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Background:. The first visible change in an aging face and neck is the loss of neck contour, which can be corrected by treating the platysmal bands; however, it remains unclear as to which is the best strategy to approach these bands. The aim of the present study is to verify whether the lateral platysmal bands approaches, before the medial ones, cause widening of the gap between them. Methods:. This is a prospective, randomized, comparative study involving 30 individuals presenting various stages of neck and facial flaccidity and sagging. The patients were split into 2 groups according to the lateral platysmal approach (group A: lateral platysmal traction/plication; group B: lateral platysmal undermined/traction). A protocol was established to measure the gap between the medial bands, 3 and 5 cm away from the chin, before and after superficial musculoaponeurotic system/platysma lateral suspension. Measurements were taken using a compass and a ruler. The endpoint was to determine whether the gap between the medial platysmal bands widens after the lateral procedure. Results:. Group A, first measure (1-M): the gap ranged between 1.0 and 1.6 cm in point M3 (3 cm away from chin) and between 1.8 and 3.0 cm in point M5 (5 cm away from chin) (mean in M3 = 1.2; SD, 0.22 and mean in M5 =2.3; SD, 0.52). Group A, second measure (2-M): the measure ranged between 1.0 and 1.7 cm in point M3 and between 1.8 and 3.2 cm in point M5 (mean = 1.28; SD, 0.25 and mean = 2.42; SD, 0.63, respectively). Group B, first measure (1-M): the gap ranged between 1.1 and 1.7 cm in M3 (mean = 1.32; SD, 0.21) and between 1.8 and 3.2 cm in M5 (mean = 2.38; SD, 0.57). Group B, second measure (2-M): the measure ranged between 1.2 and 1.7 cm in M3 (mean = 1.4; SD, 0.18) and between 2.0 and 3.2 cm in M5 (mean = 2.5; SD, 0.55). Group A: P = 0.07 (M3) and 0.10 (M5); Group B: P = 0.09 (M3) and 0.07 (M5). Conclusion:. The lateral platysmal approach, plication or undermined, does not lead to a widening of the gap between the medial platysmal bands.

INTRODUÇÃO: A trombose venosa profunda (TVP) e o seu desfecho imediato mais grave, o tromboembolismo pulmonar (TEP), são complicações de incidência elevada em pacientes hospitalizados e principalmente naqueles submetidos à cirurgia. OBJETIVO: Apresentar o protocolo de profilaxia de Tromboembolismo (TEV) da Clínica Ivo Pitanguy, mostrando a incidência de TEV no Serviço antes e após a introdução deste protocolo, assim como a incidência de hematomas, no período de cinco anos. MÉTODO: Estudo de revisão dos prontuários dos pacientes operados no período de julho de 2004 a maio de 2009. Comparou-se a incidência de eventos trombóticos antes e após a introdução do protocolo, assim como a incidência de hematomas. RESULTADOS: Foram analisados 1700 prontuários. Desde a introdução do protocolo, não ocorreu nenhum caso de tromboembolismo venoso, em 711 pacientes operados. A incidência de hematomas com necessidade de revisão cirúrgica foi reduzida, provavelmente pelo controle pressórico mais rigoroso após a introdução do protocolo. CONCLUSÃO: O protocolo tem se mostrado de utilização simples e efetiva. Houve redução da incidência de TEV e hematomas a partir de sua introdução.BACKGROUND: The deep vein thrombosis (DVT) and its most dangerous outcome, the pulmonary embolism (PE), are complications of high incidence in hospitalized patients and in those submitted to surgery. OBJECTIVE: This study presents the guideline to prevention of thromboembolism at Ivo Pitanguy Clinic and its incidence before and after the introduction of this protocol, in a period of five years. We also relate the incidence of hematoma before and after the beginning of the protocol. METHODS: The study consists of the revision of the medical records of all patients operated between July 2004 and May 2009. We compared the incidence of thromboembolic events before and after the beginning of the protocol as well as the incidence of hematomas that were submitted to revision at the surgery room. RESULTS: Analyzing 1700 medical records, since the introduction of the guideline of prevention of VTE, there is no case of VTE in 711 operated patients. The incidence of reoperated hematomas at the surgery room was reduced, maybe because there was a more rigorous control of the blood pression after the introduction of the guideline. CONCLUSION: The guideline has shown itself practical and simple use. There were reduction in cases of VTE and hematomas after its introduction.

