The therapeutic effects of a modified palatal memory plate on oral motor function in children with Trisomy 21 at age 3 and 4 years: Case Reports

ABSTRACT People with Trisomy 21 (T21) have generalized hypotonia, also manifesting in oral structures. The palatal memory plate (PMP) is a removable appliance to improve tongue and lip posture. The evidence of research elucidates an improvement in oral motor function in children with T21 up to the age of 2 who received PMP-based therapy, with only limited, scanty reports in the literature concerning older children. Therefore, the aim of this study is to evaluate the effects of modified PMP on an oral motor function in patients over 2 years old. Two patients with T21, aged 4 and 3, with absence of lip seal and tongue malposition, were subjected to PMP-based therapy for 6 months. The patients were evaluated for an extra and intra oral exam; their parents answered a questionnaire about their children's habitual tongue and lip position. Two-minute footage to record orofacial motor functions was performed monthly, during follow-up appointments to assess the changes. The substantial improvement of tongue and lip posture was observed after 6 months of plate regular use. PMP has proved to be clinically effective in children over 2 years old, presented with T21, leading to improvement of lip and tongue posture, observed by parents and professionals.

Cytotoxic and Hemolytic Activities of Extracts of the Fish Parasite Dinoflagellate Amyloodinium ocellatum.

The dinoflagellate Amyloodinium ocellatum is the etiological agent of a parasitic disease named amyloodiniosis. Mortalities of diseased fish are usually attributed to anoxia, osmoregulatory impairment, or opportunistic bacterial infections. Nevertheless, the phylogenetic proximity of A. ocellatum to a group of toxin-producing dinoflagellates from Pfiesteria, Parvodinium and Paulsenella genera suggests that it may produce toxin-like compounds, adding a new dimension to the possible cause of mortalities in A. ocellatum outbreaks. To address this question, extracts prepared from different life stages of the parasite were tested in vitro for cytotoxic effects using two cell lines derived from branchial arches (ABSa15) and the caudal fin (CFSa1) of the gilthead seabream (Sparus aurata), and for hemolytic effects using erythrocytes purified from the blood of gilthead seabream juveniles. Cytotoxicity and a strong hemolytic effect, similar to those observed for Karlodinium toxins, were observed for the less polar extracts of the parasitic stage (trophont). A similar trend was observed for the less polar extracts of the infective stage (dinospores), although cell viability was only affected in the ABSa15 line. These results suggest that A. ocellatum produces tissue-specific toxic compounds that may have a role in the attachment of the dinospores' and trophonts' feeding process.

Treponema pallidum among Female Sex Workers: A Cross-Sectional Study Conducted in Three Major Cities in Northern Brazil.

Female sex workers (FSWs) are an important group of people vulnerable to sexually transmitted infections. Northern Brazil is a rural and socioeconomically underdeveloped region, with lack of epidemiological information on syphilis in key populations. This study investigated the prevalence and factors associated with exposure to Treponema pallidum among FSWs in three major cities in northern Brazil. This cross-sectional study was conducted with a convenience sample of 415 FSWs from the cities of Belém, Macapá, and Rio Branco. Blood samples and personal data were collected from January 2009 to August 2010. Rapid plasma reagin and immunoenzymatic assays were used to detect antibodies against T. pallidum. Logistic regression models were used to determine factors associated with exposure to T. pallidum. In total, 36.1% were exposed to T. pallidum, and 15.7% had active syphilis. Sexual risk behaviors, use of illicit drugs, low education, and reduced monthly income were associated with exposure to T. pallidum. The high rate of exposure to T. pallidum indicates the urgent need for measures to identify, treat, and prevent syphilis and an education program for the valuation, care, and social inclusion of FSWs in northern Brazil.

