Complications associated with submental liposuction: a scoping review.

BACKGROUND: Liposuction is one of the most commonly performed cosmetic procedures worldwide. Complications associated with submental liposuction are rare. However, when they occur they are significant and can cause disfiguring consequences. The objective of this study was evaluated complications from submentual liposuction in literature and description of clinical experience of complication after submentual liposuction. MATERIAL AND METHODS: At first, a scoping review was carried out online search with no time restrictions for complications after submental liposuction was performed in the databases Medline / PubMed, Embase, and Web of Science. The variables analyzed were: age, sex, type of esthetic procedure, anesthesia, complications, time after Procedure, treatment, follow-up care, and sequelae. Then, a case of a patient with submental hematoma after an aesthetic procedure for submental liposuction was described. RESULTS: Firstly, 539 articles were selected, after application of the inclusion criteria, 4 studies were included. Most cases were female (8:1), with a mean age of 55.77 years. Postoperative complications were found, such as submental depression, submental edema, hypertrophic scar formation, scar contracture, cervical necrotizing fasciitis, Cervico-facial dystonia and transient facial nerve paralysis. The follow-up period for cases ranged from 3 to 12 months. The clinical case presented there was no sequelae. CONCLUSIONS: Submental liposuction requires the surgeon's attention. Anatomical knowledge, correct clinical and surgical management, diagnosis, and immediate approach to adverse situations are points that must be respected in this type of esthetic procedure to avoid more serious complications.

Is there an association between the use of antidepressants and complications involving dental implants? A systematic review and meta-analysis.

The aim of this systematic review was to evaluate published evidence on the association between the use of antidepressants and complications involving dental implants. Two reviewers independently performed electronic searches of the MEDLINE/PubMed, Cochrane Library, and Scopus databases for relevant articles published up to May 30, 2019. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The Newcastle-Ottawa Scale was used for the appraisal of the methodological quality of the studies included. A meta-analysis was performed to determine the risk of dental implant failure in individuals taking antidepressants. Five comparative observational studies were selected for this review; these included a total of 2056 participants with 5302 implants. The results suggest a risk ratio of 3.73 (95% confidence interval 1.85-7.52, P=0.0002) for implant failure in antidepressant users submitted to oral rehabilitation when compared to non-users. However, these studies did not present methodological rigour or standardize the drugs used. Thus, there is insufficient evidence for an association between antidepressant use and dental implant complications.

Alcohol abusive use increases facial trauma?

BACKGROUND: Trauma is among the main death causes and morbidity in the world and is often related to the use of alcohol and its abuse has reached massive proportions, no matter if the country is developed or not, being considered as public health problem. Since there are very few randomized and prospective studies in literature about the association of facial trauma and the use of alcohol, this study aims to investigate the impact of alcohol use in facial trauma. MATERIAL AND METHODS: This was a prospective and cross sectional study, involving facial trauma patients attended at Oral Maxillofacial Surgery Division of a State Hospital. Variables included patient's profile, trauma etiology, facial region involved, type of injury and treatment and days of hospitalization. AUDIT test was applied to identify risks and damages of alcohol use and chemical dependence. Absolute distribution, uni and mutilvaried percentages were made for data evaluation. Pearson's qui-squared and Fisher's Exact tests were also used. RESULTS: One hundred patients were evaluated. The patient's mean age was 33.50 years-old, 48% had between 17 and 29 years old, 28% had 30 to 39, and 24% 40 or more. Most of them were male (86%). The most frequent etiology was traffic accident (57%), the extraoral area was most committed (62%), the most frequent type of injury was fractures (78%) and the most affected bone was the mandible (36%). More than half of the patients (53%) had surgical treatment. 38% had their discharge from hospital right after the first attendance. The AUDIT most frequent answer was "moderate use" (46%) and use at risk (39%). There was significant difference between the use of alcohol (AUDIT) and hematoma (0.003) and number of days of hospitalization (p=0.005). CONCLUSIONS: In this study it was not observed association between alcohol consumption using the AUDIT and trauma etiology, but patient victims of traffic accidents were classified as with risk in the scale. Most of the trauma were caused by traffic accidents using motorcycles and occurred in young aged men.

Burnout syndrome in oral and maxillofacial surgeons: a critical analysis.

The aim of this study was to determine the prevalence of burnout syndrome among Brazilian oral and maxillofacial surgeons and its relationship with socio-demographic, clinical, and habit variables. The sample of this study comprised 116 surgeons. The syndrome was quantified using the Maslach Burnout Inventory (General Survey), which defines burnout as the triad of high emotional exhaustion, high depersonalization, and low personal accomplishment. The criteria of Grunfeld et al. were used to evaluate the presence of the syndrome (17.2%). No significant differences between the surgeons diagnosed with and without the syndrome were observed according to age (P=0.804), sex (P=0.197), marital status (P=0.238), number of children (P=0.336), years of professional experience (P=0.102), patients attended per day (P=0.735), hours worked per week (P=0.350), use of alcohol (P=0.148), sports practice (P=0.243), hobbies (P=0.161), or vacation period per year (P=0.215). Significant differences occurred in the variables sex in the emotional exhaustion subscale (P=0.002) and use or not of alcohol in the personal accomplishment subscale (P=0.035). Burnout syndrome among Brazilian surgeons is average, showing a low personal accomplishment.

Treatment of chronic mandibular dislocations using a new miniplate.

Temporomandibular joint (TMJ) dislocation is defined as an excessive forward movement of the condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. The aim of this study was to describe a modified miniplate designed for treating chronic mandibular dislocations and evaluate the results of its placement in one patient, who was followed for 18 months. The treatment of chronic mandibular dislocation using this modified miniplate was shown to be efficient in relation to the postoperative maximal mouth opening, recurrence and articular function.

