In the assessment of tactile perception, 42 patients (89.3%) perceived cartilaginous prominences on palpation and only 2 (4%) visually. Satisfaction was high in 45 (96%) patients. Conclusion: Free minced cartilage can be used in the radix region with satisfactory results.

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.

Desmistificando a técnica de deep plane facelift com dissecção anatômica em cadáveres frescos / Demystifying the deep plane facelift technique with anatomical dissection in fresh cadavers

Introdução: Os estudos de anatomia em cadáveres permitiram um melhor entendimento das estruturas da face e, consequentemente, mais segurança ao explorar os planos profundos da região facial. Uma boa técnica deve ser segura, reprodutível e respeitar os pontos anatômicos. O objetivo deste trabalho é desmistificar a técnica de deep plane facelifting por meio da dissecção de cadáveres e exposição das estruturas faciais. Método: A reprodução da técnica de "deep plane facelifting" foi realizada em 14 hemifaces de 7 peças de cadáveres frescos no Instituto de Treinamento de Cadáver em Curitiba no ano de 2021. A técnica cirúrgica foi realizada conforme nossa prática clínica e reproduzida no cadáver. Após o procedimento, as estruturas anatômicas faciais foram dissecadas para correlacionar seu posicionamento junto aos espaços anatômicos da face. Foram avaliados os posicionamentos dos ligamentos da face, vascularização e os ramos do nervo facial. Resultados: Foram identificados os espaços anatômicos relevantes à técnica de deep plane facelifting, como os espaços massetéricos inferior e superior, espaço pré-zigomático, espaço bucal e espaço cervical. Os ramos do nervo facial foram identificados no plano subSMAS e correlacionados com os espaços e planos anatômicos. Conclusão: A técnica de deep plane facelift pode ser reproduzida com segurança desde que sejam respeitados dois parâmetros. O primeiro é a entrada correta nos espaços a fim de respeitar a anatomia. O segundo é o uso de descoladores rombos para dissecção nos planos profundos da face a fim de evitar lesão nervosa dos ramos do nervo facial.

Introduction: Anatomy studies on cadavers have allowed a better understanding of the structures of the face and, consequently, greater safety when exploring the deep planes of the facial region. A good technique must be safe, reproducible, and respect anatomical points. The objective of this work is to demystify the deep plane facelifting technique through the dissection of cadavers and exposure of facial structures. Method: The reproduction of the "deep plane facelifting" technique was performed on 14 hemifaces of 7 pieces of fresh cadavers at the Instituto de Treinamento de Cadáver (Cadaver Training Institute) in Curitiba in 2021. The surgical technique was performed according to our clinical practice and reproduced on the cadaver. After the procedure, the facial anatomical structures were dissected to correlate their positioning with the anatomical spaces of the face. The positioning of the facial ligaments, vascularization, and branches of the facial nerve were evaluated. Results: The anatomical spaces relevant to the deep plane facelifting technique were identified, such as the inferior and superior masseteric spaces, prezygomatic space, buccal space, and cervical space. The facial nerve branches were identified in the sub-SMAS plane and correlated with the anatomical spaces and planes. Conclusion: The deep plane facelift technique can be reproduced safely as long as two parameters are respected. The first is the correct entry into spaces to respect the anatomy. The second is the use of blunt detachers for dissection in the deep planes of the face to avoid nerve damage to the branches of the facial nerve.

Research on Clinical Characteristics of Metaplastic Chronic Atrophic Gastritis Patients from Complexion Diagnosis Based on Gender Difference / 世界科学技术-中医药现代化

Objective Based on gender differences,this paper discusses the characteristics of facial color diagnosis in male and female patients with metaplastic chronic atrophic gastritis(CAG),and explores the pathological mechanism of different gender patients from the perspective of TCM pathogenesis,so as to provide personalized reference for TCM prevention and treatment of metaplastic CAG.Methods In this study,the complexion information of patients with chronic non atrophic gastritis(CNG)and CAG was collected by MT-BX-01 four-diagnostic instrument.The color colorimetric characteristics of male and female metaplastic CAG patients and CNG patients were analyzed by case-control study.Results In female patients,the L value and a value of liver region in CAG with mild intestinal metaplasia(IM)group,moderate and severe IM were significantly lower than those in CNG group(P<0.05).In male patients,the L value of spleen region in CAG with moderate and severe IM group was significantly higher than that in CNG group(P<0.05).Conclusion There is a certain gender difference in the facial color characteristics of patients with metaplastic CAG.The facial chromaticity value of female patients with metaplastic CAG changes most significantly in the liver area,while that of male patients mainly in the spleen area.It is suggested that the incidence of female metaplastic CAG is mostly related to liver,while that of male is mostly related to spleen,which provides a personalized method for clinical diagnosis and treatment of metaplastic CAG based on gender differences.

