scholarly journals Etiopatogenia e Tratamento da Contractura Capsular Mamária

2013 ◽  
Vol 26 (6) ◽  
pp. 737
Author(s):  
Luis Pereira Leite ◽  
Inês Correia Sá ◽  
Marisa Marques
Keyword(s):  
Capsular Contracture ◽  
Fibrous Tissue ◽  
Surgical Techniques ◽  
Breast Implants ◽  
Augmentation Mammoplasty ◽  
Great Incidence ◽  
Non Invasive ◽  
Clinical Investigations ◽  
Invasive Techniques

Introduction: Capsular contracture is a chronic and the most frequent complication of augmentation mammoplasty with breast implants and the main cause of patient’s and surgeon’s dissatisfaction. The mammary capsule consists of a fibrous tissue that surrounds the implant that may contract, changing the shape and consistency of the breast. In its advanced stage is accompanied by pronounced deformity, hardness and pain, being indicated for surgical treatment.Material and Methods: All the articles indexed on PubMed through the search ‘capsular contracture’ (2000 – January 2012) were reviewed and were included the articles of greater interest in terms of etiology, prophylaxis and treatment. Articles referred in relevant publications were also examined.Results: Everything indicates that its etiology is multifactorial; the etiopathology of breast capsular contracture continues being subject of multiple pre-clinical investigations. There are many studies performed in order to prevent the onset of capsular contracture but, although promising results, little is set for its application on clinical practice. The capsulectomy/capsulotomy continues being the goldstandard treatment although the future may undergo non invasive techniques, at least in mild stages of disease.Conclusion: Although the surgical techniques and the quality of breast implants have been improving drastically in recent years, capsular contracture remains a real complication with great incidence and that continues affecting thousands of women all over the world.

scholarly journals Treatment of bilateral mammary ptosis and pectus excavatum through the same incision in one surgical stage

2012 ◽  
Vol 130 (3) ◽  
pp. 198-201 ◽  
Author(s):  
Fernando Passos Rocha ◽  
Jefferson André Pires ◽  
Vinicius Franchini Torres ◽  
Djalma José Fagundes
Keyword(s):  
Pectus Excavatum ◽  
Surgical Techniques ◽  
Breast Implants ◽  
Self Esteem ◽  
Young Female ◽  
Thoracic Wall ◽  
Congenital Deformities ◽  
Bone Segment ◽  
Mammary Ptosis ◽  
Invasive Techniques

CONTEXT: Congenital deformities of the anterior thoracic wall are characterized by unusual development of the costal cartilages. All these medical conditions are frequently associated with a variety of breast deformities. Several surgical techniques have been described for correcting them, going from sternochondroplasty to, nowadays, minimally invasive techniques and silicone prosthesis implantation. CASE REPORT: The present article reports the case of a young female patient who presented bilateral mammary ptosis and moderate pectus excavatum that caused a protrusion between the eighth and the tenth ribs and consequent esthetic disharmony. The proposed surgical treatment included not only subglandular breast implants of polyurethane, but also resection of part of the rib cartilage and a bone segment from the eighth, ninth and tenth ribs by means of a single submammary incision in order to make the scar minimally visible. Correction through a single incision benefited the patient and provided an excellent esthetic result. CONCLUSIONS: The techniques used to repair bilateral mammary ptosis and pectus excavatum by plastic and thoracic surgery teams, respectively, have been shown to be efficient for correcting both deformities. An excellent esthetic and functional result was obtained, with consequent reestablishment of the patient's self-esteem.

scholarly journals Removal of fibroadenoma of the breast augmentation and breast implants. Analysis of the possibility of simultaneous and delayed execution of these operations

