Six-Month Comparative Analysis Monitoring the Progression of the Largest Diameter of the Sweating Inhibition Halo of Different Botulinum Toxins Type-A.

BACKGROUND: Excessive sweating is a clinical condition that can be improved with type-A botulinum toxin (BTX-A). OBJECTIVES: To evaluate and compare the largest diameter of sweating inhibition halo (SIH) of 5 different commercially available BTX-A, in five different doses, in a 6-month-long clinical evaluation. METHODS: Twenty-five adult female volunteers were injected in the dorsal trunk area with both 100 units (100UI) and 500 units (500UI) BTX-A products, reconstituted in a ratio of 1:2.5 IU, respectively. Products were applied in five different concentrations (1:2.5U, 2:5U, 3:7.5U, 4:10U, and 5:12.5U). After 30, 60, 90, 120, 150, and 180 days, a starch-iodine test was performed to obtain the largest diameter of each SIH. RESULTS: The higher the number of units used, the larger the SIH p < 0.05 for all BTX-A. However, Botox®, Botulift®, Dysport®, and Prosigne® have pretty likewise SIH along the study, with some few differences for some doses and months between one and another. However, Xeomin® is the BTX-A with the smallest SIH, in comparison with all others, in any dose and period. CONCLUSIONS: Differences were observed among all brands of BTX-As, based on dose and time after injection. Xeomin® provides the smallest SIH in comparison with others BTX-A.

Clasificación morfológica de células endoteliales de venas del cordón umbilical humano en imágenes digitales de cultivos in vitro / Morphological classification of endothelial cells of veins from the human umbilical cord in digital images of in vitro cultures

Se realizó un estudio descriptivo y transversal desde julio hasta octubre de 2017, por especialistas de la Universidad de Oriente y de la Universidad de Sao Paulo, Brasil, para analizar desde el punto de vista morfológico células endoteliales de venas del cordón umbilical humano, presentes en imágenes digitales de cultivos in vitro 2D, tratadas con la β2GPI. Se propuso la clasificación supervisada celular considerando 3 clases: circulares, deformadas alargadas y deformadas poco alargadas, según los coeficientes de formas elíptico y circular, todo lo cual permitió identificar formas celulares relevantes. Para comparar los resultados de las muestras de control y las tratadas, se calcularon los intervalos de confianza para cada una de las clases, con un nivel de confianza de 95 por ciento. Se concluye que el análisis de las alteraciones morfológicas in vitro puede ser utilizada en cultivos 2D precoces (de 24 y 48 horas) para la cuantificación de la angiogénesis(AU)

A descriptive and cross-sectional study was carried out from July to October, 2017, by specialists of the Oriente University and the University of Sao Paulo, Brazil, to analyze from the morphological point of view endothelial cells of the human umbilical cord veins, which were present in digital images of 2D in vitro cultures, treated with the β2GPI. The cellular supervised classification was proposed considering 3 classes: circular, distorted elongated and distorted not very elongated, according to the coefficients of elliptic and circular shapes, all that allowed to identify outstanding cellular forms. To compare the results of the control and treated samples, the intervals of confidence were calculated for each of the classes, with a 95 percent level of confidence. It was concluded that the analysis of the morphological disorders in vitro can be used in early 2D cultures (24 and 48 hours) for the quantification of the angiogenesis(AU)

Clasificación morfológica de células endoteliales de venas del cordón umbilical humano en imágenes digitales de cultivos in vitro / Morphological classification of endothelial cells of veins from the human umbilical cord in digital images of in vitro cultures

Se realizó un estudio descriptivo y transversal desde julio hasta octubre de 2017, por especialistas de la Universidad de Oriente y de la Universidad de Sao Paulo, Brasil, para analizar desde el punto de vista morfológico células endoteliales de venas del cordón umbilical humano, presentes en imágenes digitales de cultivos in vitro 2D, tratadas con la ß2GPI. . Se propuso la clasificación supervisada celular considerando 3 clases: circulares, deformadas alargadas y deformadas poco alargadas, según los coeficientes de formas elíptico y circular, todo lo cual permitió identificar formas celulares relevantes. Para comparar los resultados de las muestras de control y las tratadas, se calcularon los intervalos de confianza para cada una de las clases, con un nivel de confianza de 95 por ciento. Se concluye que el análisis de las alteraciones morfológicas in vitro puede ser utilizada en cultivos 2D precoces (de 24 y 48 horas) para la cuantificación de la angiogénesis