Fonoaudiologia, conflitos decisórios e pacientes disfágicos: revisão integrativa / Speech therapy, decision conflicts and dysphagic patients: an integrative review / Fonoaudiología, conflictos de decisión y disfagia: revisión integradora

Resumo A disfagia tem impactos negativos multidimensionais na vida do paciente disfágico e pode gerar conflitos decisórios relacionados à alimentação. O objetivo deste artigo é revisar a literatura sobre fonoaudiologia, conflitos na tomada de decisão e agentes envolvidos nas deliberações sobre a nutrição desse tipo de paciente. Trata-se de estudo exploratório-descritivo, de revisão integrativa, com análise de conteúdo conforme proposta por Bardin. As bases de dados utilizadas foram: PubMed, Scopus, Web of Science, Cochrane, Embase e Biblioteca Virtual em Saúde. Identificaram-se conflitos envolvendo o fonoaudiólogo, o paciente, a família e a equipe multidisciplinar. Nos artigos selecionados não foi possível identificar uma teoria ou método que fundamentasse a mediação desses conflitos. Não foram encontradas publicações brasileiras que respondessem à pergunta norteadora da revisão.

Abstract Dysphagia presents multidimensional negative impacts on the life of dysphagic patients and may generate decision conflicts related to their diet. This is a review of the literature on speech-language therapy, decision conflicts and the agents involved in the decision making process for deliberations related to the nutrition of this type of patient. This is an exploratory and descriptive study, with content analysis as proposed by Bardin. The databases used were PubMed, Scopus, Web of Science, Cochrane, Embase and Virtual Health Library. Conflicts involving the speech-language therapist, the patient, the family and the multidisciplinary team were identified. In the selected articles, no theory or method was identified to support the mediation of these conflicts. No Brazilian publications that answered the guiding question were found.

Resumen La disfagia tiene impactos negativos multidimensionales en la vida del paciente disfágico y puede generar conflictos de decisión relacionados con su alimentación. El objetivo de este artículo fue revisar la literatura sobre fonoaudiología, los conflictos de decisión y los agentes involucrados en el proceso de toma de decisiones para las deliberaciones relacionadas con la nutrición de este tipo de pacientes. Se trata de un estudio exploratorio y descriptivo, donde se realizó una revisión integradora con análisis de contenido y categorización por Bardin. Las bases de datos utilizadas fueron: PubMed, Scopus, Web of Science, Cochrane, Embase y Biblioteca Virtual en Salud. Se identificaron los conflictos entre fonoaudiólogo, paciente, familia y equipo multidisciplinario. En los artículos seleccionados no se identificó ninguna teoría o método que sustente la mediación de estos conflictos. No hay publicaciones nacionales que respondan a la pregunta orientadora.

Fish Pathology Research and Diagnosis in Aquaculture of Farmed Fish; a Proteomics Perspective.

One of the main constraints in aquaculture production is farmed fish vulnerability to diseases due to husbandry practices or external factors like pollution, climate changes, or even the alterations in the dynamic of product transactions in this industry. It is though important to better understand and characterize the intervenients in the process of a disease outbreak as these lead to huge economical losses in aquaculture industries. High-throughput technologies like proteomics can be an important characterization tool especially in pathogen identification and the virulence mechanisms related to host-pathogen interactions on disease research and diagnostics that will help to control, prevent, and treat diseases in farmed fish. Proteomics important role is also maximized by its holistic approach to understanding pathogenesis processes and fish responses to external factors like stress or temperature making it one of the most promising tools for fish pathology research.

Aspectos funcionais e epidemiológicos da deglutição na laringectomia supratraqueal extendida com traqueohiodoepiglotopexia / Functional and epidemiological outcomes of swallowing in supratracheal laryngectomy with traqueohyoidoepiglottopexy / Resultados funcionales y epidemiológicos de la deglución en la laringectomía supratraqueal con tracheohioidoepiglotopexia