2021 ◽  
Vol 14 (2) ◽  
pp. 140-146
Author(s):  
Viktoriia Dzhuganova ◽  
Valery V. NOVOMLINSKY ◽  
Andrey Petrovich Sokolov ◽  
Pavel Alekseevich Lynov ◽  
Margarita Gennedievna Sokolova ◽  
...  
Keyword(s):  
Breast Augmentation ◽  
Capsular Contracture ◽  
Breast Implants ◽  
Needle Aspiration ◽  
Augmentation Mammoplasty ◽  
Simultaneous Treatment ◽  
Implant Placement ◽  
Simultaneous Operations ◽  
Cosmetic Effect

Introduction. Fibroadenomas (FA) are the most common benign breast neoplasms that are diagnosed in 25% of women. Dissatisfaction with the size of the breast and the desire to increase it occurs in 40%. For this reason, in the practice of a plastic surgeon, there are cases when the patient wants to remove fibroadenomas (FA) and increase the size of the breast. In this situation, there are two options for managing the patient- the simultaneous execution of two operations and the delayed one.Aim. To evaluate the possibility of simultaneous FA removal and augmentation mammoplasty, to analyze possible complications and methods of their correction.Materials and methods. We have analyzed the experience of simultaneous interventions of FA removal and augmentation mammoplasty on the example of 10 cases performed in the period from 2014-2019, as well as FA removal after implant placement-3 cases.Results. Performing a simultaneous operation has advantages due to the minimization of injuries (the ability to perform from a single access - submammary or periareolar), reducing psychological stress and better cosmetic effect. Two patients had postoperative complications in the form of capsular contracture, manifested in the asymmetry of the mammary glands, corrected by performing capsulotomy and forming a new submammary fold. When performing invasive diagnostic tests and surgical intervention in three patients after endoprosthesis augmentation mammoplasty, extreme caution was required due to the risk of violating the integrity of the implant. It was found that the incision of the posterior leaf of the MJ capsule with a large number of removed neoplasms in the postoperative period leads to the development of breast asymmetry. The fact of FA recurrence was also confirmed (2 patients), who subsequently underwent repeated surgical intervention.Conclusion. Performing simultaneous operations for benign breast tumors can be surely practiced by plastic surgeons, including as one of the options for simultaneous treatment of breast FA and augmentation mammoplasty. The occurrence of FA in the long-term period after breast augmentation surgery is associated with difficulties in diagnostics (mammography and fine needle aspiration biopsy under the control of ultrasound), as well as in the course of surgery itself, due to the presence of the implant and the risk of violation of its integrity.

scholarly journals PO 18042 - Surgical treatment of moderate and severe hallux valgus

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 4S
Author(s):  
Rafael Ferreira da Silva ◽  
André Donato Baptista ◽  
Kepler Alencar Mendes de Carvalho
Keyword(s):  
Surgical Treatment ◽  
Hallux Valgus ◽  
Surgical Techniques ◽  
Intermetatarsal Angle ◽  
Chevron Osteotomy ◽  
The Mean ◽  
Invasive Techniques ◽  
Severe Hallux Valgus

Introduction: Hallux valgus is a multifactorial disease, and heredity is the main associated factor. Pain and discomfort when using closed-toed shoes occur in many cases, adversely affecting quality of life. Surgical treatment is indicated when pain and disability persist after conservative treatment. Currently, more than 150 surgical techniques are described for hallux valgus correction, with no consensus regarding the best treatment. With the advent of minimally invasive techniques for hallux valgus correction, Vernois developed the percutaneous chevron osteotomy. This technique allows up to 100% lateral translation of the contact area of the osteotomy. Objective: the objective of the present study was to assess the correction of radiographic parameters, clinical improvement and potential complications of the first 30 cases of moderate and severe hallux valgus operated on at our hospital using the percutaneous chevron technique. Methods: A total of 26 patients (30 feet) underwent surgery. The following parameters were measured in the pre- and postoperative periods: the first metatarsophalangeal (MTP) angle, the intermetatarsal angle between the 1st and 2nd metatarsals (IMA), the distal metatarsal articular angle (DMAA) and the pre- and postoperative American Orthopedic Foot and Ankle Society (AOFAS) scores, with a minimum follow-up period of 6 months. Results: The mean age of the patients was 52.3 years. During the preoperative period, the mean AOFAS score was 45.6; it increased to 90.3 after the procedure, indicating a statistically significant improvement. The mean MTP angle, IMA and DMAA were 29.7°, 14.2° and 14.2° before surgery and 12.8°, 8.2° and 11.1° after surgery, respectively. The improvements in the MTP angle and the IMA were also significant. There was no decrease in angles or worsening of AOFAS scores during follow-up. Conclusion: The percutaneous chevron technique was safe and effective for correcting cases of moderate and severe hallux valgus, with significant improvements in clinical and radiological parameters and a low rate of postoperative complications.