A descriptive and cross-sectional study was carried out from July to October, 2017, by specialists of the Oriente University and the University of Sao Paulo, Brazil, to analyze from the morphological point of view endothelial cells of the human umbilical cord veins, which were present in digital images of 2D in vitro cultures, treated with the ß2GPI. The cellular supervised classification was proposed considering 3 classes: circular, distorted elongated and distorted not very elongated, according to the coefficients of elliptic and circular shapes, all that allowed to identify outstanding cellular forms. To compare the results of the control and treated samples, the intervals of confidence were calculated for each of the classes, with a 95 percent level of confidence. It was concluded that the analysis of the morphological disorders in vitro can be used in early 2D cultures (24 and 48 hours) for the quantification of the angiogenesis

Metformin influences on respiratory system in obese mice induced by postnatal overnutrition.

Many studies have confirmed the merits of metformin to treat type 2 diabetes, but few studies have addressed its effect on the respiratory system. Moreover, vascular endothelial growth factor (VEGF) is critical to many lung functions. In this way, we evaluated the metformin impact on the lung in treated obese Swiss mice, induced by postnatal overnutrition. Glucose and insulin were detected and the insulin resistance index (HOMA) was calculated; inflammatory cells and nitrite/nitrate concentration (NOx) was quantified from bronchoalveolar lavage, collagen and lung VEGF-a was analysed in the lung tissue and lung mechanics were evaluated by methacholine-induced bronchoconstriction. Values of glucose, insulin, HOMA; VEGF-a and collagen demonstrate the partial ability of metformin to improve the effects of obesity. However, metformin is ineffective in re-establishing the inflammation, shows no effects on NOx and does not restore bronchoconstriction in obese mice. In conclusion, metformins beneficial effects on lung are questionable in the postnatal overnutrition model of obesity.

A Cross-Continental Study on Children's Drawings of Football Players: Implications for Understanding Key Issues and Controversies in Human Figure Drawings.

Professionals examine various aspects of girls' and boys' drawings as a way of understanding their intelligence, personality and emotional state. However, the extent to which such measures could be universally generalised or attributed to a specific cultural norm is still a debatable issue. In the present study five key features of children's drawings namely: the size (height) of the drawings, profile or full face, figure in action or static, shaded or non-shaded and the nature of additional details were examined from a cross-cultural perspective, and by providing a topic (football) for which children's drawing of a human figure could provide opportunities for the latter indices to manifest and flourish. Children from three countries; England, Iran and Brazil, representing three continents took part in this study. The participants were asked to draw a football player from their own country and from the other participating countries. The results showed that Brazilian children differ from Iranian and English children by drawing significantly smaller figures and putting more football action in the drawings. Shading of the figure drawn was more prevalent amongst English children. Such findings have implications for the interpretation of key aspects of children's drawings in educational, clinical and therapeutic settings and from a universal vs. culturally-specific viewpoint.

Stewart Treves Syndrome.

Stewart-Treves Syndrome is characterized by the presence of lymphangiosarcoma on limb extremities. Rare, it occurs in 0.5% of patients who have undergone radical mastectomy with axillary node dissection. The main cause is chronic lymphedema with endothelial and lymphatic differentiation, with no direct relationship to breast cancer. Seven years after a radical right-side mastectomy with lymph node dissection and adjuvant therapy, the patient developed a lesion on her right arm. The dermatological examination revealed an erythematous nodule with bleeding surface on chronic right forearm lymphedema. After the biopsy, a lymphangiosarcoma on chronic lymphedema was diagnosed. Infrequent, this syndrome is relevant because of its associated mortality. Early diagnosis is important to improve survival and reduce complications.

Assessment of clinical effects and safety of an oral supplement based on marine protein, vitamin C, grape seed extract, zinc, and tomato extract in the improvement of visible signs of skin aging in men.