INTRODUÇÃO: A cirurgia de aumento mamário foi a cirurgia plástica mais realizada no Brasil, em 2008. Com a evolução da técnica e da qualidade dos implantes de silicone, a taxa de complicações tem diminuído progressivamente, tornando a cirurgia mais segura. OBJETIVO: Demonstrar o perfil das pacientes submetidas à troca de implante mamário, nos últimos cinco anos, na Clínica Ivo Pitanguy, analisando as características dos implantes de silicone e as causas que motivaram a troca. MÉTODO: Foram analisadas, retrospectivamente, todas as pacientes submetidas a procedimentos cirúrgicos de troca, retirada ou reinclusão de implantes mamários, nos últimos cinco anos, num total de 59 pacientes em 68 procedimentos e 129 mamas operadas. RESULTADOS: O intervalo de tempo entre a colocação e a retirada dos implantes variou de 1 mês a 34 anos; 44 pacientes eram provenientes do nosso serviço e 24 de outros. Quarenta e três implantes eram, antes da troca, de poliuretano, 13 texturizados e seis lisos. O grande motivo de troca foi estético, com 50 casos, seguido por contratura capsular em 13 casos, e cinco casos de infecção, ruptura ou nódulo mamário. CONCLUSÃO: O principal motivo de troca de implantes foi estético, diferentemente da literatura. Os índices de contratura capsular e de infecção da loja do implante do presente estudo foram comparáveis aos apresentados em vários outros estudos.BACKGROUND: The breast augmentation surgery was the most performed in Brazil in 2008. With the evolution of the technique and the quality of the implants, complications have diminished, leading to a more secure procedure. OBJECTIVE: To assess the profile of patients submitted to implant exchange in the last five years at Ivo Pitanguy Clinic, analyzing the causes that led to implant removal. METHODS: We have analyzed all patients submitted to exchange, removal or replacement of mammary implants in the last five years, at a total of 59 patients, 68 procedures and 129 breasts operated. RESULTS: The time interval from the inclusion to the removal of the implants ranged from one month to 34 years; 44 patients have first operated at our service and 24 at other services. Forty three implants were, before the exchange, made of polyurethane, 13 texturized and six smooth. The major cause of the exchange was esthetic, with 50 cases, followed by capsular contracture, 13 cases and five cases of infection, rupture or breast nodule. CONCLUSION: The major reason of implants exchange was esthetic, differing from the literature. The capsular contracture and infection rates, at this study, were comparable to several others.

INTRODUÇÃO: Eventos tromboembólicos causam grande preocupação, em decorrência das altas taxas de morbidade e mortalidade existentes e da possibilidade de apresentação clínica com sintomas escassos e, muitas vezes, inespecíficos. A prevenção é a maneira mais eficaz de lidar com esse tipo de evento, que, uma vez estabelecido, pode levar rapidamente à morte. MÉTODO: Foi realizado estudo retrospectivo, no período entre maio de 2009 e maio de 2010, com pacientes submetidos a cirurgia plástica no Instituto Ivo Pitanguy. Todos os pacientes foram submetidos ao protocolo de prevenção de tromboembolismo venoso, após serem avaliados quanto aos fatores predisponentes e de risco. A soma desses fatores gerou uma pontuação, que determinou a profilaxia a ser adotada. RESULTADOS: Foram avaliados 1.351 pacientes durante o período de um ano. Não houve incidência de tromboembolismo venoso. Foram observados 16 casos de hematoma, 9 (56,25%) deles ocorreram após profilaxia com heparina e 7 (43,75%) sem o uso de quimioprofilaxia. CONCLUSÕES: O protocolo para prevenção de tromboembolismo venoso no Instituto Ivo Pitanguy foi eficaz, sem ocorrência de eventos tromboembólicos e com incidência de hematomas abaixo da encontrada na literatura médica.

Green chemistry principles are pivotal in driving sustainable and innovative solutions to global health challenges. This study explores a hydroalcoholic extract from Castanea sativa (chestnut) burrs, an underutilized natural resource, as a potent source of antimicrobial compounds against Helicobacter pylori (H. pylori). The extract demonstrated significant bactericidal activity, synergizing effectively with clarithromycin and showing additive effects with metronidazole. Remarkably, combining the extract with clarithromycin and sub-inhibitory concentrations of pantoprazole reduced clarithromycin’s Minimum Bactericidal Concentration (MBC) to just 1.56% of its original value. Mechanistic studies suggest that the extract’s polyphenolic compounds compromise bacterial membrane integrity, enhancing antibiotic uptake, while pantoprazole disrupts bacterial ATPase activity. This research highlights the critical role of natural product extraction within the framework of green chemistry, offering a sustainable and environmentally friendly alternative to synthetic antimicrobials. By harnessing bioactive compounds from plant sources, this approach addresses the pressing issue of antibiotic resistance while promoting the responsible use of natural resources. The findings underscore the transformative potential of green chemistry in developing effective, eco-conscious antimicrobial therapies that align with global sustainability goals.