Introdução: A laringectomia parcial supratraqueal (LPST) é uma alternativa atual de intervenção cirúrgica, indicada para o tratamento de tumor laríngeo intermediário / avançado. Quando sua ressecção é mais ampla do que previsto, acrescentamos à nomenclatura o termo "extendida". Sua reconstrução é feita por uma traqueohioidoepiglotopexia (THEP). As principais complicações conhecidas deste procedimento estão relacionadas à deglutição e respiração. Objetivo: Caracterizar a população selecionada e avaliar aspectos funcionais da deglutição na LPST extendida em reconstrução THEP. Método: Estudo observacional de corte transversal de pacientes de ambos os sexos com neoplasia de laringe submetidos à LPST extendida THEP de um hospital oncológico entre 1995 a 2017. Realizou-se estudo de prontuário, consulta ao sistema cirúrgico, videofluoroscopia da deglutição e aplicação da escala National Outcomes Measurement System da American Speech-Language Hearing Association (ASHA NOMS). Resultados: 10 homens, idade entre 52 e 83 anos (mediana 69), 80% tabagistas e etilistas ao diagnóstico; T2 [70%], T3 [30%]. Resultados da videofluoroscopia da deglutição: 100% de estase em base da língua, 80% em valécula, aritenóide(s) e recessos piriformes, 40% em esfíncter esofágico superior e 30% em parede posterior da faringe; 30% apresentou aspiração. Todos apresentaram alimentação e hidratação exclusiva por via oral. Conclusão: Indivíduos homens, majoritariamente idosos, etilistas e tabagistas com estadiamentos intermediários e avançados. Todos possuíam capacidade de nutrição e hidratação sem vias alternativas de alimentação. A função de deglutição foi satisfatoriamente restaurada com atendimento fonoaudiológico especializado em todos os momentos do tratamento. Os pacientes com mais de nove meses de cirurgia apresentaram melhores resultados funcionais.

Introduction: Supratracheal partial laryngectomy (STPL) is a current alternative for surgical intervention, indicated for the treatment of intermediate / advanced laryngeal tumor. When its resection is broader than predicted by this technique, we add the term "extended" to its nomenclature. Its reconstruction is made, among variations, by traqueohyoidoepiglottopexy (THEP). The main complications of this procedure are related to swallowing and breathing. Objective: To characterize the selected population and to evaluate functional aspects of swallowing in extended STPL by THEP reconstruction. Method: Observational cross-sectional study on patients of both sexes with laryngeal neoplasm submitted to extended STPL by THEP in a cancer hospital from 1995 to 2017. A study of the medical record, consultation on the surgical system, Videofluoroscopy Swallowing Study and application of the scale National Outcomes Measurement System of the American Speech-Language Hearing Association (ASHA NOMS) were made. Results: 10 men, aged between 52 and 83 years (median 69), 80% smokers and alcoholics at diagnosis; T2 [70%], T3 [30%]. Results of videofluoroscopy of swallowing: 100% stasis on tongue base, 80% on vallecula, arytenoid (s) and pyriform recess, 40% on upper esophageal sphincter and 30% on posterior wall of pharynx; 30% presented aspiration. All of them presented oral nutrition and hydration. Conclusion: Male patients, mostly elderly, alcoholics and smokers with intermediate and advanced tumor staging. All of them had nutrition and hydration capacity without alternative food routes. The swallowing function was satisfactorily restored with specialized speech therapy at all times of treatment. Patients with more than nine months of surgery had better functional results.

Introducción: La laringectomía parcial supratraqueal (LPST) és indicada para el tratamiento de tumor laríngeo intermedio / avanzado. Cuando su resección es más amplia de lo previsto por la técnica, añadimos a nomenclatura el término "extendida". Su reconstrucción se realiza, entre variaciones, por traqueohioidoepiglotopexia (THEP). Las principales complicaciones conocidas de este procedimiento se relacionan con la deglución y la respiración. Objetivo: Caracterizar la población selecionada y evaluar aspectos funcionales de la deglución en la LPST extendida en reconstrucción THEP. Método: Estudio observacional de corte transversal de pacientes de ambos sexos con neoplasia de laringe sometidos a LPST extendida THEP de un hospital oncológico entre 1995-2017. Se realizó estudio de prontuario, consulta al sistema quirúrgico, videofluoroscopia de deglución y aplicación de la escala National Outcomes Measurement System da American Speech-Language Hearing Association (ASHA NOMS). Resultados: 10 hombres, edad entre 52 y 83 años (mediana 69), 80% tabaquistas y etilistas al diagnóstico; T2 [70%], T3 [30%]. Resultados de la videofluoroscopia de la deglución: 100% de estase en base de la lengua, 80% en valécula, ariteoide y recesos piriformes, 40% en esfínter esofágico superior y 30% en pared posterior de la faringe; El 30% presentó aspiración. Todos presentaron alimentación e hidratación exclusiva por vía oral. Conclusión: Individuos hombres, mayoritariamente ancianos, etilistas y tabaquistas con estadios intermedios y avanzados. Todos poseían capacidad de nutrición e hidratación sin vías alternativas de alimentación. La función de deglución fue satisfactoriamente restaurada con atención fonoaudiológica especializada en todos los momentos del tratamiento. Los pacientes con más de nueve meses de cirugía presentaron mejores resultados funcionales.