Efficacy and safety of botulinum toxin type A in improving face and neck aging / 中华医学美学美容杂志

Objective:To evaluate the clinical effectiveness and safety of combined face and neck injections of botulinum toxin type A to improve face and neck aging.Methods:From January 2020 to January 2023, 30 female patients with age of 29-66 years, average (42.2±8.8) years, underwent face and neck combined injection of A-type botulinum toxin in the Department of Dermatology, Henan Provincial People′s Hospital. The injection sites included the forehead, between the eyebrows, around the eyes, the dorsum of the nose, and the mandibular margin, etc. The efficacy was assessed by the wrinkle severity scale (FWS) and the AB value of the distance from the lowest point of the mandibular margin on the midline of the hemiface to the level of the medial canthus at 4 and 24 weeks after the injection, as well as the subjective degree of improvement by the Global Aesthetic Improvement of the Face Scale (GAIS) and the Self-perception of Age (SPA), and the satisfaction of the patients and post-injection adverse reactions.Results:At 4 weeks after the injection, the total effective rate of improvement of wrinkles in all parts of the upper face was 100% (30/30), and there was a statistically significant difference in the improvement of AB ( t=28.35, P<0.05). At 24 weeks after the injection, the total effective rate of improvement of wrinkles in all parts of the upper face ranged from 16.7% (5/30) to 36.7% (11/30), and the improvement of AB still showed a statistically significant difference ( t=3.98, P<0.05). 100% (30/30) and 66.7% (20/30) of patients assessed their facial status as improved on GAIS at 4 and 24 weeks after the injection, respectively, and 100% (30/30) and 63.3% (19/30) of patients perceived themselves as younger. Patient satisfaction was 100% (30/30). After injection, there were 5 cases of slight ecchymosis at the injection site and 1 case of weakness in eyebrow elevation in the 30 patients, which disappeared on their own within 1 to 2 weeks. Conclusions:The therapeutic effect of face and neck combined injection of botulinum toxin type A on facial rejuvenation is obvious, with high patient′s satisfaction and no serious adverse reactions.

Effect of a new liquid dressing of quaternary ammonium chitosan on facial laceration healing and scar inhibition / 中华医学美学美容杂志

Objective:To investigate the effect of a novel liquid dressing of quaternary chitosan on facial laceration healing and inhibition of scar formation.Methods:This study was a prospective study, including 113 cases of facial skin soft tissue laceration 52 males, 61 females, age range of 18-30 years, with mean (25.8±5.2) years in the Department of Plastic and Reconstructive Surgery, Sichuan Provincial People′s Hospital from May 2022 to February 2023. Patients were divided into two groups: the experimental group (62 cases) used quaternary ammonium chitosan rinsing wounds in the suture, and trauma spray quaternary ammonium chitosan liquid dressing in the dressing change; saline instead of an equal amount of chitosan was used to rinse wounds during the suture process and routine dressing change in the control group (51 cases). Follow-up visits were carried out in 30 d, 60 d, and 90 d postoperatively, and standardized photographs were taken preoperatively in the immediate postoperative period, before and after dressing change. The healing of the patients′ facial lacerations and patient satisfaction were recorded and assessed at the follow-up visits.Results:A total of 113 patients were included in this study, with no lost visits. During postoperative dressing change, 1 d NRS (1.03±0.18), 3 d NRS (2.69±0.53), and 5 d NRS (0.53±0.50) were lower in the experimental group than those in the control group [1 d NRS (2.35±0.59), 3 d NRS (3.27±0.75), and 5 d NRS (0.80±0.40) (all P<0.05)]. Grade A healing rate was 93.5% (58 patients) in the test group were higher than 78.4% (40 patients) in the control group (χ 2= 5.56, P<0.05); the total scores of the Vancouver Scar Rating Scale in the experimental group were lower than those of the control group at 30 d (1.65±0.48), 60 d (3.97±1.11), and 90 d (2.90±0.76) vs. 30 d (2.43 ±0.50), 60 d (5.16±1.21), and 90 d (3.55±0.78) ( t=8.48, 5.44, t=4.43; P<0.05); the overall satisfaction rate in the experimental group (93.6%) was higher than that of the control group (82.3%) (χ 2=8.16, P<0.05). Conclusions:Quaternary chitosan liquid dressing has obvious advantages in reducing wound pain, promoting wound healing, and reducing scar formation. It can improve patients′ satisfaction and worthwhile to be applied clinically.

