Xanthelasma palpebrarum after hyaluronic acid injection in the lower eyelid: A case report and review of the literature.

BACKGROUND: Hyaluronic acid filler treatments are a very popular nonsurgical procedure worldwide, most wanted to create a more attractive profile and correct facial aging. Since its usage has expanded, more complications have been seen. AIMS: To report a probably new adverse effect related to injectable fillers. PATIENT: A 38-year-old white woman who underwent hyaluronic acid filling in the periorbital area and presented twelve months after with two symmetrically yellowish plaque lesions on the lower eyelids, with no edema or nodules. RESULTS: The lesion appeared to be xanthelasma, in a patient with no history of hyperlipidemia. Histological analysis showed unspecific findings with rare histiocytes present in the papillary dermis. The patient was treated with hyaluronidase infiltration in both lower eyelid areas as an attempt to minimize the appearance of the lesions, with a satisfactory response. CONCLUSIONS: As hyaluronic acid fillings are becoming more popular, all physicians have to be aware of its complications. The xanthelasma-like reaction is probably a new adverse effect related to injectable fillers and it is important to be alert to this possibility.

Cervical cancer screening abnormalities in immunosuppressed renal transplant women: case-control study in Southern Brazil.

PURPOSE: To evaluate the prevalence of cervical pre-malignancies in the cervical cytology of female renal transplant recipients (RTR) and compare to immunocompetent patients. METHODS: A prospective case-control study of 165 RTR (cases) and 372 immunocompetent women (controls) was carried out from May 2015 to August 2016. The participants completed a questionnaire with demographic characteristics, habits, reproductive history, and information about the renal transplant. Cervical cytology samples were collected at their visit for cervical cancer screening. Relevant medical history was obtained from medical records and previous cervical cytology results were retrieved: from the time of kidney transplantation to the beginning of this study for RTR and all collected throughout life for controls. RESULTS: The mean age was similar between groups (42.6 ± 11.4 vs. 41.8.2 ± 11.1 years, p = 0.447). Considering cervical cytology collected since the kidney transplant, RTR had three times higher rates of abnormal cervical cytology test (24.8% of RTR vs. 6.3% for controls), and the abnormalities were more frequent (p < 0.001) for low squamous intraepithelial lesion (LSIL) (n = 23, 13.9%) and high squamous intraepithelial lesion (HSIL) (n = 9, 5.5%). Cervical cytology collected during the study had normal results in 152 RTR (92.1%) vs. 326 controls (93.9%) (p > 0.05). When the altered results were broken down, a higher frequency of LSIL could be seen in RTR (3.6% vs 0.0%, p = 0.008). CONCLUSION: RTR had significantly higher rates of cervical cytology abnormalities comparing to the control group and most of it was composed of LSIL.

Exercício físico e diabetes mellitus: explorando efeitos e implicações / Physical exercise and diabetes mellitus: exploring effects and implications

Objetivos: Este estudo tem como objetivo realizar uma revisão da literatura sobre a efetividade do exercício físico no controle glicêmico de indivíduos portadores de Diabetes Mellitus (DM). Métodos: A revisão foi conduzida no mês de maio de 2018 nas bases Pubmed/Medline e Lilacs com o cruzamento dos termos "Diabetes Mellitus" e "Exercise", sendo selecionadas apenas publicações de textos completos - guidelines ou revisões - escritos em língua inglesa ou língua portuguesa, considerando participantes humanos adultos durante o período de 2016 até o momento da busca. Resultados: Sete revisões sistemáticas que examinaram o efeito de atividade física em pacientes diabéticos estavam de acordo com os critérios de inclusão. Técnicas de mudança no comportamento como o acompanhamento com profissionais da saúde e educação acerca da doença foram intervenções associadas a uma maior adesão à prática de atividade física, assim como dieta e exercício físico trouxeram melhorias ao controle glicêmico. Conclusão: O estudo identifica que a prescrição de exercício físico, sendo este de moderada à alta intensidade, é um dos pilares para a melhora na qualidade de vida de indivíduos diabéticos. Caso a atividade física seja adequada à realidade do paciente, haverá a regressão não só dos indicadores do DM, tal como o nível de Hemoglobina Glicosilada (Hb1AC), mas também dos fatores de risco, como, por exemplo, doenças cardiovasculares.

Aims: This study aims to review the effect of physical exercise in the glycemic control in individuals with Diabetes Mellitus (DM). Methods: The review was conducted in May 2018, using the terms "Diabetes Mellitus" and "Exercise" in two electronic databases: Pubmed/Medline and Lilacs. There were only included full-term studies, such as guidelines or reviews, written in english and in portuguese, considering human adults participants during the period between 2016 and May 2018. Studies that did not meet this criteria were not picked. Results: Seven systematic reviews examining the effect of physical activity in diabetic patients met the eligibility criteria. Behavioral change techniques such as follow-up with health professionals and education about the disease were interventions associated with a better adherence to physical activity, as well as diet and physical exercise had improvements in glycemic control. Conclusion: The study identifies that the prescription of physical exercise, from moderate to high intensity, improves the quality of life in people with DM. If the physical activity is adequate to the patient's particularities, there will be decrease not only of diabetes indicators, such as glycosylated hemoglobin (HbA1C), but also of the risk factors, as cardiovascular diseases.