scholarly journals Does Implant Surface Texture Affect the Risk of Capsular Contracture in Subglandular Breast Augmentation and Breast Augmentation-Mastopexy?

2019 ◽  
Vol 40 (5) ◽  
pp. 499-512 ◽  
Author(s):  
Frank Lista ◽  
Ryan E Austin ◽  
Maryam Saheb-Al-Zamani ◽  
Jamil Ahmad
Keyword(s):  
Breast Augmentation ◽  
Bacterial Contamination ◽  
Capsular Contracture ◽  
Surgical Techniques ◽  
Breast Implants ◽  
Textured Surface ◽  
Implant Surface ◽  
Silicone Gel ◽  
Increased Risk ◽  
Augmentation Mastopexy

Abstract Background Previous studies have reported decreased rates of capsular contracture associated with the use of textured surface breast implants placed in the subglandular plane during breast augmentation. However, since the publication of these studies, our understanding of the pathophysiology of capsular contracture, as well as the surgical techniques utilized to minimize bacterial contamination of the implant, have advanced considerably. Objectives The purpose of this study was to re-evaluate the relation between implant surface texturization and capsular contracture rates for breast implants placed in the subglandular plane during primary breast augmentation. Methods Retrospective chart review was performed of all primary subglandular breast augmentation procedures involving the use of either smooth or textured round silicone gel implants, with or without simultaneous mastopexy. The primary outcome measures included clinically significant capsular contracture (Baker grade III/IV) and revision surgery for capsular contracture. Results Between 2010 and 2017, 526 patients underwent primary subglandular breast augmentation with either smooth (n = 212) or textured (n = 314) round silicone gel implants; 248 patients underwent breast augmentation, whereas 278 underwent breast augmentation-mastopexy. Average follow-up was 756 days in the textured group and 461 days in the smooth group. Five cases of capsular contracture were observed in the textured group, and 7 cases of capsular contracture were observed in the smooth group (P = 0.20). Conclusions Smooth surface implants placed in the subglandular plane were not at a significantly increased risk of capsular contracture compared with textured surface implants. We suggest that adherence to a surgical technique focused on minimizing bacterial contamination of the implant is of greater clinical significance than implant surface characteristics when discussing capsular contracture. Level of Evidence: 4

scholarly journals STRATEGIES TO PROMOTE LONG-TERM CARDIAC IMPLANT SITE HEALTH: CURRENT UPDATE

2020 ◽  
pp. 30-32
Author(s):  
Pradeep Kumar Radhakrishnan ◽  
Gayathri Ananyajyothi Ambat ◽  
Nihaz Nazer ◽  
Y A Nazer
Keyword(s):  
Heart Rhythm ◽  
Well Being ◽  
Ventricular Assist Devices ◽  
Cardiac Pacemakers ◽  
Implantable Medical Devices ◽  
Ventricular Assist ◽  
Non Invasive ◽  
Invasive Techniques

Active implantable medical devices (AIMDs) are used for diagnostic, therapeutic, and rehabilitation purposes. Implants and devices improve the quality of life and well-being of the recipient. These include cardiac pacemakers (for controlling heart rhythm), ventricular assist devices (heart support), spinal cord stimulators (chronic pain management), deep brain stimulators (control symptoms of conditions, such as Parkinson’s disease, essential tremor, epilepsy, and depression), cochlear implants (enable hearing) and, more recently, bionic eyes (restore vision). Implant life and strategies to enhance it is of paramount importance. The use of non-invasive techniques like Raman Spectroscopy to match the implant and recipient characteristics and non-invasive diagnosis of rejection would be the way forward.