Efficacy and safety of injection of hyaluronic acid filler VYC-20L in facial rejuvenation / 中华医学美学美容杂志

Objective:To explore the efficacy and safety of hyaluronic acid filler VYC-20L for full-face lifting in aesthetic seeking patients.Methods:Between November 2020 and November 2021, a total of 216 aesthetic seeking patients were enrolled in Shanghai Chingho Outpatient Department, World Path Clinic International, Qihe Medical Beauty Hospital and Qinhuangdao Qiaozhi Beauty Hospital, including 37 males and 179 females, aged 25-67 (41.42±10.93) years. According to the needs and requirements, the novel injection technique of " ROYGBbP-rainbow lifting method" was used to inject hyaluronic acid filler VYC-20L. The global aesthetic improvement scale (GAIS) and the treatment satisfaction questionnaires were scored and evaluated before the injection, and at follow-up visits 1, 6, and 12 months after the injection. Any adverse reaction or adverse events presenting or reported by the patients post-injection were recorded.Results:At 1 month, 6 months and 12 months after the injection, about 203 (94.0%), 208 (96.3%) and 205 (94.9%) of the aesthetic seeking patients rated their full-face appearance as " excellently improved" or " much improved" on the GAIS, respectively. And 12 months after the injection, the overall facial satisfaction scores and appearance recognition scores of all aesthetic seeking patients were all significantly higher than those before injection ( P<0.01). 197 (91.2%), 198 (91.7%) and 198 (91.7%) of the aesthetic seeking patients were " very satisfied" or " relatively satisfied" with the treatment at 1 month, 6 months and 12 months, respectively. Treatment site responses most frequently reported were tenderness, bruising, topical swelling and skin redness. Most of the symptoms were moderate or mild feeling, lasting for no more than two weeks. Conclusions:The application of hyaluronic acid filler VYC-20L is safe and effective for full-face lifting in aesthetic seeking patients, which can significantly improve facial sagging and rejuvenate the face. The effect of improvements can last for 12 months.

Screening and optimization of process parameters of SARS-CoV-2 monoclonal antibody F61 in affinity chromatography stage using design of experiment / 中国生物制品学杂志

@#Objective To select and optimize the process parameters of SARS-CoV-2 F61 affinity chromatography by the screening and optimization experiment of Design of Experiment(DoE),in order to obtain the optimal process conditions.Methods Eight process parameters that may affect the experimental response results in affinity chromatography were selected and their level ranges were determined.DoE screening test was used to perform 8 factor 2 level screening tests on the selected process parameters.The response values were detected and the mathematical model was fitted by statistical software.Three key process parameters significantly affecting the key quality attributes were obtained by Pareto diagram analysis(P < 0.05).Then DoE response surface method(RSM)was selected to optimize the key process parameters.First,the full factorial experiment design was completed,the response results were detected to fit the mathematical model,and the bending term P value was analyzed to judge the range of significant factors in the optimal range(bending P < 0.05),then according to the sequential complement of the central composite face-centered design(CCF)experiment,through the detection of the response results to fit the response surface model,the range of optimal conditions was obtained,and the stability of the optimal parameters was finally verified by repeated experiments.Results In the screening experiment,it was found that the significant factors affecting F61 in the affinity chromatography stage were elution buffer pH,elution buffer salt concentration,leaching buffer salt concentration and equilibrium buffer salt concentration.The optimal conditions of key process parameters in affinity chromatography were obtained by CCF.When the pH of elution buffer was 3.2,the elution buffer salt concentration was 0.07 mol/L NaCl,and the leaching buffer salt concentration was 0.31 mol/L NaCl,the yield of F61 reached 95.25%,the residual amount of host cell protein(HCP)was 97.33 ppm,and the monomer purity of the sample was98.51% at the affinity chromatography stage.Conclusion Different types of DoE methods were used to screen and optimize the process parameters of F61 affinity chromatography stage,and the optimal process conditions were obtained,which lays a foundation for the esta-blishment of F61 purification process.

