Correction of bifid nose with tongue-in-groove technique in patient with Tessier fissure 0-14

Madelung’s disease (MD) or Multiple Symmetric Lipomatosis is a condition characterized by the accumulation of unencapsulated adipose tissue deposited symmetrically around the neck and upper trunk (type I - most common form). Its etiology is still unclear, but it is clearly associated with chronic excessive consumption of alcoholic beverages. Physical deformities lead the patient to seek medical care, along with possible symptoms of cervical involvement such as reduced mobility and respiratory disorders. Multiple Symmetric Lipomatosis diagnosis is clinical and can be complemented with imaging to rule out other diagnostic hypotheses and assess the extent of involvement. Treatment can be performed in two ways: clinical or surgical (lipectomy or liposuction). We report the case of a patient with Multiple Symmetric Lipomatosis type I surgically treated with both techniques: cervical lipectomy and abdominal liposuction. The patient evolved satisfactorily, with a reduction in complaints and no recurrences so far

Scalp reconstruction with expanded flap

Introduction: The presence of extensive scalp defects is a major reconstructive challenge for the plastic surgeon. These defects have a vast etiology, such as traumatic, thermal or electrical burns, benign and malignant or congenital tumor resections, radiotherapy treatments sequelae, and infections. Noting that injuries such as scalping and burns (thermal or electrical), generate significant repercussions such as severe tissue loss, chronic osteomyelitis or minor sequelae such as scar alopecia. This study aims to report a case of late scalp reconstruction with a tissue expander and posterior advancement flap, due to cicatricial alopecia, in an 11-year-old female, victim of scalding by hot water in the right frontotemporal region. Methods: It was performed a retrospective analysis of the patient's medical record. The present work follows the standards of the Helsinki ethics committee. Conclusion: The scalp tissue expansion technique by stages and subsequent scalp advancement flap performing proved to be effective in restoring the patient's hair structure and hairline with minimal local distortion, restoring the scalp's shape and aesthetics of the patient

Osmoprotectants play a major role in the Portulaca oleracea resistance to high levels of salinity stress—insights from a metabolomics and proteomics integrated approach

IntroductionPurslane (Portulaca oleracea L.) is a non-conventional food plant used extensively in folk medicine and classified as a multipurpose plant species, serving as a source of features of direct importance to the agricultural and agri-industrial sectors. This species is considered a suitable model to study the mechanisms behind resistance to several abiotic stresses including salinity. The recently achieved technological developments in high-throughput biology opened a new window of opportunity to gain additional insights on purslane resistance to salinity stress—a complex, multigenic, and still not well-understood trait. Only a few reports on single-omics analysis (SOA) of purslane are available, and only one multi-omics integration (MOI) analysis exists so far integrating distinct omics platforms (transcriptomics and metabolomics) to characterize the response of purslane plants to salinity stress.MethodsThe present study is a second step in building a robust database on the morpho-physiological and molecular responses purslane to salinity stress and its subsequent use in attempting to decode the genetics behind its resistance to this abiotic stress. Here, the characterization of the morpho-physiological responses of adult purslane plants to salinity stress and a metabolomics and proteomics integrative approach to study the changes at the molecular level in their leaves and roots is presented.Results and discussionAdult plants of the B1 purslane accession lost approximately 50% of the fresh and dry weight (from shoots and roots) whensubmitted to very high salinity stress (2.0 g of NaCl/100 g of the substrate). The resistance to very high levels of salinity stress increases as the purslane plant matures, and most of the absorbed sodium remains in the roots, with only a part (~12%) reaching the shoots. Crystal-like structures, constituted mainly by Na+, Cl−, and K+, were found in the leaf veins and intercellular space near the stoma, indicating that this species has a mechanism of salt exclusion operating on the leaves, which has its role in salt tolerance. The MOI approach showed that 41 metabolites were statistically significant on the leaves and 65 metabolites on the roots of adult purslane plants. The combination of the mummichog algorithm and metabolomics database comparison revealed that the glycine, serine, and threonine, amino sugar and nucleotide sugar, and glycolysis/gluconeogenesis pathways were the most significantly enriched pathways when considering the total number of occurrences in the leaves (with 14, 13, and 13, respectively) and roots (all with eight) of adult plants; and that purslane plants employ the adaptive mechanism of osmoprotection to mitigate the negative effect of very high levels of salinity stress; and that this mechanism is prevalent in the leaves. The multi-omics database built by our group underwent a screen for salt-responsive genes, which are now under further characterization for their potential to promote resistance to salinity stress when heterologously overexpressed in salt-sensitive plants