scholarly journals Nanobiotechnology medical applications: Overcoming challenges through innovation

2018 ◽  
Vol 2 (3) ◽  
pp. 146-160 ◽  
Author(s):  
Anthony Singer ◽  
Eleni Markoutsa ◽  
Alya Limayem ◽  
Subhra Mohapatra ◽  
Shyam S. Mohapatra
Keyword(s):  
Targeted Delivery ◽  
Surgical Techniques ◽  
Interdisciplinary Approach ◽  
Pharmacokinetic Profile ◽  
Diagnostic Techniques ◽  
Stimuli Responsive ◽  
Diagnostic Assays ◽  
Non Invasive

AbstractBiomedical Nanotechnology (BNT) has rapidly become a revolutionary force that is driving innovation in the medical field. BNT is a subclass of nanotechnology (NT), and often operates in cohort with other subclasses, such as mechanical or electrical NT for the development of diagnostic assays, therapeutic implants, nano-scale imaging systems, and medical machinery. BNT is generating solutions to many conventional challenges through the development of enhanced therapeutic delivery systems, diagnostic techniques, and theranostic therapies. Therapeutically, BNT has generated many novel nanocarriers (NCs) that each express specifically designed physiochemical properties that optimize their desired pharmacokinetic profile. NCs are also being integrated into nanoscale platforms that further enhance their delivery by controlling and prolonging their release profile. Nano-platforms are also proving to be highly efficient in tissue regeneration when combined with the appropriate growth factors. Regarding diagnostics, NCs are being designed to perform targeted delivery of luminescent tags and contrast agents that enhance the NC -aided imaging capabilities and resulting diagnostic accuracy of the presence of diseased cells. This technology has also been advancing the ability for surgeons to practice true precision surgical techniques. Incorporating therapeutic and diagnostic NC-components within a single NC can facilitate both functions, referred to as theranostics, which facilitates real-time in vivo tracking and observation of drug release events via enhanced imaging. Additionally, stimuli-responsive theranostic NCs are quickly developing as vectors for tumor ablation therapies by providing a model that facilitates the location of cancer cells for the application of an external stimulus. Overall, BNT is an interdisciplinary approach towards health care, and has the potential to significantly improve the quality of life for humanity by significantly decreasing the treatment burden for patients, and by providing non-invasive therapeutics that confer enhanced therapeutic efficiency and safety

scholarly journals Highly Versatile, Non-Invasive Method for Collecting Buccal DNA from Free-Ranging Non-Human Primates

2020 ◽  
Author(s):  
Aru Toyoda ◽  
Kazunari Matsudaira ◽  
Tamaki Maruhashi ◽  
Suchinda Malaivijitnond ◽  
Yoshi Kawamoto
Keyword(s):  
Sugar Solution ◽  
Failure Rates ◽  
Allelic Dropout ◽  
Buffer Solution ◽  
Non Invasive ◽  
Genome Wide ◽  
Invasive Method ◽  
Invasive Techniques ◽  
Free Ranging

ABSTRACTNon-invasive techniques for collection of DNA samples of suitable quality and quantity are important for improving the efficiency of genetic wildlife research. The development of a non-invasive method for collection of DNA samples from wild stump-tailed macaques (Macaca arctoides) is described herein. Polyester rope was cut into 10 cm pieces, which were then soaked in a 20% sugar solution to bait individuals. Rope swabs were immediately collected and transferred to a lysis buffer solution after subjects had picked up, chewed, and discarded them. DNA was later extracted from the buffer. Quantitative real-time PCR and both allelic dropout and genotype failure rates were used to compare the quantity and quality of the buccal DNA samples to those of intestinal slough cell DNA samples collected from freshly dropped feces. The buccal samples yielded significantly more DNA (27.1 ± 33.8 ng/μL) than did the fecal samples (11.4 ± 15.4 ng/μL) and exhibited lower allelic dropout and genotyping failure rates for the 10 autosomal microsatellites investigated. Buccal cell collection was also simple, inexpensive, reliable, and less time-consuming compared to fecal sampling. Thus, this method should facilitate genome-wide studies of non-human primates and other wildlife species.

