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[PMID]:29419662
[Au] Autor:Pu Y; Mao TC; Zhang YM; Wang SL; Fan DL
[Ad] Endereço:Department of Plastic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
[Ti] Título:The role of postmastectomy radiation therapy in patients with immediate prosthetic breast reconstruction: A meta-analysis.
[So] Source:Medicine (Baltimore);97(6):e9548, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The controversy remains as to whether immediate prosthetic breast reconstruction with postmastectomy radiation therapy (PMRT) is associated with acceptable complications and aesthetic outcomes. The aim of this meta-analysis was to provide a pooled analysis of comparative clinical studies that evaluated breast cancer patients who were treated with a mastectomy and an immediate prosthetic breast reconstruction to compare the complications and satisfaction of those who underwent or did not undergo PMRT. METHODS: According to the recommendations of the Cochrane Collaboration, we established a rigorous study protocol. We performed a systematic electronic search of the PubMed and Embase databases to identify articles for inclusion in our meta-analysis. Reconstruction failure, overall complications, capsular contracture, and patient satisfaction were analyzed individually. RESULTS: Fifteen controlled trials were included, comprising 5314 patients (1069 PMRT vs 4245 non-PMRT). Primary outcomes revealed a statistically significant increase in overall complications [odds ratio (OR) 3.45; 95% confidence interval (95% CI) 2.62-4.54; P < .00001], reconstruction failure (OR: 2.59; 95% CI 1.46-4.62; P = .001), and capsular contracture (OR: 5.26, 95% CI: 2.73-10.13, P < .00001) after receiving PMRT. CONCLUSION: Our review found that PMRT for patients who underwent immediate implant-based breast reconstruction led to higher risks of reconstruction failure, overall complications, and capsular contracture. However, it is still the standard adjuvant therapy for mastectomy patients who have opted for immediate implant-based breast reconstruction.
[Mh] Termos MeSH primário: Implante Mamário/métodos
Neoplasias da Mama/radioterapia
Radioterapia Adjuvante/métodos
[Mh] Termos MeSH secundário: Neoplasias da Mama/cirurgia
Feminino
Seres Humanos
Mastectomia/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009548


  2 / 1726 MEDLINE  
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[PMID]:29280860
[Au] Autor:Nava MB; Adams WP; Botti G; Campanale A; Catanuto G; Clemens MW; Del Vecchio DA; De Vita R; Di Napoli A; Hall-Findlay E; Hammond D; Heden P; Mallucci P; Martin Del Yerro JL; Muti E; Rancati A; Randquist C; Salgarello M; Stan C; Rocco N
[Ad] Endereço:Como, Milan, Naples, Catania, Salò, and Turin, Italy; Dallas and Houston, Texas; Boston, Mass.; Grand Rapids, Mich.; Alberta, British Columbia, Canada; Stockholm and Halmstad, Sweden; London, United Kingdom; Madrid, Spain; Buenos Aires, Argentina; and Bucharest, Romania From Valduce Hospital; the University of Milan; the G.Re.T.A. Group for Reconstructive and Therapeutic Advancements; the Department of Clinical Medicine and Surgery, University of Naples "Federico II"; Villa Bella Clinic; the General Directorate of Medical Devices and Pharmaceutical Services, Italian Ministry of Health; National Cancer Institute "Regina Elena"; the Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital; the Department of Plastic Surgery, Catholic University of Sacred Heart, University Hospital A. Gemelli; the Multidisciplinary Breast Unit, Azienda Ospedaliera Cannizzaro; University of Turin; the University of Texas Southwestern Medical Center; M. D. Anderson Cancer Center; Private practice; Partners in Plastic Surgery; Banff Plastic Surgery; Akademikliniken; Viktoriakliniken; London Royal Free Hospital; Plastic, Aesthetic and Reconstructive Surgery Department, Hospital Quiròn; Instituto Henry Moore, University of Buenos Aires; and S Clinic.
[Ti] Título:MBN 2016 Aesthetic Breast Meeting BIA-ALCL Consensus Conference Report.