RELATIONSHIP BETWEEN NUTRITIONAL STATUS AND THE CLINICAL OUTCOMES OF PATIENTS WITH AND WITHOUT NEOPLASMS ACCORDING TO MULTIPLE CORRESPONDENCE ANALYSIS

ABSTRACT BACKGROUND For many years, many studies have reported undesirable outcomes that may occur during the hospital stay of patients diagnosed with malnutrition or even at some nutritional risk. OBJECTIVE To investigate the relationship between nutritional status and clinical outcomes during hospital stay using the multiple correspondence analysis technique. METHODS This cross-sectional study included 600 patients with and without neoplasms. The following data were collected: subjective global assessment, nutritional indicators, nutritional risk screening, anthropometric data (body mass index (BMI), mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MUAMC), triceps skinfold thickness (TST), recent weight loss (RWL)), and habitual energy intake (HEI/ER <75%). The clinical outcomes of interest were complications, length of hospital stay (LOHS), and death. The data were analyzed by the chi-square or Fisher&#8217;s exact test at a significance level of 5%. Multiple correspondence analysis was used for the multivariate data analysis. RESULTS The multiple correspondence analysis map for the patients with neoplasms showed that the following characteristics were associated and represented by death, complications, and a greater likelihood of LOHS &#8805;7 days: underweight according to BMI; TST, MUAC, and MUAMC &#8804;15th percentile; malnutrition according to the subjective global assessment; at nutritional risk according to the nutritional risk screening; being male; age &#8805;60 years; and HEI/ER <75%. The multiple correspondence analysis map for the patients without neoplasms showed that the following characteristics were associated and represented by death: underweight according to BMI; TST &#8804;15th percentile; malnutrition according to the subjective global assessment; and at nutritional risk according to the nutritional risk screening. Complications and LOHS &#8805;7 days represented the categories male, no recent weight loss, HEI/ER <75%, MUAC and MUAMC &#8804;15th percentile, TST between the 15th and 85th percentiles, and age <60 years. CONCLUSION The results of this study confirm an association between unsatisfactory nutritional indicators and undesirable clinical outcomes

Investigation of nutritional risk factors using anthropometric indicators in hospitalized surgery patients

CONTEXT: The investigation of risk factors associated with nutritional status could contribute for better knowledge of the malnutrition. OBJECTIVE: To investigate the incidence of malnutrition and its possible association with many parameters that assess nutritional status and to identify the associated risk factors. METHODS: The nutritional status was assessed in 235 hospitalized patients. Malnutrition was defined as present when the patient presented at least two anthropometric criteria below the normal range and habitual energy intake below 75% of the energy requirement (HEI/ER<75%). Gender, age, type of disease, recent weight change and dental problems were investigated as possible associated risk factors. The chi-square and Mann-Whitney tests were used to compare the data and univariate and multiple logistic regressions were used to identify the factors associated with malnutrition. The odds ratio (OR) and confidence interval (CI) of 95% were calculated with the significance level set at 5% (P<0.05). RESULTS: One-fifth (20%) of the patients were malnourished on admission to the hospital and 27.5% reported recent weight loss. Malnutrition (P<0.0001) was greater in patients with malignant diseases. The only variables significantly associated with malnutrition according to univariate logistic regression were recent weight loss (P = 0.0058; OR = 2.909; IC95% = 1.362; 6.212) and malignant disease (P = 0.0001; OR = 3.847; IC95% = 1.948; 7.597). When multiple regression was used in the model which included type of disease, malignant disease was shown to increase the chance of malnutrition fourfold (P = 0.0002; OR = 3.855; IC95% = 1.914; 7.766). When disease was excluded, recent weight loss also increased malnutrition fourfold (P = 0.0012; OR = 3.716; IC95% = 1.677; 8.236). CONCLUSION: Patients with a history of recent weight loss and those with malignant diseases are more susceptible to malnutrition