Use of miltefosine to treat canine visceral leishmaniasis caused by Leishmania infantum in Brazil.

BACKGROUND: Visceral leishmaniasis (VL) is an infectious disease with a variety of clinical signs. The main form of parasite transmission to humans and other mammalian hosts is through the bite of infected arthropod females with Lutzomyia longipalpis serving as the main vector in the Americas. Dogs are the main urban domestic reservoirs of the parasite and the main source of vector infection due to their high prevalence in endemic areas and the large number of parasites in the skin of infected animals. Although miltefosine has been used in Europe since 2002 for treatment of VL infected dogs, in the Americas the treatment of dogs has not been recommended. Therefore, this study aimed to evaluate efficacy of miltefosine observing a reduction of clinical signs in infected dogs and the infectiveness to the vector by Leishmania (L.) infantum. METHODS: To our knowledge, this is the first controlled study using qPCR and xenodiagnosis to evaluate the efficacy of miltefosine (Milteforan®, Virbac) as a single treatment in Brazil. Thirty-five adult dogs with canine visceral leishmaniasis (CVL), confirmed by clinical and laboratory tests, were included in this study. They received miltefosine at a dose of 2 mg/kg every 24 h for 28 days. The dogs were observed over a three-month period, during which clinical evaluations based on a scoring system were conducted at pre-established times. Parasite load was assessed by cytology and real-time polymerase chain reaction (qPCR). Transmissibility to the vector was evaluated by xenodiagnosis. RESULTS: At the end of the period, the following were observed: (i) the remission of clinical signs with a reduction in clinical scores for 94.2% of the animals; (ii) a statistically significant reduction (98.7%) in parasitic load by qPCR; and (iii) a reduction in infectivity to sand flies. After treatment, 74.2% of the animals remained or had become non-infectious. CONCLUSIONS: Our study indicates that the use of miltefosine administered orally for 4 weeks contributes to a clinical improvement and reduction in infectivity of dogs to L. infantum.

Stress effects of amyloodiniosis in gilthead sea bream Sparus aurata.

Amyloodiniosis is a parasitological disease caused by one of the most common and important parasitic dinoflagellates in fish, Amyloodinium ocellatum (Brown), that represents a major bottleneck for gilthead seabream semi-intensive aquaculture in Southern Europe. In this experiment, we analyzed some metabolic, osmoregulatory and stress indicators to elucidate some of the physiological responses of gilthead sea bream when exposed to an A. ocellatum outbreak. We observed significant differences between Control and Infection groups in the cortisol, lactate and gill Na+/K+-ATPase (NKA) activity levels but that glucose, osmolarity, pH and total protein did not present such differences. This could indicate that the presence of the parasite induced a stress response, possibly enhancing the metabolization of glucose and subsequently lactate to cope with the higher energy requirements of the organism. There was also a decrease in gill NKA activity possibly due to severe epithelial damage and increased mucus production caused by the parasite A. ocellatum, which could induce anoxia and osmoregulatory impairment in the organism. However, further works must be performed to fully understand the physiological reactions of fish for A. ocellatum outbreaks.

