Síndrome autoimune induzida por adjuvantes (ASIA) sinais e sintomas experienciados por mulheres / Implementation of an intravenous therapy team based on convergent-assistance research / Síndrome autoinmune inducido por adyuvante (ASIA) signos y síntomas experimentados por mujeres

Objetivo: Identificar sinais e sintomas experienciados por mulheres com síndrome autoimune induzida por adjuvantes (ASIA) devido ao uso de prótese mamária e os tratamentos realizados. Método: Estudo de campo de abordagem qualitativa realizado por meio de entrevistas online utilizan-do-se a técnica bola de neve. Incluíram-se 13 participantes. Resultados: A partir da análise dos dados, foram elencadas quatro categorias: conhecimento acerca da síndrome; sinais e sintomas; tratamento; e cuidados e implicações de Enfermagem. Identificaram-se mais de 120 sinais e sintomas, e o explante foi mencionado como tratamento definitivo por todas as entrevistadas. Os sinais e sintomas apresentados pelas participantes vão ao encontro do que é descrito pela literatura. Conclusão: Antes da descoberta da doença, as participantes realizaram tratamento com foco no alívio dos sintomas. Após o diag-nóstico, todas as mulheres procederam com o explante

Objective: To identify signs and symptoms experienced by women with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to the use of breast implants and the treatments performed. Method: Field study with a qualitative approach carried out through online interviews using the snowball technique. 13 participants were included. Results: Based on data analysis, four categories were listed: knowledge about the syndrome; signs and symptoms; treatment; and nursing care and implications. Over 120 signs and symptoms were identified, and the explant was mentioned as a defi-nitive treatment by all interviewees. The signs and symptoms presented by the participants are in line with what is described in the literature. Conclusion:Before discovering the disease, the participants underwent treatment focused on symptom relief. After diagnosis, all women proceeded with the explant.Keywords: Autoimmune diseases. Prothesis implantation. Breast implantation. Silicones. Perioperative nursing

Objetivo: Identificar los signos y síntomas experimentados por mujeres con síndrome autoinmune inducido por adyuvantes (ASIA) debido al uso de implantes mamarios y los tratamientos realizados. Método: Estudio de campo con enfoque cualitativo realizado a través de entrevistas en línea utilizando la técnica de bola de nieve. Se incluyeron 13 participantes. Resultados: Con base en el análisis de los datos, se enumeraron cuatro categorías: conocimiento sobre el síndrome; signos y síntomas; tratamiento; y cuidados e implicaciones de enfermería. Se identificaron más de 120 signos y sínto-mas, y todos los entrevistados mencionaron el explante como tratamiento definitivo. Los signos y síntomas presentados por los participantes están en línea con lo descrito en la literatura. Conclusión: Antes de descubrir la enfermedad, los participantes realizaban un tratamiento enfocado en el alivio de los síntomas. Después del diagnóstico, todas las mujeres procedieron al explante

Aortic Valve Replacement Via Right Anterior Mini-Thoracotomy: the Conventional Procedure Performed Through a Smaller Incision.

Minimally invasive aortic valve replacement has gained consent due to its good results in terms of minimized surgical trauma, faster rehabilitation, pain control and patient compliance. In our experience, we have tried to replicate the conventional and gold standard approach through a smaller incision. Sparing the right internal thoracic artery, avoiding rib fractures and performing total central cannulation is important to make this procedure minimally invasive from a biological point of view too. In addition, the total central cannulation is pivotal to simplify perfusion and drainage. Moreover, a complete step-by-step procedure optimization and-when possible-the use of sutureless prosthesis help to reduce the cross-clamping and perfusion times. After more than 1000 right anterior thoracotomy (RAT) aortic valve replacements, we have found tips and tricks to make our technique more effective.

Aortic valve replacement via right anterior mini-thoracotomy: the conventional procedure performed through a smaller incision

Abstract Minimally invasive aortic valve replacement has gained consent due to its good results in terms of minimized surgical trauma, faster rehabilitation, pain control and patient compliance. In our experience, we have tried to replicate the conventional and gold standard approach through a smaller incision. Sparing the right internal thoracic artery, avoiding rib fractures and performing total central cannulation is important to make this procedure minimally invasive from a biological point of view too. In addition, the total central cannulation is pivotal to simplify perfusion and drainage. Moreover, a complete step-by-step procedure optimization and-when possible-the use of sutureless prosthesis help to reduce the cross-clamping and perfusion times. After more than 1000 right anterior thoracotomy (RAT) aortic valve replacements, we have found tips and tricks to make our technique more effective.