Renal SPECT/CT with 99mTc—dimercaptosuccinic acid is a non-invasive predictive marker for the development of interstitial fibrosis in a rat model of renal insufficiency

2020 ◽  
Author(s):  
Mickaël Bobot ◽  
Guillaume Hache ◽  
Anaïs Moyon ◽  
Samantha Fernandez ◽  
Laure Balasse ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Renal Dysfunction ◽  
Renal Fibrosis ◽  
Interstitial Fibrosis ◽  
Fibrous Tissue ◽  
Predictive Marker ◽  
Renal Scintigraphy ◽  
Non Invasive ◽  
Renal Histology ◽  
Invasive Techniques

Abstract Background CKD increases cardiovascular risk and mortality. Renal fibrosis plays a major role in the progression of CKD but to date, histology remains the gold standard to assess fibrosis. Non-invasive techniques are needed to assess renal parenchymal impairment, and to perform longitudinal evaluation of renal structure. Thus, we evaluated renal isotopic imaging by SPECT/CT with 99mTc-DMSA to monitor renal impairment during renal insufficiency in rats. Methods Renal insufficiency was induced by adenine-rich diet (ARD) at 0.25% and 0.5% for 28 days. Renal dysfunction was evaluated by assaying biochemical markers and renal histology. Renal parenchymal impairment was assessed by SPECT/CT isotopic imaging with 99mTc-DMSA on days 0, 7, 14, 21, 28, 35, 49. Results Compared to control, ARD rats developed renal dysfunction characterized by increased serum creatinine and BUN, fibrosis and tubulointerstitial damage in kidneys, with dose-dependent effect of the adenine concentration. 99mTc-DMSA SPECT-CT imaging showed a significant decrease in renal uptake over time in 0.25% and 0.5% ARD rats compared to control rats (P = 0.011 and P = 0.0004 respectively). 99mTc-DMSA uptake on D28 was significantly inversely correlated with sirius red staining evaluated on D49 (r = 0.89, P < 0.0001, R2=0.67). Conclusions 99mTc-DMSA renal scintigraphy allows a longitudinal follow-up of risk of renal fibrosis in rats. We described that the reduction of renal parenchyma in ARD rats is inversely proportional to newly formed fibrous tissue in the kidney. Our results suggest that 99mTc-DMSA renal scintigraphy may be a useful prognostic non-invasive marker of the development of renal fibrosis in animals and should be tested in humans.

scholarly journals 167 EVALUATION OF SUPEROVULATORY RESPONSE IN Santa Inês EWES BY ULTRASONOGRAPHY AND LAPAROSCOPY

2010 ◽  
Vol 22 (1) ◽  
pp. 242
Author(s):  
F. Z. Brandão ◽  
E. K. N. Arashiro ◽  
M. Henry ◽  
L. M. Figueira ◽  
J. M. G. Souza ◽  
...  
Keyword(s):  
Body Condition Score ◽  
Animal Health ◽  
Surgical Techniques ◽  
Sao Paulo ◽  
Poor Responders ◽  
São Paulo ◽  
Non Invasive ◽  
Condition Score ◽  
Santa Inês ◽  
Invasive Techniques