Arranjo de estímulos em treino discriminativo simples com compostos e emergência de classes de estímulos equivalentes / Arreglo de estímulo en compuestos simples con entrenamiento discriminativo y la clase equivalente de estímulos

O treino discriminativo simples simultâneo com compostos (DSSi) tem produzido variabilidade nos resultados de testes de estímulos equivalentes. O presente trabalho investigou em dois estudos o papel de variáveis metodológicas, que alteram as chances de controle por aspectos não definidos como relevantes, sobre a formação de classes de estímulos equivalentes. O Estudo 1 avaliou o efeito da utilização de um composto incorreto (S-) para cada composto correto (S+) em cada tentativa do DSSi que garantia o contexto de discriminação condicional sem redundância (e.g., A1B1 com A1B2 ou A1B1 com A2B1). Cinco estudantes universitários aprenderam as discriminações básicas e mostraram relações simétricas e transitivas. O Estudo 2 verificou o efeito da inclusão de um elemento redundante (mancha preta) nos compostos de uma das classes, utilizando um delineamento intra-sujeito. Avaliou-se o efeito dessa manipulação em um procedimento de treino de relações condicionais arbitrárias com DSSi sobre os desempenhos nos testes de relações emergentes, utilizando-se MTS e DSSi. Os doze universitários mostraram relações simétricas, mas apenas cinco apresentaram relações transitivas. Esses resultados expandem as evidências de que configurações das tentativas de treino e as características irrelevantes dos estímulos podem gerar falso positivo nos treinos discriminativos.(AU)

El entrenamiento discriminativo sencilla simultáneamente con compuestos (DSSi) han producido variabilidad en los resultados de las pruebas de estímulos equivalentes. Este estudio investigó en dos estudios el papel de las variables metodológicas que alteran las posibilidades de control por parte de los aspectos no definidos como relevantes, sobre la formación de las clases de equivalencia de estímulo. Estudio 1 evaluó el efecto del uso de un compuesto incorrecta (S+) para cada compuesto correcta (S +) en cada intento de garantía DSSi que el contexto discriminación condicional sin redundancia (por ejemplo, A1B1 con A1B2 A1B1 o con A2B1). Cinco estudiantes universitarios aprendieron la discriminación básica y mostraron relaciones simétricas y transitivas. El segundo estudio evaluó el efecto de la inclusión de un elemento redundante (punto negro) en los compuestos de las clases utilizando un diseño intrasujeto. Se evaluó el efecto de esta manipulación en un procedimiento de formación de las relaciones condicionales arbitrarias con DSSi sobre actuaciones en relaciones emergentes pruebas, utilizando MTS y DSSi. Los doce estudiantes mostraron relaciones simétricas, pero sólo cinco tenido relaciones transitivas. Estos resultados amplían la evidencia de que los intentos de formación configuraciones y características irrelevantes de los estímulos pueden generar falsos positivos en la práctica discriminatoria.(AU)

Arranjo de estímulos em treino discriminativo simples com compostos e emergência de classes de estímulos equivalentes / Arreglo de estímulo en compuestos simples con entrenamiento discriminativo y la clase equivalente de estímulos / Stimulus arrangement in simple discriminative training with compound and emergence of stimulus equivalence classes

O treino discriminativo simples simultâneo com compostos (DSSi) tem produzido variabilidade nos resultados de testes de estímulos equivalentes. O presente trabalho investigou em dois estudos o papel de variáveis metodológicas, que alteram as chances de controle por aspectos não definidos como relevantes, sobre a formação de classes de estímulos equivalentes. O Estudo 1 avaliou o efeito da utilização de um composto incorreto (S-) para cada composto correto (S+) em cada tentativa do DSSi que garantia o contexto de discriminação condicional sem redundância (e.g., A1B1 com A1B2 ou A1B1 com A2B1). Cinco estudantes universitários aprenderam as discriminações básicas e mostraram relações simétricas e transitivas. O Estudo 2 verificou o efeito da inclusão de um elemento redundante (mancha preta) nos compostos de uma das classes, utilizando um delineamento intra-sujeito. Avaliou-se o efeito dessa manipulação em um procedimento de treino de relações condicionais arbitrárias com DSSi sobre os desempenhos nos testes de relações emergentes, utilizando-se MTS e DSSi. Os doze universitários mostraram relações simétricas, mas apenas cinco apresentaram relações transitivas. Esses resultados expandem as evidências de que configurações das tentativas de treino e as características irrelevantes dos estímulos podem gerar falso positivo nos treinos discriminativos.