BACKGROUND: Skin aging is a natural process that may be aggravated by environmental factors. Topical products are the conventional means to combat aging; however, the use of oral supplements is on the rise to assist in the management of aged skin. OBJECTIVE: The purpose of this study was to assess the effects and safety of an oral supplement containing (per tablet) marine protein (105 mg), vitamin C (27 mg), grape seed extract (13.75 mg), zinc (2 mg), and tomato extract (14.38 mg) in the improvement of skin aging in men. METHODS: This single-center, open-label, quasi-experimental clinical study enrolled 47 male subjects, aged 30-45 years, with phototypes I-IV on the Fitzpatrick scale. Subjects received two tablets of the oral supplement for 180 consecutive days. Each subject served as their own control. Clinical assessments were made by medical personnel and by the subjects, respectively. Objective assessments were carried out through pH measurements, sebumetry, corneometry, ultrasound scanning, skin biopsies, and photographic images. RESULTS: Forty-one subjects (87%) completed the study. Clinical improvements on both investigator- and subject-rated outcomes were found for the following parameters: erythema, hydration, radiance, and overall appearance (P<0.05). The objective measurements in the facial skin showed significant improvements from baseline in skin hydration (P<0.05), dermal ultrasound density (P<0.001), and reduction of skin pH (P<0.05). No statistical improvement in relation to sebum was found. The photographic assessment showed an improvement in the overall appearance. The results of the objective measurements were found to be correlated with the subjects' satisfaction by an increase of collagen and elastic fibers. CONCLUSION: The use of an oral supplement based on a unique biomarine complex, vitamin C, grape seed extract, zinc, and tomato extract produced improvements in the signs of skin aging in men.

Effect of glycemic index on obesity control.

OBJECTIVE: Evaluate the effect of glycemic index (GI) on biochemical parameters, food intake, energy metabolism, anthropometric measures and body composition in overweight subjects. MATERIALS AND METHODS: Simple blind study, in which nineteen subjects were randomly assigned to consume in the laboratory two daily low GI (n = 10) or high GI (n = 9) meals, for forty-five consecutive days. Habitual food intake was assessed at baseline. Food intake, anthropometric measures and body composition were assessed at each 15 days. Energy metabolism and biochemical parameters were evaluated at baseline and the end of the study. RESULTS: Low GI meals increased fat oxidation, and reduced waist circumference and HOMA-IR, while high GI meals increased daily dietary fiber and energy intake compared to baseline. There was a higher reduction on waist circumference and body fat, and a higher increase on postprandial fat oxidation in response to the LGI meals than after high GI meals. High GI meals increased fasting respiratory coefficient compared to baseline and low GI meals. CONCLUSION: The results of the present study showed that the consumption of two daily low GI meals for forty-five consecutive days has a positive effect on obesity control, whereas, the consumption of high GI meals result has the opposite effect.

Tratamento de micose fungoide com fototerapia UVB de banda estreita (UVB-NB) / Treatment of mycosis fungoides with narrow-band UVB phototherapy (NB-UVB)

O linfoma cutâneo de células T (LCCT) compreende um grupo heterogêneo de neoplasias de linfócitos T que se apresentam de diversas formas clínicas, histológicas, imunofenotípicas e evolutivas. Micose fungoide (MF) é a forma mais comum de LCCT e corresponde a 50% de todos os linfomas cutâneos primários. A variante hipocrômica da micose fungoide apresenta características epidemiológicas próprias, sendo rara em pacientes caucasianos, atingindo faixas etárias precoces, apresentando evolução na maioria das vezes benigna. O tratamento de eleição para MF é terapia direcionada à pele nos estágios iniciais, enquanto a terapia sistêmica fica reservada para os casos mais avançados. Dentre as terapias descritas, a fototerapia é um dos métodos mais utilizados atualmente para fases iniciais de MF pelos bons resultados apresentados e menor efeito colateral em relação aos demais. Recentemente muitos relatos têm mostrado que UVB-NB é efetiva para o tratamento de estádios precoces de MF. Descrevemos um caso de MF em uma adolescente no estágio IA da doença, apresentando resposta satisfatória com o tratamento com UVB-NB, duas vezes por semana.

Effect of glycemic index on obesity control

Objective Evaluate the effect of glycemic index (GI) on biochemical parameters, food intake, energy metabolism, anthropometric measures and body composition in overweight subjects.Materials and methods Simple blind study, in which nineteen subjects were randomly assigned to consume in the laboratory two daily low GI (n = 10) or high GI (n = 9) meals, for forty-five consecutive days. Habitual food intake was assessed at baseline. Food intake, anthropometric measures and body composition were assessed at each 15 days. Energy metabolism and biochemical parameters were evaluated at baseline and the end of the study.Results Low GI meals increased fat oxidation, and reduced waist circumference and HOMA-IR, while high GI meals increased daily dietary fiber and energy intake compared to baseline. There was a higher reduction on waist circumference and body fat, and a higher increase on postprandial fat oxidation in response to the LGI meals than after high GI meals. High GI meals increased fasting respiratory coefficient compared to baseline and low GI meals.Conclusion The results of the present study showed that the consumption of two daily low GI meals for forty-five consecutive days has a positive effect on obesity control, whereas, the consumption of high GI meals result has the opposite effect. Arch Endocrinol Metab. 2015;59(3):245-51.