[So] Source:Plast Reconstr Surg;141(1):40-48, 2018 01.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon neoplasia occurring in women with either cosmetic or reconstructive breast implants. The actual knowledge about BIA-ALCL deriving from the literature presents several limits, and it remains difficult to make inferences about BIA-ALCL epidemiology, cause, and pathogenesis. This is the reason why the authors decided to organize an evidence-based consensus conference during the Maurizio Bruno Nava (MBN 2016) Aesthetic Breast Meeting held in Milan in December of 2016. Twenty key opinion leaders in the field of plastic surgery from all over the world have been invited to express and discuss their opinion about some key questions on BIA-ALCL, trying to reach a consensus about BIA-ALCL cause, pathogenesis, diagnosis, and treatment in light of the actual best evidence.
[Mh] Termos MeSH primário: Implante Mamário
Linfoma Anaplásico de Células Grandes/etiologia
Complicações Pós-Operatórias/etiologia
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Linfoma Anaplásico de Células Grandes/diagnóstico
Linfoma Anaplásico de Células Grandes/terapia
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/terapia
[Pt] Tipo de publicação:CONSENSUS DEVELOPMENT CONFERENCE; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003933


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[PMID]:29280857
[Au] Autor:Galdiero M; Larocca F; Iovene MR; Francesca M; Pieretti G; D'Oriano V; Franci G; Ferraro G; d'Andrea F; Nicoletti GF
[Ad] Endereço:Naples, Italy From the Department of Plastic, Reconstructive and Aesthetic Surgery, the Department of Experimental Medicine, Section of Virology and Microbiology, Università della Campania Luigi Vanvitelli; the Unit of Plastic, Reconstructive and Aesthetic Surgery, Università Federico II; and the Department of Public Health.
[Ti] Título:Microbial Evaluation in Capsular Contracture of Breast Implants.
[So] Source:Plast Reconstr Surg;141(1):23-30, 2018 01.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Capsular contracture around breast implants is a severe and unpredictable complication experienced by up to 50 percent of patients after breast augmentation and reconstruction, and represents a major cause leading to reoperation. Several lines of evidence point to the involvement of subclinical infections and of bacterial biofilm formation. METHODS: To reduce the incidence of capsular contracture following mammaplasty, the authors studied the correlation between contamination by exogenous and endogenous bacterial flora and the capacity to develop bacterial biofilm in mammary implants. The authors performed a microbiological study assessing microbial growth of swabs from breast skin, nipple-areola complex, and mammary gland biopsy specimens. Furthermore, the authors compared the results with the data resulting from cultural experiments from biopsy specimens of periprosthetic capsule, contracted or not, and from the surfaces of the relative prosthesis. RESULTS: Between July of 2012 and July of 2013, a series of 65 female patients from the area of Naples, Italy, and its province, who underwent breast plastic surgery with the use of implants for aesthetic or reconstructive reasons, were included in the study. The authors noticed that there is a greater tendency for capsular contracture to form in oncologic patients who received radiotherapy, patients with precedent capsular contracture, and patients with cutaneous contamination by biofilm-producing microbes. CONCLUSIONS: Although all of the new technical procedures tend to reduce the amount of bacterial charge that comes into contact with the prosthesis at the time of its introduction, a minimal amount must always be taken for granted. This is the rationale for a preventative personalized antibiotic therapy. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
[Mh] Termos MeSH primário: Biofilmes
Implante Mamário/instrumentação
Implantes de Mama/microbiologia
Mama/microbiologia
Contratura Capsular em Implantes/microbiologia
Infecções Relacionadas à Prótese/microbiologia
Pele/microbiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Biópsia
Mama/patologia
Mama/cirurgia
Implantes de Mama/efeitos adversos
Candida albicans/isolamento & purificação
Candida albicans/fisiologia
Candidíase/diagnóstico
Candidíase/microbiologia
Estudos de Casos e Controles
Feminino
Seguimentos
Seres Humanos
Infecções por Klebsiella/diagnóstico
Infecções por Klebsiella/microbiologia
Klebsiella pneumoniae/isolamento & purificação
Klebsiella pneumoniae/fisiologia
Meia-Idade
Infecções Relacionadas à Prótese/diagnóstico
Fatores de Risco
Pele/patologia
Infecções Estafilocócicas/diagnóstico
Infecções Estafilocócicas/microbiologia
Staphylococcus/isolamento & purificação
Staphylococcus/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003915


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[PMID]:29280858
[Au] Autor:Campanale A; Boldrini R; Marletta M
[Ad] Endereço:Rome, Italy From the General Directorate of Medical Devices and Pharmaceutical Services, Medical Device Vigilance System and Inspections, Italian Ministry of Health.