A comparative analysis of ocular surface parameters before and after N95 face mask use among healthcare workers

Objectives@#This study determined whether the use of an N95 face mask was associated with changes in ocular surface parameters and dry eye symptomatology among healthcare workers with no baseline dry eye disease. @*Methodology@#This was a prospective, analytical, quasi-experimental study. The ocular surface and dry eye symptomatology of 33 healthcare workers (n=66 eyes) were evaluated at baseline and 3 hours after use of 3M™ VFlex™ Particulate Respirator 9105 N95 mask (3M, Minnesota, USA). The following parameters were measured: ocular surface disease index (OSDI), tear break-up time (TBUT), tear break-up pattern (TBUP), non-invasive TBUT (NIKBUT), tear meniscus height (TMH), meibography, and bulbar conjunctival redness.@*Results@#Among all the parameters tested, only OSDI and bulbar redness showed significant changes when pre-N95 and post-N95 values were compared. Although each was interpreted as normal, the median OSDI score improved from 7 to 1 (p < 0.001). Median bulbar conjunctival redness score worsened from 0.9 to 1.1 (p < 0.001). @*Conclusion@#Among healthcare workers with no dry eye disease, the use of the 3M™ Vflex™ Particulate Respirator 9105 N95 mask was not associated with changes in TBUT, TBUP, NIKBUT, TMH, and meibogaphy. An improvement of dry eye symptoms was reported after VFlex™ mask use.

Student performance in year 1 undergraduate medical education during traditional, emergency online, online and HyFlex teaching strategy: A single center study / Health Sciences Journal

Background@#The global pandemic caused by COVID-19, the subsequent improvement in health situation caused by anti- COVID-19 vaccination and the developments in digital technology prompted changes in undergraduate medical education as to content delivery and assessment. This study determined the difference in the performance of first year medical students in traditional face-to face, online and Hyflex teaching strategy.@*Methods@#A non-concurrent cohort study was done to determine the performance of students in three annual subjects in Year 1 undergraduate medical education for school years 2018 to 2023. One-way ANOVA at p=0.001 determined significance of differences of variables.@*Results@#There was no difference in the profile of students as to their sex, pre-medicine course and scores in the National Medical Admission Test (NMAT). The performance in the written examinations in Anatomy and Physiology showed significant difference (p=0.001) when the conduct of examinations was shifted online on an emergency basis. There was no difference (p=0.001) in performance in the laboratory conference sessions in Physiology, as compared to the focused group discussion sessions in Biochemistry and practical examinations in Anatomy.@*Conclusion@#Significant difference in the performance of first year medical students was observed only during the emergency shift to online examinations, otherwise the performance was similar in traditional face-to face, online and Hyflex teaching strategy.

Research on the Moral Responsibility of Face Recognition and Medical Diagnosis / 中国医学伦理学

The application of face recognition technology is gradually expanding to the medical field. It has been initially used in the medical diagnosis of endocrine diseases and genetic syndrome. This technology is expected to be used for the screening of genetic syndrome and endocrine diseases, shortening the delay period of disease diagnosis and helping the staging of endocrine diseases. However, this technology also has some moral risks, such as the risk of personal information security disclosure, the challenge to the future of mankind and the division of moral responsibility. This paper reflected on the dilemma of moral responsibility in the application of face recognition and medical diagnosis, and explored the two basic problems of "who is the subject of moral responsibility" and "the specific division of moral responsibility of different moral subjects" in face recognition and medical diagnosis. Finally, some suggestions on the moral responsibility in face recognition and medical diagnosis are put forward. The first is to determine the role of face recognition and medical diagnosis as an auxiliary category, and doctors are still the main medical subject; the second is to build the responsibility ethics mechanism and laws and regulations, the establishment of the responsibility system of face recognition and medical diagnosis is inseparable from the joint action of law and ethics.