Stewart Treves Syndrome

Stewart-Treves Syndrome is characterized by the presence of lymphangiosarcoma on limb extremities. Rare, it occurs in 0.5% of patients who have undergone radical mastectomy with axillary node dissection. The main cause is chronic lymphedema with endothelial and lymphatic differentiation, with no direct relationship to breast cancer. Seven years after a radical right-side mastectomy with lymph node dissection and adjuvant therapy, the patient developed a lesion on her right arm. The dermatological examination revealed an erythematous nodule with bleeding surface on chronic right forearm lymphedema. After the biopsy, a lymphangiosarcoma on chronic lymphedema was diagnosed. Infrequent, this syndrome is relevant because of its associated mortality. Early diagnosis is important to improve survival and reduce complications.

Inhibition of endogenous glucocorticoid synthesis aggravates lung injury triggered by septic shock in rats.

The aim of this study was to determine the effects of previous administration of metyrapone (met) on the acute lung injury (ALI) induced by caecal ligation and puncture (CLP) and to explore met's relationship with endogenous glucocorticoids (GCs) as measured by inflammatory, oxidative and functional parameters. One hundred and thirty-five Wistar rats were divided into three main groups: Control (Naïve), Sham and CLP. The animals received pretreatment one hour before surgery. The Naïve group did not undergo any procedure or pretreatment. The Sham group only had the caecum exposed and was pretreated with saline. The CLP group was divided into three pretreatments: metyrapone (CLP met 50 mg/kg i.p.), dexamethasone (CLP dex 0.5 mg/kg i.p.) or saline (CLP sal equivalent volume of 0.9% NaCl). Analyses were performed after 6 and 24 h of sepsis. Previous administration of met significantly increased inflammatory cells, as well as myeloperoxidase (MPO) activity in the lung tissue and alveolar collapsed area, with consequent impairment of respiratory mechanics being observed compared to Sham and Naïve; CLP sal exhibited similar results to those of met. The met reduced corticosterone (CCT) levels and dramatically increased hydrogen peroxide (H2 O2 ) levels in the lung tissue compared to CLP sal. Our results suggest that previous administration of met may have contributed to increased pulmonary oxidative stress and increased mortality by mechanisms dependent of endogenous GC.

Mycobacterium chelonae cutaneous infection in a patient with mixed connective tissue disease.

Around 50 mycobacteria species cause human disease. Immunosuppressive states predispose to non-tuberculous mycobaterium infection, such as Mycobacterium chelonae: AFB, non-tuberculous, fast growth of low virulence and uncommon as a human pathogen. It may compromise the skin and soft tissues, lungs, lymph nodes and there is also a disseminated presentation. The diagnosis involves AFB identification and culture on Agar and Lowenstein-Jensen medium base. A 41-year-old female with MCTD (LES predominance) is reported, presenting painless nodules in the right forearm. She denied local trauma. Immunosuppressed with prednisone and cyclophosphamide for 24 months. Lesion biopsy has demonstrated positive bacilloscopy (Ziehl-Neelsen stain) and M.chelonae in culture (Lowenstein-Jensen medium base), therefore clarithromycin treatment has been started (best therapy choice in the literature).

Mycobacterium chelonae cutaneous infection in a patient with mixed connective tissue disease

Around 50 mycobacteria species cause human disease. Immunosuppressive states predispose to non-tuberculous mycobaterium infection, such as Mycobacterium chelonae: AFB, non-tuberculous, fast growth of low virulence and uncommon as a human pathogen. It may compromise the skin and soft tissues, lungs, lymph nodes and there is also a disseminated presentation. The diagnosis involves AFB identification and culture on Agar and Lowenstein-Jensen medium base. A 41-year-old female with MCTD (LES predominance) is reported, presenting painless nodules in the right forearm. She denied local trauma. Immunosuppressed with prednisone and cyclophosphamide for 24 months. Lesion biopsy has demonstrated positive bacilloscopy (Ziehl-Neelsen stain) and M.chelonae in culture (Lowenstein-Jensen medium base), therefore clarithromycin treatment has been started (best therapy choice in the literature).