[Ti] Título:22 Cases of Breast Implant-Associated ALCL: Awareness and Outcome Tracking from the Italian Ministry of Health.
[So] Source:Plast Reconstr Surg;141(1):11e-19e, 2018 01.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To date, 359 cases of anaplastic large cell lymphoma (ALCL) in women with breast implants (breast implant-associated ALCL [BIA-ALCL]) worldwide have been reported among more than 10 million patients who have received implants, but health care authorities suspect this is a possible underestimation, and the limited number of cases makes it difficult to clarify its cause. The General Directorate of Medical Devices and Pharmaceutical Services of the Italian Ministry of Health has examined and studied the Italian BIA-ALCL cases. METHODS: An official document has been diffused to all medical associations, aiming at encouraging all physicians to notify each BIA-ALCL case. A retrospective study has been performed on the notified BIA-ALCL cases collected in the database named Dispovigilance. RESULTS: Research on Dispovigilance returns a list of 22 BIA-ALCL cases. The mean patient age was 49.6 years (range, 30 to 71 years). The average time to the onset of the symptoms was 6.8 years (range, 1 to 22 years). The average time to diagnosis was 7.8 years (range, 4 to 22 years). The estimated incidence of the Italian BIA-ALCL cases related to 2015 is 2.8 per 100,000 patients. CONCLUSIONS: The pathogenesis of BIA-ALCL remains unknown. The establishment of a national breast implant registry is needed to better understand some aspects of this disease. Future genetic studies on the population affected could clarify why only some patients with implants develop this disease.
[Mh] Termos MeSH primário: Implante Mamário
Linfoma Anaplásico de Células Grandes/etiologia
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Adulto
Idoso
Bases de Dados Factuais
Feminino
Seguimentos
Seres Humanos
Incidência
Itália
Linfoma Anaplásico de Células Grandes/diagnóstico
Linfoma Anaplásico de Células Grandes/epidemiologia
Meia-Idade
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/epidemiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003916


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[PMID]:29176426
[Au] Autor:Serrurier LCJ; Rayne S; Venter M; Benn CA
[Ad] Endereço:University of the Witwatersrand and, Milpark Breast Care Centre of Excellence, Johannesburg, South Africa.
[Ti] Título:Reply: Direct-to-Implant Breast Reconstruction without the Use of an Acellular Dermal Matrix Is Cost Effective and Oncologically Safe.
[So] Source:Plast Reconstr Surg;140(6):821e-822e, 2017 12.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Derme Acelular
Mamoplastia
[Mh] Termos MeSH secundário: Implante Mamário
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171218
[Lr] Data última revisão:
171218
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003896


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[PMID]:29208440
[Au] Autor:Ho AY; Hu ZI; Mehrara BJ; Wilkins EG
[Ad] Endereço:Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: alice.ho@cshs.org.
[Ti] Título:Radiotherapy in the setting of breast reconstruction: types, techniques, and timing.
[So] Source:Lancet Oncol;18(12):e742-e753, 2017 Dec.
[Is] ISSN:1474-5488
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:As the use of breast reconstruction and postmastectomy radiotherapy (PMRT) has increased over the past decade, the typical approach to integrating radiotherapy with breast reconstruction has provoked intense controversy in the management of breast cancer. PMRT can lead to an increased frequency of complications in the reconstructed breast. Conversely, the reconstructed breast can increase the complexity of radiotherapy delivery. How to minimise the frequency of complications without compromising oncological or cosmetic outcomes of the reconstructed breast is an important shared multidisciplinary goal for oncologists and their patients. Several questions remain, however, regarding the type of reconstruction that should be used with PMRT, when reconstruction should be done relative to PMRT and whether radiotherapy treatment should be directed towards the tissue expander or the implant for women who opt for a two-stage expander-implant reconstruction. Following advances in the planning of radiotherapy treatment, new questions about the application of these technologies in the setting of breast reconstruction have arisen. In this Review, we address these questions by reviewing contemporary evidence on the optimal integration of radiotherapy and breast reconstruction in the management of breast cancer.