Fetal facial ultrasound plane recognition based on real-time object detection network and its application / 中国医学物理学杂志

Objective To explore the role of an artificial intelligence(AI)model based on real-time object detection network in fetal facial ultrasound examination.Methods With the normal fetal facial ultrasound standard plane(FFUSP)at 20-24 weeks of gestation as the research object,a FFUSP recognition model based on real-time object detection network was constructed.The recognition accuracy of the model for FFUSP and the anatomical structures were analyzed,and the clinical value was evaluated by analyzing its performance in identifying FFUSP in 119 cases of fetal ultrasound images.Results The overall precision,recall rate,mAP@.5 and mAP@.5:.95 of the AI model were 97.8%,98.5%,98.1%and 61.0%,respectively.The clinical validation showed that the AI model had a sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 100.0%,98.5%,87.4%,100.0%and 98.7%for facial anatomy recognition,and the results were highly consistent with the classification of fetal ultrasound experts(k=0.925,P<0.001).The recognition accuracy of the model for 3 types of standard planes reached 100%;and the average speed of dynamic video detection was 33.93 frames per second.Conclusion The FFUSP recognition model based on real-time object detection network exhibits excellent performance,and it can be applied to real-time ultrasound diagnosis,teaching and intelligent quality evaluation.

Cosmetic attributes (oiliness reduction and firmness) from face masks composed of red, green and black clays / Atributos cosméticos (redução de oleosidade e melhora de firmeza) de máscaras faciais compostas por argilas vermelha, verde e preta

The appearance of skin strongly influences people´s self-esteem and well-being. Among the characteristics that affect the most, we can cite acne and wrinkles. Therefore, minimizing those characteristics by using cosmetics has important value for the consumer. Nowadays, there is a demand for natural ingredients, mainly concerning cosmetic products. The use of clays in beauty care is old, with therapeutic uses since Prehistory. There is an essential advantage in using clays for cosmetic purposes, as it is a low-cost, environmentally friendly, natural, and abundant ingredient, which is chemically inert with a low level of toxicity (when in adequate conditions), easy to apply and remove, dries, and hardens fast. In this research work, we aimed at developing and investigating the effect of formulations containing red, green, and black clays as active components in oiliness reduction, and firmness and elasticity improvement in vivo, as well as characterizing clays mineralogically. All clays presented different compositions. Black clay was the one with the simplest mineralogic content, lowest density, and smallest particle size. It was the richest in Si and Al. Green clay presented expandable smectite and the highest density. Red clay presented the largest particle average size and was the richest in iron content. By thermal analysis, clays presented two characteristic events: the water loss (dehydration) and the dihydroxylation of kaolinite, turning into meta kaolinite. In Sebumetry, clays showed a significant reduction of skin oiliness on the forehead in both concentrations after 2h of contact compared to control, baseline, and placebo. However, after 4h (2h after removal), no significant difference was observed with the control. In the Cutometry, clays did not present significant efficacy in skin firmness and elasticity improvement when compared to control and placebo sites, thus, further studies should be performed comparing the efficacy of different vehicles with dispersed clays. Finally, clay mask formulations were developed with black, red, and green clay dispersed in an oil-free gel vehicle, which proved to be adequate for oily skin

