Background:Quality of life (QoL) is an important outcome in plastic surgery. However, authors use different scales to address this subject, making it difficult to compare the outcomes. To address this discrepancy, the aim of this study was to perform a systematic review and a random effect meta-analysis.Methods:The search was made in two electronic databases (LILACS and PUBMED) using Mesh and non-Mesh terms related to aesthetic plastic surgery and QoL. We performed qualitative and quantitative analyses of the gathered data. We calculated a random effect meta-analysis with Der Simonian and Laird as variance estimator to compare pre- and postoperative QoL standardized mean difference. To check if there is difference between aesthetic surgeries, we compared reduction mammoplasty to other aesthetic surgeries.Results:Of 1,715 identified, 20 studies were included in the qualitative analysis and 16 went through quantitative analysis. The random effect of all aesthetic surgeries shows that QoL improved after surgery. Reduction mammoplasty has improved QoL more than other procedures in social functioning and physical functioning domains.Conclusions:Aesthetic plastic surgery increases QoL. Reduction mammoplasty seems to have better improvement compared with other aesthetic surgeries.
OBJETIVO: Quantificar a experiência clínica do Serviço de Cirurgia Geral do Complexo Hospitalar da Santa Casa de Porto Alegre, criando um diagnóstico epidemiológico de demanda e traçando um perfil do paciente de risco de evisceração, através da análise do manejo e conduta mais adequados. MÉTODO: No período de 2000 a 2001, foram estudados prospectivamente 1182 pacientes submetidos a laparotomias, dos quais 13 evoluiram com evisceração. RESULTADOS: Dos 13 pacientes eviscerados, 69,2% eram homens, com idade média de 55,9 anos. A neoplasia foi a patologia de base mais prevalente (61,5%), e o tempo médio de evisceração foi de 12,1 dias. A albumina sérica média encontrada foi de 2,8 g/dl e a sutura contínua a técnica de fechamento mais utilizada no Serviço. CONCLUSÃO: O perfil do paciente eviscerado nesta série,inclui homens com mais de 50 anos e obesos, com doença maligna e hipoalbuminemia. Esses pacientes têm maior probabilidade de desenvolver complicações locais, tais como infecção e aumento da pressão intra-abdominal, contribuindo para a deiscência total da parede abdominal. A análise destes fatores deve ser imperiosa na decisão de ancoragem primária dessa população.
SUMMARY A patient with endogenously acquired Clostridium septicum panophthalmitis is presented. The patient exhibited a striking sequence of signs and symptoms associated with this devastating ocular infection. Intensive antibiotic therapy was ineffective and enucleation of the globe was required. The microscopic pathology of the enucleated globe showed extensive infarction and necrosis of ocular structures in association with the panophthalmitis. In addition thrombosis of the central retinal artery and of choroidal vessels was observed. Physical examination revealed a Caucasian male appearing acutely ill with abdominal pain, mild diaphoresis, and chills. Vital signs on admission were blood pressure 150/68 mmHg, pulse 100/minute and regular, respiratory rate 32/minute, and temperature 38-90C. Eye examination by his internist at this time showed the pupils to be equal and reactive to light, and a funduscopic examination showed nothing abnormal. On cardiovascular examination a grade 3/6 systolic murmur was heard. The abdominal examination revealed decreased bowel sounds, with diffuse tenderness, especially in the right upper quadrant. There was no rebound or guarding tenderness. On rectal examination no masses were felt. Occult blood was detected in the stools. The remainder of the physical examination was unremarkable.Laboratory data on admission showed a white cell count of 23.7x 109/l, with 88 polymorphonuclear cells and 10 band forms per 100 cells. The haemoglobin was 13-1 g/dl and the packed cell volume (haematocrit) was 0-37. Other significant values include a blood urea nitrogen level of 24 mg/dl (4-0 mmol/l), creatinine of 1*3 mg/dl (115 itmol/l), and a decreased total protein and albumin of 5.2 g/dl (52 g/l) and 2*9 g/dl (29 g/1), respectively. Radiological examination included chest, anteroposterior plane film of the abdomen, biliary tree scan, and intravenous pyelogram. All these studies were within normal limits. A peritoneal lavage was negative for red blood cells. The differential diagnosis at this time included subacute bacterial endocarditis, pneumonia, or a primary abdominal process such as 380 on 12 May 2018 by guest. Protected by copyright.
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