The development and use of non-invasive techniques would reduce risks of surgery sequels on the same animal and use of the donor could be optimized. The aim of this study was to evaluate the accuracy of ultrasonography performed prior to embryo collection to estimate superovulation response in sheep. Fifteen pluriparous Santa Inês sheep, 2 to 5 year old, with an average body weight of 46.79 ± 6.00 kg and body condition score of 2.96 ± 0.32 (1 to 5 scale) were allocated into 3 groups (GI, GII, GIII) in a cross-over design. In GI, intravaginal sponges (60 mg of medroxyprogesterone acetate; Progespon®, Schering Plough Animal Health, São Paulo, Brazil) were inserted (Day 0) and maintained for 14 days, and the superovulatory (SOV) protocol started on Day 12. In GII and GIII, intravaginal sponges were inserted (Day 0) and maintained for 6 days. On Day 5, the animals were treated with 300 IU of eCG (Novormon 5000®, Schering Plough Animal Health) and 5 mg of dinoprost (Lutalyse® Pfizer Animal Health, São Paulo, Brazil) i.m. Animals in GIII received 0.025 mg of gonadorelin acetate (Gestran-Plus®, Tecnopec, São Paulo, Brazil) i.m. 12 h after sponge withdrawal. In GII and GIII, the SOV protocol started 48 h after sponge removal and a new sponge was inserted immediately after its removal. The SOV protocol in all groups consisted of 200 mg of pFSH (Folltropin-V®, Tecnopec) administered in 6 decreasing doses given every 12 h (50/50, 30/30, and 20/20 mg). At the time of the fifth dose of pFSH, 5 mg of dinoprost was administered i.m. and the sponges were removed. Animals were bred by a sexually mature ram twice a day until the end of estrus. Prior to embryo collection, an ultrasonographic evaluation (5 MHz, Aloka SSD-500, Tokyo, Japan) was performed to determine the number of CL present on both ovaries. The number of CL was further evaluated by laparoscopy, when it was possible to detect poor responders or even non-ovulating animals. Statistical analysis was performed using all tests at the 95% confidence interval by SAEG program. Results are presented as mean ± SE. The number of CL was not different among all groups. The total number (GI, GII, and GIII) of CL determined by ultrasonography (9.09 ± 5.01) was not different (P > 0.05) from that observed by laparoscopy (8.87 ± 5.25). A significant correlation (r = 0.56, P < 0.0005) between evaluation performed by ultrasonography and laparoscopy was observed. These results suggest that ultrasonography can be used to determine the response to the superovulatory protocol. As embryo collection in sheep is performed mainly by surgical techniques, the implementation of non-invasive techniques such as ultrasonography could avoid unnecessary surgeries on animals that did not respond to the SOV protocol, therefore preventing early culling of embryo donors. Financial support: Fopesq/Proppi and Faperj (E26/171.065/2006).

scholarly journals COMPLICATIONS OF AUGMENTATION MAMMOPLASTY

2020 ◽  
pp. 629-634
Author(s):  
I.V. SERGEEV ◽  
◽  
T.R. FAYZULLIN ◽  
D.P. LARIONOV ◽  
◽  
...  
Keyword(s):  
First Generation ◽  
Breast Implant ◽  
Capsular Contracture ◽  
Late Complication ◽  
Large Cell ◽  
Augmentation Mammoplasty ◽  
Double Bubble ◽  
Clear Idea

Augmentation mammoplasty is one of the most demanded and most frequently performed plastic surgeries in the world. The first breast augmentation using first-generation implants performed in 1962. Since, the surgery technique and the quality of implants have been improved. Although the number of complications significantly decreased, they still occur both in the early and the late postoperative periods. Often complications include seroma, hematoma, asymmetry, double bubble (double fold), implant displacement, rippling, capsular contracture, etc. The most formidable late complication described in 1997, is breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which is manifested more than after a year, by the formation of the late malignant seroma after implantation. A review of modern literature provides a clear idea of the number of received complications. However, the pathogenesis of the development of some of them (capsular contracture, implant-associated lymphoma) is still unclear, and therefore, further long-term studies are needed to obtain more accurate data. Keywords: Augmentation mammoplasty, double fold (double bubble), capsular contracture, seroma, hematoma, implant-associated lymphoma.

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