Complications associated with submental liposuction:a scoping review

Liposuction is one of the most commonly performed cosmetic procedures worldwide. Complications associated with submental liposuction are rare. However, when they occur they are significant and can cause disFiguring consequences. The objective of this study was evaluated complications from submentual liposuction in literature and description of clinical experience of complication after submentual liposuction. At first, a scoping review was carried out online search with no time restrictions for complications after submental liposuction was performed in the databases Medline / PubMed, Embase, and Web of Science. The variables analyzed were: age, sex, type of esthetic procedure, anesthesia, complications, time after Procedure, treatment, follow-up care, and sequelae. Then, a case of a patient with submental hematoma after an aesthetic procedure for submental liposuction was described. Firstly, 539 articles were selected, after application of the inclusion criteria, 4 studies were included. Most cases were female (8:1), with a mean age of 55.77 years. Postoperative complications were found, such as submental depression, submental edema, hypertrophic scar formation, scar contracture, cervical necrotizing fasciitis, Cervico-facial dystonia and transient facial nerve paralysis. The follow-up period for cases ranged from 3 to 12 months. The clinical case presented there was no sequelae. Submental liposuction requires the surgeon's attention. Anatomical knowledge, correct clinical and surgical management, diagnosis, and immediate approach to adverse situations are points that must be respected in this type of esthetic procedure to avoid more serious complications

Sinusectomia maxilar via endoscópica como tratamento da rinossinusite crônica oriunda de fístula oroantral / Maxillary sinusectomy via endoscopy as treatment of chronic rhinosinusitis from oroantral fistula

O seio maxilar define-se por um espaço pneumático na maxila bilateralmente que possui volume e proximidade com os ápices de 2º pré-molares e molares superiores, possibilitando que intervenções nestes afetem sua integridade, levando a inflamação e podendo resultar em Rinossinusite Crônica (RSC).  Este estudo visa elucidar a atribuição da cirurgia endoscópica para tratamento da RSC através de um relato de caso clínico. Paciente sexo masculino, 50 anos, compareceu ao serviço de CTBMF do Hospital da Restauração – PE, com algesia em região zigomático-maxilar direita e comunicação oroantral, há sete meses, por exodontia traumática do elemento 15, já submetido à terapêuticas clínicas, sem sucesso. Diagnosticou-se ao exame físico e de imagem, RSC secundária, optando pela sinusectomia via endoscópica ântero-posterior acessando o seio maxilar direito por antrostomia maxilar na parede nasal lateral, removendo a mucosa doente e instalando um dreno de manutenção. Concomitantemente, fechou-se a comunicação bucossinusal por um retalho na mucosa vestibular maxilar recobrindo toda falha, sob anestesia geral. No pós-operatório imediato, iniciou-se antibioticoterapia, analgesia e irrigação com soro fisiológico 0,9%, pelo dreno, removido após 72 horas. A cirurgia endoscópica como tratamento da RSC mostra-se uma alternativa quando há falha terapêutica clínica, apresentando melhora da sintomatologia e qualidade de vida dos pacientes.

Studies of the mass composition of cosmic rays and proton-proton interaction cross-sections at ultra-high energies with the Pierre Auger Observatory

In this work, we present an estimate of the cosmic-ray mass composition from the distributions of the depth of the shower maximum (Xmax) measured by the fluorescence detector of the Pierre Auger Observatory. We discuss the sensitivity of the mass composition measurements to the uncertainties in the properties of the hadronic interactions, particularly in the predictions of the particle interaction cross-sections. For this purpose, we adjust the fractions of cosmic-ray mass groups to fit the data with Xmax distributions from air shower simulations. We modify the proton-proton cross-sections at ultra-high energies, and the corresponding air shower simulations with rescaled nucleus-air cross-sections are obtained via Glauber theory. We compare the energy-dependent composition of ultra-high-energy cosmic rays obtained for the different extrapolations of the proton-proton cross-sections from low-energy accelerator data

Study of downward Terrestrial Gamma-ray Flashes with the surface detector of the Pierre Auger Observatory

The surface detector (SD) of the Pierre Auger Observatory, consisting of 1660 water-Cherenkov detectors (WCDs), covers 3000 km2 in the Argentinian pampa. Thanks to the high efficiency of WCDs in detecting gamma rays, it represents a unique instrument for studying downward Terrestrial Gamma-ray Flashes (TGFs) over a large area. Peculiar events, likely related to downward TGFs, were detected at the Auger Observatory. Their experimental signature and time evolution are very different from those of a shower produced by an ultrahigh-energy cosmic ray. They happen in coincidence with low thunderclouds and lightning, and their large deposited energy at the ground is compatible with that of a standard downward TGF with the source a few kilometers above the ground. A new trigger algorithm to increase the TGF-like event statistics was installed in the whole array. The study of the performance of the new trigger system during the lightning season is ongoing and will provide a handle to develop improved algorithms to implement in the Auger upgraded electronic boards. The available data sample, even if small, can give important clues about the TGF production models, in particular, the shape of WCD signals. Moreover, the SD allows us to observe more than one point in the TGF beam, providing information on the emission angle

The dynamic range of the upgraded surface-detector stations of AugerPrime

The detection of ultra-high-energy cosmic rays by means of giant detector arrays is often limited by the saturation of the recorded signals near the impact point of the shower core at the ground, where the particle density dramatically increases. The saturation affects in particular the highest energy events, worsening the systematic uncertainties in the reconstruction of the shower characteristics. The upgrade of the Pierre Auger Observatory, called AugerPrime, includes the installation of an 1-inch Small PhotoMultiplier Tube (SPMT) inside each water-Cherenkov station (WCD) of the surface detector array. The SPMT allows an unambiguous measurement of signals down to about 250m from the shower core, thus reducing the number of events featuring a saturated station to a negligible level. In addition, a 3.8m2 plastic scintillator (Scintillator Surface Detector, SSD) is installed on top of each WCD. The SSD is designed to match the WCD (with SPMT) dynamic range, providing a complementary measurement of the shower components up to the highest energies. In this work, the design and performances of the upgraded AugerPrime surface-detector stations in the extended dynamic range are described, highlighting the accuracy of the measurements. A first analysis employing the unsaturated signals in the event reconstruction is also presented

Combined fit to the spectrum and composition data measured by the Pierre Auger Observatory including magnetic horizon effects

The measurements by the Pierre Auger Observatory of the energy spectrum and mass composition of cosmic rays can be interpreted assuming the presence of two extragalactic source populations, one dominating the flux at energies above a few EeV and the other below. To fit the data ignoring magnetic field effects, the high-energy population needs to accelerate a mixture of nuclei with very hard spectra, at odds with the approximate E$^{-2}$ shape expected from diffusive shock acceleration. The presence of turbulent extragalactic magnetic fields in the region between the closest sources and the Earth can significantly modify the observed CR spectrum with respect to that emitted by the sources, reducing the flux of low-rigidity particles that reach the Earth. We here take into account this magnetic horizon effect in the combined fit of the spectrum and shower depth distributions, exploring the possibility that a spectrum for the high-energy population sources with a shape closer to E$^{-2}$ be able to explain the observations