Methotrexate and liver function: a study of 13 psoriasis cases treated with different cumulative dosages.

BACKGROUND: The need and frequency of hepatic biopsies during methotrexate (MTX) therapy are still controversial. OBJECTIVES: The purpose of this investigation is to assess MTX liver toxicity in patients with psoriasis through percutaneous liver biopsy, and compare liver morphology changes with increasing cumulative dosages (1, 2, 3 and 4 g) of MTX. RESULTS: Cumulative dosages of 1 to 2 g MTX did not cause significant liver toxicity. From a cumulative dosage of 3 to 4 g, there is fibrosis formation, inflammation enhancement in the portal area and fibrous septa, configuring regenerative nodes. CONCLUSION: In patients with no risk factors for liver disease, with normal physical examination and liver tests, biopsy can be done after a cumulative MTX dosage of approximately 1 to 1.5 g and repeated for each gram. In patients with risk factors, liver biopsy should be done before use of MTX, or within the first 2 months of treatment at the most, and repeated for each gram of cumulative dosage.

Psoriasis vulgaris and human leukocyte antigens.

BACKGROUND: Psoriasis vulgaris is a skin disease with a complex immunological and genetic background, triggered by environmental factors. The association of human leukocyte antigens (HLA) and psoriasis has long been reported on population and familial studies. OBJECTIVES: To review and discuss studies on psoriasis vulgaris and HLA, in Caucasian and non-Caucasian populations. METHODS: The major population studies on psoriasis vulgaris and the associated HLA antigens and alleles are described and discussed based on a review of the current literature. RESULTS: Population studies demonstrate the presence of different HLA specificities as well as extended haplotypes in patients with psoriasis, when compared to controls. Some alleles occur in a lower frequency in patients with psoriasis, indicating they could be protection alleles. In all studies which HLA class I was typed, Cw6 or Cw*0602 was present in a significant frequency in patients with psoriasis, mainly when early onset and positive family history were considered. HLA-DRB1*0701 was also present in a higher frequency in patients in different populations. CONCLUSIONS: Different antigens and alleles from both HLA classes I and II were seen in a significantly higher frequency in patients with psoriasis vulgaris. HLA Cw*0602 and DRB1*0701 were represented in different reports, and the former was related mainly to psoriasis type I.

Superalimentação e desenvolvimento do esqueleto de cães da raça Dogue Alemão: aspectos clínicos e radiográficos / Overfeeding and skeletal development in Great Dane puppies: clinical and radiographic aspects

Estudou-se o efeito da superalimentação no desenvolvimento do esqueleto de 14 cães da raça Dogue Alemão, utilizando dieta hipercalórica (ração super-premium) associada ao método de alimentação à vontade. Os animais foram distribuídos em dois tratamentos, sendo a ração fornecida à vontade ou restrita. O consumo de alimento foi registrado diariamente e realizaram-se, mensalmente, radiografias do cotovelo e, bimestralmente, do ombro, do quadril e do carpo, visando acompanhar alterações do esqueleto, especificamente quanto ao aparecimento da osteocondrose do ombro e da metáfise distal da ulna, da osteodistrofia hipertrófica e da displasia coxofemoral (DCF). Ao final do experimento, seis cães do grupo que recebeu alimentação à vontade apresentaram-se gordos (87,7 por cento) e um animal obeso (14,3 por cento). Do grupo de alimentação restrita, três filhotes mostraram condição corporal ideal (42,8 por cento), e quatro apresentaram-se magros (57,2 por cento). O exame radiológico revelou alterações compatíveis com o diagnóstico de DCF nos dois grupos; nos alimentados à vontade, a prevalência foi de 51,1 por cento e nos restritos, de 28,6 por cento. A osteocondrose na metáfise distal da ulna, conhecida como retenção do núcleo cartilaginoso, foi observada apenas nos cães alimentados à vontade (57,1 por cento). A superalimentação provocada pelo método de alimentação à vontade, associada com dieta de alta palatabilidade e alta densidade energética em filhotes da raça Dogue Alemão, induziu ao aparecimento de osteocondrose na metáfise distal da ulna e de displasia coxofemoral.

The effects of overfeeding on growing Great Dane puppies were examined by ad libitum feeding of a hypercaloric diet (super premium ration). Fourteen puppies from six litters were divided into two groups, with representation from each litter in each group. The dogs in the overfed group were provided ad libitum access to the diet from 8 AM to 6 PM daily, while the restricted group received the same feed but in amounts recommended by the manufacturer at 7 AM, 12:30 PM and 5 PM. Daily intake was individually recorded. To monitor skeletal changes due to osteochondrosis, hypertrophic osteodystrophy and hip dysplasia, elbow radiographs were taken monthly and shoulder, pelvis and corpus radiographs were taken bi-monthly. Weekly feed consumption and weight gain were greater in ad libitum than in restricted puppies (P<0.01). At the end of the experiment, 85.7 percent of the ad libitum group was over weight and 14.3 percent was obese, whereas 57.2 percent of restricted puppies were slim and 42.8 percent had ideal body weight. None of the dogs had hypertrophic osteodystrophy. Radiographic examination showed alterations compatible with hip dysplasia in both groups, but such observations were more frequent and more severe in the ad libitum group. Osteochondrosis of metaphisis distal ulna, known by the retention of cartiloginous nucleus, was observed only in the ad libitum group, at a rate of 57.1 percent. The thickness of the cortical and diameter of the ulna were greater (P<0.01) in ad libitum dogs than in those fed a restricted amount of the same diet. In summary, overfeeding caused by ad libitum access to a highly palatable and high energy food caused osteochondrosis and hip dysplasia in Great Dane puppies.