A aparência da pele influencia fortemente autoestima e o bem-estar das pessoas. Dentre as características que mais afetam podemos citar acne e rugas. Portanto, minimizar estas características com o uso de cosméticos tem um valor importante para o consumidor. Atualmente existe uma procura por ingredientes naturais, principalmente no que diz respeito a produtos cosméticos. O uso das argilas nos cuidados de beleza é antigo, com usos terapêuticos desde a Pré-História. Há uma vantagem essencial na utilização de argilas para fins cosméticos, pois é um ingrediente de baixo custo, ecologicamente correto, natural, e abundante, que é quimicamente inerte e tem baixo nível de toxicidade (quando usado em condições adequadas), fácil de aplicar e remover, seca, e endurece rapidamente. Neste trabalho de pesquisa, objetivamos desenvolver e investigar o efeito de formulações contendo argilas vermelha, verde e preta como componentes ativos na redução da oleosidade e na melhoria da firmeza e elasticidade in vivo, bem como caracterizar mineralogicamente as argilas. Todas as argilas apresentaram diferentes composições. A argila preta foi a de conteúdo mineralógico mais simples, mais baixa densidade, e menor tamanho de partícula. Foi a mais rica em Si e Al. A argila verde apresentou esmectita expansível e mais alta densidade. A argila vermelha apresentou o maior tamanho médio de partícula e foi a mais rica em ferro. Segundo a análise térmica, as argilas apresentaram dois eventos característicos: a perda de água (desidratação) e a desidroxilação da caulinita, transformando-se em meta-caulinita. Na Sebumetria, as argilas demonstraram significativa redução na oleosidade da pele na testa em ambas as concentrações após 2h de contato comparada ao controle, basal e placebo. Porém, após 4h (2h após remoção), nenhuma diferença significativa foi observada com o controle. Na Cutometria, as argilas não apresentaram Eficácia significativa na melhora da firmeza e elasticidade quando comparadas aos sítios controle e placebo, portanto, mais estudos devem ser realizados comparando a eficácia de diferentes veículos com argilas dispersas. Finalmente, as formulações de máscaras de argilas foram desenvolvidas com argilas preta, vermelha e verde dispersas em um veículo em gel livre de oleosidade, o qual provou ser adequado para pele oleosa

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.

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.

Distribution and Etiology of Facial Fractures in Patients Admitted by the Oral and Maxillofacial Specialty at an Emergency Hospital in Recife / Distribuição e Etiologia das Fraturas Faciais em Pacientes Internados pela Especialidade Buco-Maxilo-Facial em um Hospital de Emergência de Recife

Among the traumas, those that affect the oral and maxillofacial region stand out considerably, due to their high complexity and the fact that they affect a bodily region with great physiological, aesthetic and social importance. This study aimed to characterize the facial traumas that generate fractures, specifying their distribution and etiology, in patients who were hospitalized. For this, a cross sectional study was carried out on secondary data, in which 407 medical records of patients hospitalized by the Oral and Maxillofacial Surgery Service of the public network at Hospital da Restauração Governador Paulo Guerra - HR, in the city of Recife-Pernambuco, were collected, from which 130 medical records were selected whose reason for admission into the hospital was trauma to the bones of the face, hospitalized in the period between January 1st and December 31st, 2021, representing the sample of this study. The results regarding the distribution of fractures showed that the mandible was the most affected bone (66% of the cases), followed by the maxilla with 35%, the zygoma with 29%, the orbit with 15% and the bones of the nose in 12%. As for the etiology, car accident was responsible for the highest frequency of fractures with 29%, followed by physical aggression, with 22%, Firearm Projectile (16%), falls (16%), others (10%). It can be concluded that, in the period studied, the mandible was the most affected bone by fractures and traffic accidents were the main causes of facial fractures requiring hospitalization, and men being five times more affected than women. (AU)

Entre os traumas, os que acometem o campo buco-maxilo-facial se destacam consideravelmente, devido a sua alta complexidade e pelo fato de atingirem uma região corporal com grande importância fisiológica, estética e social. Este estudo teve como objetivo caracterizar os traumas faciais geradores de fraturas, especificando sua distribuição e etiologia, em pacientes que foram hospitalizados. Para isto, foi desenvolvido um estudo transversal em dados secundários, no qual foram coletados 407 prontuários de pacientes internados pelo Serviço de Cirurgia Buco-maxilo-facial da rede pública no Hospital da Restauração Governador Paulo Guerra ­ HR, na cidade do Recife-Pernambuco, dos quais foram selecionados 130 prontuários cujo motivo da internação foi trauma em ossos da face, internados no período entre 01 de janeiro a 31 de dezembro de 2021, representando a amostra deste trabalho. Os resultados quanto a distribuição das fraturas demonstrou que a mandíbula foi o osso mais atingido (66% dos cases), seguido pela maxila com 35%, o zigoma com 29%, órbita com 15% e Ossos Próprios de Nariz em 12%. Quanto a etiologia, o acidente automobilístico foi o responsável pela maior frequência das fraturas com 29%, seguida por agressão física, com 22%, Projétil de Arma de Fogo (16%), quedas (16%), outros (10%). Pode-se concluir que, no período estudado, a mandíbula foi o osso mais acometido pelas fraturas e os acidentes de trânsito foram os maiores causadores de fraturas faciais com necessidade de internamento, sendo os homens cinco vezes mais acometidos do que as mulheres. (AU)