Use of the glycemic index in nutrition education / Uso do índice glicêmico na educação nutricional

Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and the factors that affect the glycemic index were selected for this article. The preparation of lists grouping foods according to their glycemic index should be based on information found in tables and specific web sites. This is an interesting strategy that must be very carefully conducted, considering the eating habits of the assisted people. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed in association with the following foods: high protein and low fat foods, good quality oils and unprocessed foods with high fiber content. Caffeine should also be avoided. The glycemic index should be considered as an additional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promoting and/or maintaining body weight and health.

Recentemente, a falta de artigos que visam fornecer orientação quanto ao uso do índice glicêmico foi apontada como causa de sua baixa utilização na educação nutricional. O objetivo do presente trabalho é oferecer suporte para o uso do índice glicêmico como ferramenta a ser adotada na educação nutricional, para estimular o consumo preferencial de alimentos que apresentem menores valores nesse indicador. Foram selecionados estudos publicados nos últimos doze anos, além de estudos clássicos referentes ao tema, indexados nos bancos de dados MedLine, ScienceDirect, SciELO e Lilacs, que exploraram a importância do índice glicêmico e os fatores que interferem em seu valor. A elaboração de listas agrupando os alimentos segundo o índice glicêmico deve ser feita com base nas informações encontradas em tabelas e sites específicos. Essa é uma estratégia interessante que deve ser conduzida de maneira criteriosa, considerando-se os hábitos alimentares do público assistido. Para resultar em resposta glicêmica pós-prandial mais baixa, os produtos de alto índice glicêmico devem ser ingeridos em associação com alimentos ricos em proteína e pobres em gordura, com óleos de boa qualidade, com alimentos menos processados por ricos em fibras, evitando-se os com alto teor em cafeína. O índice glicêmico deve ser considerado uma ferramenta adicional para a escolha de alimentos fonte de carboidratos, os quais devem ser incluídos em uma dieta nutricionalmente equilibrada, capaz de promover e/ou manter tanto o peso corporal adequado quanto a saúde.

Comparative study of the diffusion of five botulinum toxins type-A in five dosages of use: are there differences amongst the commercially-available products?

BACKGROUND: Diffusion halo profiles of different commercially available type-A botulinum toxins (BTX-A) have been studied. OBJECTIVE: To evaluate and compare the largest diameter of diffusion halos of 5 different doses of 5 different commercially available BTX-A. METHODS: Twenty-five adult female volunteers were included. Products with 100 units (100 UI) and the product with 500 units (500 UI) were reconstituted in a ratio of 1:2.5. Products were applied in five different concentrations (1 U/2.5 U, 2 U/5 U, 3 U/7.5 U, 4 U/10 U, and 5 U/12.5 U). After 30 days, a starch-iodine test was conducted to obtain the largest diameter of each halo. RESULTS: For all BTX-As, the higher the number of units used, the larger the diameter of the diffusion halo p<0.05). Statistically significant differences (p<0.05) were observed between the North American and Chinese BTX-As for the three lowest doses, between the Korean and German BTX-As for all doses, between the French and Chinese BTX-As for the four highest doses, between the French and German BTX-As for all doses, between the Chinese and German BTX-As for the four highest doses, and between the North American and German BTX-As for all doses (p<0.01). CONCLUSIONS: Differences were observed between all brands of BTX-As and between the different doses of each brand.

Estudo clínico para a avaliação das propriedades clareadoras da associação de ácido kójico, arbutin, sepiwhite® e achromaxyl® na abordagem do melasma, comparada à hidroquinona 2% e 4% / Evaluation of the whitening properties of combined kojic acid, arbutin, sepiwhite® and achromaxyl® vs. 2% and 4% hydro- quinone in the treatment of melasma