Reconstrução de sequela facial por prótese interna acrílica / Reconstruction of facial sequela by internal acrylic prothesis

As sequelas faciais decorrentes do trauma representam grande desafio para o cirurgião buco-maxilo-facial e exigem que este tenha em mente o conhecimento anatômico, cirúrgico, do acervo material, bem como do aporte tecnológico que lhe assiste a prática cirúrgica. Frente aos biomateriais utilizados na confecção protética, a resina acrílica aparece como uma possibilidade amplamente vantajosa para o profissional e para o paciente, e, uma vez somada às técnicas de prototipagem, se tornam ainda mais eficientes e eficazes. O presente trabalho objetiva discutir o uso da resina acrílica no tratamento das sequelas faciais após o trauma por meio da apresentação de um caso clínico... (AU)

As the facial sequelae resulting from trauma represent a great challenge for the maxillo-facial surgeon, and require that keep in mind the knowlodge about anatomical, surgical, material assets and the technological support that assists you to surgical practice. In view of the prosthetic biomaterials used in making the acrylic resin appears as a widely advantageous possibility for professional and patient, and once added to the prototyping techniques become more efficient and effective. This paper aims to discuss the use of acrylic resin in the treatment of facial sequelae after trauma by presenting a clinical case... (AU)

Unusual redo mitral valve replacement for bleeding in Glanzmann thrombasthenia.

We report the case of 23-year-old man with mitral valve regurgitation and Glanzmann thrombasthenia, who underwent mechanical mitral valve replacement. Warfarin therapy was devastating, causing bilateral hemothorax, pericardial effusion, gastrointestinal bleeding, and hematuria. Redo mitral valve replacement with a biological prosthesis was required to resolve this critical situation. To our knowledge, this is the first report of mitral valve replacement in Glanzmann thrombasthenia, highlighting the danger of oral anticoagulation in this pathology.

Mandibular resection via mandibular-lip L flap for the treatment of extensive multicystic Ameloblastoma.

Ameloblastoma is a benign odontogenic tumor accounting for 1% of all tumors of the maxilla and mandibula. The mandibula is committed in 85% of the cases. The tumor is locally invasive, able to infiltrate bone marrow spaces, without radiographic or macroscopic evidence. High recurrence rates are associated with different surgical techniques, which range from simple tumoral enucleation to extensive resections. The authors report a case of a 26-year old female patient with an 8-year history of progressive, non-tender, swelling of the left mandibular region. The intraoral examination showed that the floor of mouth was raised on the left side by a bulging along the bottom of the left mandibular vestibule as well as the lingual region. Over this area, there were ulcerated areas in the alveolar region of the molars and mucosal fenestration in the alveolar and lingual regions were present. A panoramic radiography revealed a multicystic lesion, resembling the soap-bubble shape endosseous lesion. The computed tomography revealed an expandable multicystic lesion compromising both mandibular cortices. The patient underwent a biopsy, which revealed the diagnosis of a multicystic variant of Ameloblastoma, with plexiform pattern, treated with left mandibular resection and immediate installation of a customized prosthesis. After a year of follow-up, no evidence of the tumor relapse was evidenced.

Circulação periférica em pacientes com insuficiência aórtica crônica e indicação de troca valvar / Peripheral circulation in patients with chronic aortic insufficiency and valve replacement indication

Introdução: O recente aperfeiçoamento da ultra-sonografia permitiu a análise estrutural e funcional do vaso. Casuística e Métodos: 36 pacientes com insuficiência aórtica e indicação de troca valvar, divididos em grupos com pressão arterial diastólica (PAD) superior e inferior a 50mmHg, avaliados antes e seis meses após a cirurgia. A função arterial compreendeu a complacência, distensibilidade e a função endotelial pela dilatação fluxo-mediada e nitrato-mediada. Conclusão: A complacência e a distensibilidade foram maiores no grupo com menor PAD e diminuíram após a cirurgia. A disfunção endotelial foi presente em insuficiência aórtica crônica independente do nível da pressão arterial diastólica.

Introduction: The recent improvement of ultrasonography made possible a functional and structural analysis of the vessel. Methods: 36 patients with aortic insufficiency and valve replacement need, divided in 2 groups with diastolic blood pressure (DBP) above and below 50mmHg. Checked twice: before and 6 months after surgery. The arterial function comprised compliance, distensibility and endothelial function through flow-mediated dilatation and nitrate-mediated dilatation. Conclusion: The compliance and distensibility were higher in the group with lower DBP and decreased after surgery. Endothelial dysfunction was present in chronic aortic insufficiency no matter the level of DBP.