El entrenamiento discriminativo sencilla simultáneamente con compuestos (DSSi) han producido variabilidad en los resultados de las pruebas de estímulos equivalentes. Este estudio investigó en dos estudios el papel de las variables metodológicas que alteran las posibilidades de control por parte de los aspectos no definidos como relevantes, sobre la formación de las clases de equivalencia de estímulo. Estudio 1 evaluó el efecto del uso de un compuesto incorrecta (S+) para cada compuesto correcta (S +) en cada intento de garantía DSSi que el contexto discriminación condicional sin redundancia (por ejemplo, A1B1 con A1B2 A1B1 o con A2B1). Cinco estudiantes universitarios aprendieron la discriminación básica y mostraron relaciones simétricas y transitivas. El segundo estudio evaluó el efecto de la inclusión de un elemento redundante (punto negro) en los compuestos de las clases utilizando un diseño intrasujeto. Se evaluó el efecto de esta manipulación en un procedimiento de formación de las relaciones condicionales arbitrarias con DSSi sobre actuaciones en relaciones emergentes pruebas, utilizando MTS y DSSi. Los doce estudiantes mostraron relaciones simétricas, pero sólo cinco tenido relaciones transitivas. Estos resultados amplían la evidencia de que los intentos de formación configuraciones y características irrelevantes de los estímulos pueden generar falsos positivos en la práctica discriminatoria.

Atenolol prevents the formation of expansive hematoma after rhytidoplasty.

OBJECTIVE: To evaluate the perioperative use of atenolol in reducing the incidence of hematoma after rhytidoplasty. METHODS: Between January 2007 and February 2013, 80 patients were randomized into two groups: Group A (n = 26) received perioperative atenolol in order to maintain heart rate (PR) around 60 per minute; Group B (n = 54) did not receive atenolol. Both groups underwent the same anesthetic and surgical technique. We monitored blood pressure (BP), HR, hematoma formation and the need for drainage. Patients were followed-up until the 90th postoperative day. The variables were compared between the groups using the ANOVA test. Continuous variables were presented as mean ± standard deviation and the differences were compared with the Student's t test. Values of p d" 0.05 were considered significant. RESULTS: In group A the mean BP (110-70 mm Hg ± 7.07) and HR (64 / min ± 5) were lower (p d" 0.05) than in group B (135-90 mm Hg ± 10.6) and (76 / min ± 7.5), respectively. There were four cases of expansive hematoma in group B, all requiring reoperation for drainage, and none in group A (p d" 0,001). CONCLUSION: The perioperative use of atenolol caused a decrease in blood pressure and heart rate and decreased the incidence of expanding hematoma after rhytidectomy.

Atenolol prevents the formation of expansive hematoma after rhytidoplasty / O atenolol previne a formação de hematoma expansivo após ritidoplastia

Objective: To evaluate the perioperative use of atenolol in reducing the incidence of hematoma after rhytidoplasty. Methods: Between January 2007 and February 2013, 80 patients were randomized into two groups: Group A (n = 26) received perioperative atenolol in order to maintain heart rate (PR) around 60 per minute; Group B (n = 54) did not receive atenolol. Both groups underwent the same anesthetic and surgical technique. We monitored blood pressure (BP), HR, hematoma formation and the need for drainage. Patients were followed-up until the 90th postoperative day. The variables were compared between the groups using the ANOVA test. Continuous variables were presented as mean ± standard deviation and the differences were compared with the Student's t test. Values of p d" 0.05 were considered significant. Results: In group A the mean BP (110-70mmHg ± 7.07) and HR (64 / min ± 5) were lower (p d" 0.05) than in group B (135-90mmHg ± 10.6) and (76 / min ± 7.5), respectively. There were four cases of expansive hematoma in group B, all requiring reoperation for drainage, and none in group A (p d" 0,001). Conclusion: The perioperative use of atenolol caused a decrease in blood pressure and heart rate and decreased the incidence of expanding hematoma after rhytidectomy. .