Percepciones estéticas del canteamiento del plano incisal, de la desviación y de la angulación de la línea media dentaria maxilar evaluadas en una universidad peruana / Aesthetic perceptions of incisal plane edging, deviation and angulation of the maxillary dental midline evaluated at a Peruvian university / Percepções estéticas da borda do plano incisal, desvio e angulação da linha média dentária maxilar avaliadas em uma universidade peruana

RESUMEN Objetivo : Determinar las diferencias en la percepción estética del canteamiento del plano incisal (CPI), de la desviación de la línea media (DLM) y de la angulación de la línea media (ALM) dentaria maxilar entre personas naturales, estudiantes de pregrado y de posgrado de una universidad peruana. Material y métodos : Se empleó la fotografía de un sujeto, la cual fue digitalmente manipulada para crear un modelo facial simétrico (MFS). A partir de este modelo se hicieron modificaciones a nivel del plano incisal y de la línea media dentaria, realizando desviaciones y angulaciones con diferentes valores. Se recolectó la información mediante una encuesta virtual a 60 personas naturales, 30 estudiantes de pregrado y 30 de posgrado, sobre su preferencia estética. Resultados : Se encontró que las imágenes calificadas por la mayoría de cada uno de los tres grupos como «muy poco estético¼ fueron la DLM de 3mm, el CPI de 3°, la ALM de 7°, y la imagen con dos variables combinadas de DLM 3mm y ALM 7°. Conclusión : El aumento de CPI, DLM y ALM disminuye el atractivo de la sonrisa.

ABSTRACT Objective : The aim of this study is to identify differences in aesthetic perception regarding incisal plane edging (IPC), midline deviation (MLD), and maxillary dental midline angulation (MLA) among natural individuals, undergraduate students, and graduate students at a Peruvian university. Material and methods : A photograph of a subject was digitally manipulated to generate a symmetrical facial model (SFM). Subsequently, alterations were introduced to the incisal plane and dental midline, incorporating variations in deviations and angulations with distinct values. A virtual survey was administered to 60 natural individuals, 30 undergraduate students, and 30 graduate students, gathering information regarding their aesthetic preferences. Results : The analysis revealed that images which were consistently rated by the majority within each group as "very unaesthetic" included the following: dental midline deviation (DLM) of 3 mm, midline deviation (MLD) of 3°, and maxillary dental midline angulation (ALM) of 7°. Similarly, the combined image involving a DLM of 3 mm and an ALM of 7° was also perceived as very unaesthetic. Conclusion : The study demonstrates that an increase in CPI, DLM, and ALM leads to a reduction in the perceived attractiveness of a smile.

RESUMO Objetivo : Determinar as diferenças na percepção estética da borda do plano incisal (CPI), do desvio da linha média (DLM) e da angulação da linha média dentária maxilar (ALM) entre pessoas com dentição natural, estudantes de graduação e pós-graduação em uma universidade peruana. Material e métodos : Foi utilizada uma fotografia de um indivíduo, que foi digitalmente manipulada para criar um modelo facial simétrico (MFS). Com base nesse modelo, foram realizadas modificações nos níveis do plano incisal e na linha média dentária, introduzindo desvios e angulações com diferentes valores. Os dados foram coletados por meio de um questionário virtual respondido por 60 pessoas com dentição natural, 30 estudantes de graduação e 30 estudantes de pós-graduação, sobre suas preferências estéticas. Resultados : Foi constatado que as imagens classificadas pela maioria dos três grupos como "muito inestéticas" foram aquelas com um DLM de 3 mm, um CPI de 3°, uma ALM de 7° e a imagem contendo duas variáveis combinadas, ou seja, um DLM de 3 mm e uma ALM de 7°. Conclusão : O aumento do CPI, DLM e ALM diminui a atratividade do sorriso, conforme percebido pelos participantes do estudo, que incluíram pessoas com dentição natural, estudantes de graduação e pós-graduação.

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.

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.

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)