Introdução: Melasma é alteração cutânea comum e adquirida, de curso prolongado e tratamento muitas vezes refratário, gerando impacto psicológico negativo na vida dos acometidos. Objetivos: Avaliar a eficácia, segurança e tolerabilidade da combinação tópica de ácido kójico, arbutin, sepiwhite® e achromaxyl ® em comparação à hidroquinona a 2% e a 4% na abordagem do melasma facial. Métodos: Estudo clínico mono-cego, comparativo, monocêntrico, com 120 voluntárias, fototipos I a IV de Fitzpatrick, entre 18 e 50 anos de idade, divididas em grupo A (n = 40; Blancy® 2 vezes ao dia), grupo B (n = 40; hidroquinona 2% à noite) e grupo C (n = 40; hidroquinona 4% à noite), que usaram os produtos durante 90 dias consecutivos. Foram realizadas avaliações clínicas (classificação e quantificação do melasma) e fotográficas, além do questionário de impacto à qualidade de vida e avaliação global deeficácia. Resultados: Cento e duas voluntárias (85%) finalizaram o estudo, (grupo A = 34, grupo B = 33, grupo C = 35). A métrica do Masi teve redução estatisticamente significante ao longo do estudo para os três Grupos (p-valor < 0,001). Conclusão: O uso tópico da associação de ácido kójico, arbutin, sepiwhite® e achromaxyl ® demonstrou ser eficaz e seguro na abordagem do melasma, apresentando-se como alternativa no arsenal terapêutico dessa dermatose recalcitrante e inestética.

Introduction: Melasma is a common, acquired, long-lasting skin disorder that is often resistant to treatment and causes negative psychological effects on patients. Objectives: To evaluate the efficacy, safety, and tolerability of the topical combination of kojic acid, arbutin, sepiwhite® and achromaxyl ® compared to 2% and 4% hydroquinone in the treatment of facial melasma. Methods: A single-blind, comparative, monocentric clinical study with 120 volunteers (aged 18-50, I to IV Fitzpatrick skin types) was conducted. The study population was divided into 3 groups: Group A (n = 40; Blancy®, 2 times a day), Group B (n = 40, 2% hydroquinone at night), and Group C (n = 40, 4% hydroquinone at night), and instructed to use the study product for 90 consecutive days. Clinical (classification and quantification of melasma) and photographic evaluations were carried out, and a questionnaire assessed the impact on the patients' quality of life and the products' general efficacy. Results: Most volunteers (n = 102, 85%) completed the study (Group A = 34, Group B = 33, Group C = 35). The Melasma Area Severity Index metrics presented a statistically significant decrease (i.e., improvement) throughout the study in all three groups (p-value < 0.001). Conclusion: The topical use of the kojic acid, arbutin, sepiwhite® and achromaxyl® combination proved to be an effective and safe alternative for treating melasma.

Lipodistrofia ginoide e terapêutica clínica: análise crítica das publicações científicas disponíveis / Gynoid lipodystrophy and clinical therapy: a critical analysis of scientific papers

A lipodistrofia ginoide (celulite) é dermatose inestética comum que aflige muitas mulheres ao redor do mundo. Dependendo da intensidade do quadro estabelecido, essa condição pode ser responsável por relevantes distúrbios psicossociais. Na prática clínica, muitas formas terapêuticas já foram tentadas; muitas foram colocadas no cenário das terapêuticas proscritas não só por sua ineficiência terapêutica, mas também pelo risco que impõem à saúde do paciente. Outras, ainda em voga, têm fragilidades científicas que não sustentam sua utilização; no panorama médico atual, encaramos, também, as promessas dos aparelhos médicos, sendo poucos os que realmente apresentam substrato científico de sustentação. Este artigo faz ampla revisão da literatura médica, analisando estudos presentes na literatura científica, tentando fornecer ao leitor argumentos que possam embasá-lo na indicação de uma dada terapêutica em detrimento de outra, a fim de confortá-lo no discurso clínico de resultados junto ao paciente portador de tal enfermidade.

Gynoid lipodystrophy (cellulite) is a common, unattractive dermatosis that affects many women around the world. Depending on the severity of the appearance, the condition may cause important psychosocial disorders. Many therapies have been clinically tested, and many have been proscribed, not only for their therapeutic inefficiency, but also for their risk to patients? health. Other treatments, notwithstanding their weak scientific basis, are still in vogue. Medical devices, few of which are backed by actual scientific evidence, also currently claim to help treat this condition. This paper provides an extensive scientific literature review and analysis, and aims to help dermatologists decide what specific therapies to recommend and provide assurances regarding the clinical rationale of results when treating patients with this condition.