Objetivo: avaliar o uso perioperatório do atenolol na redução da incidência de hematoma pós-ritidoplastia. Métodos: entre janeiro de 2007 e fevereiro de 2013 foram randomizados 80 pacientes em dois grupos: Grupo A (n=26) recebeu atenolol perioperatório com objetivo de manter frequência de pulso (FP) ± 60 por minuto, Grupo B (n=54) não recebeu atenolol. Ambos os grupos foram submetidos à mesma técnica anestésico-cirúrgica. A pressão arterial (PA) e FP, formação de hematoma e a necessidade de drenagem foram monitorizados. Houve seguimento até o 90º dia de pós-operatório. As variáveis foram analisadas entre os dois grupos utilizando-se o teste de ANOVA. As variáveis contínuas foram apresentadas como média (± Desvio-padrão) e as diferenças foram comparadas utilizando-se o t de Student. Foram considerados significantes os valores p<0,05. Resultados: as médias no grupo A de PA (110-70mmHg ± 7,07) e FP (64 /min ± 5) foram menores (p<0,05) em relação ao grupo B (135-90mmHg ± 10,6) e (76/min ± 7,5), respectivamente. Houve quatro casos de hematoma expansivo no grupo B, todos com necessidade de reoperação para a sua drenagem e nenhum no grupo A (p<0,001). Conclusão: o uso do atenolol perioperatório promoveu a redução de pressão arterial e frequência de pulso e diminuiu a incidência de hematoma expansivo pós-ritidoplastia. .

The combination of rhytidoplasty and fractional CO2 laser therapy in the treatment of facial aging.

BACKGROUND: Facial aging is a natural biological process with symptoms such as sagging tissue, accentuated lines, furrows, wrinkles, dyschromias, and loss of facial volume. Rhytidectomy alone often fails to achieve a patient's expected goals, which is why there is a high demand for adjunct laser skin treatment. METHODS: From January 2007 to February 2013, a total of 80 patients with skin types Fitzpatrick I-IV underwent large undermined cutaneous flap rhytidectomy and superficial muscular aponeurotic system (SMAS) plicature plus hyaluronic acid injection on the nasolabial folds and lips and concomitant Lumenis UltraPulse CO2 Active FX total ablation mode resurfacing of nonundermined skin. The undermined skin was treated with a fractional laser using different energies depending on the type of skin. Patients were evaluated at 5, 10, 15, 30, 60, and 90 days after the operation. At the last evaluation patients completed a specific questionnaire about satisfaction. RESULTS: Complications included expansive hematomas (5 %), partial necrosis (1.25 %), bacterial infection (1.25 %), herpetic infection (1.25 %), hypertrophic scar (1.25 %), and spot hyperchromia (1.25 %). 95 % of patients were extremely satisfied, 3.75 % were satisfied, and only 1.25 % were unsatisfied. CONCLUSION: The combination of subcutaneous flap rhytidectomy and SMAS plicature with fractional laser resurfacing plus hyaluronic acid injection is a safe procedure with low incidence of major complications and improves patient satisfaction.

Alcohol and crack cocaine use in women: a 14-year cross-sectional study.

This article aims to describe the record type for first-time hospital admissions of 761 women at a single institution between 1997 and 2010 according to International Classification of Diseases, 10(th) revision, criteria, for mental and behavioral disorders due to psychoactive substance use (F10-F19). This cross-sectional study included a convenience sample of 4,736 patients in the Brazilian public health system, among whom 761 were women. Overall, the rate of alcohol-related hospitalizations decreased from 93.6% in 1997 to 50.9% in 2010. In contrast, the rate of crack cocaine-related hospitalizations increased in women from 2.8% in 1997 to 67.8% in 2010. The linear regression was R(2) = 0.8472. These data indicate a new trend in the pattern of psychoactive substance use in women.