[Mh] Termos MeSH primário: Neoplasias da Mama/radioterapia
Neoplasias da Mama/cirurgia
Mamoplastia/métodos
Radioterapia Adjuvante/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Implante Mamário/efeitos adversos
Implante Mamário/métodos
Implantes de Mama
Feminino
Sobrevivência de Enxerto
Seres Humanos
Mamoplastia/efeitos adversos
Mastectomia/métodos
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/fisiopatologia
Prognóstico
Dose de Radiação
Medição de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171215
[Lr] Data última revisão:
171215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29176413
[Au] Autor:Hammond DC; Canady JW; Love TR; Wixtrom RN; Caplin DA
[Ad] Endereço:Grand Rapids, Mich.; Irvine, Calif.; Oklahoma City, Okla.; Springfield, Va.; and St. Louis, Mo. From Partners in Plastic Surgery of West Michigan; Mentor Worldwide LLC; private practice; LSCI; and Parkcrest Plastic Surgery.
[Ti] Título:Mentor Contour Profile Gel Implants: Clinical Outcomes at 10 Years.
[So] Source:Plast Reconstr Surg;140(6):1142-1150, 2017 Dec.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Contour Profile Gel/MemoryShape breast implants consist of a textured silicone elastomer shell filled with silicone gel. The objective of this clinical study was to assess the safety and effectiveness of Contour Profile Gel/MemoryShape breast implants in women who were undergoing primary breast augmentation, primary breast reconstruction, or revision surgery (revision-augmentation or revision-reconstruction). METHODS: This was a prospective, open-label, multicenter clinical study involving Contour Profile Gel/MemoryShape breast implants in 955 female subjects, including 572 primary augmentation, 124 revision-augmentation, 190 primary reconstruction, and 69 revision-reconstruction subjects. Safety was assessed based on the incidence, severity, and method of resolution of all complications. Endpoints were examined on both a per-subject and a per-implant basis. RESULTS: For the primary augmentation, revision-augmentation, primary reconstruction, and revision-reconstruction cohorts, the Kaplan-Meier estimated 10-year cumulative incidence rates for the key complications at the subject level were as follows: Baker grade III/IV capsular contracture, 3.6 (primary augmentation), 15.5 (revision-augmentation), 14.3 (primary reconstruction), and 16.4 (revision-reconstruction) percent; infection, 0.7 (primary augmentation), 1.9 (revision-augmentation), 1.6 (primary reconstruction), and 2.9 (revision-reconstruction) percent; explantation with or without replacement, 9.2 (primary augmentation), 25.9 (revision-augmentation), 34.1 (primary reconstruction), and 49.0 (revision-reconstruction) percent; explantation with replacement with study device, 4.0 (primary augmentation), 10.8 (revision-augmentation), 16.7 (primary reconstruction), and 27.9 (revision-reconstruction) percent; and any reoperation, 22.3 (primary augmentation), 35.0 (revision-augmentation), 52.7 (primary reconstruction), and 59.7 (revision-reconstruction) percent. CONCLUSION: The results of this study demonstrate that Contour Profile Gel/MemoryShape breast implants are safe and effective for primary and revision breast augmentation and reconstruction for women at least 22 years old.
[Mh] Termos MeSH primário: Implante Mamário/instrumentação
Implantes de Mama
Mamoplastia/instrumentação
Elastômeros de Silicone
Géis de Silicone
[Mh] Termos MeSH secundário: Adulto
Idoso
Implante Mamário/métodos
Implante Mamário/estatística & dados numéricos
Feminino
Seres Humanos
Mamoplastia/métodos
Mamoplastia/estatística & dados numéricos
Meia-Idade
Segurança do Paciente
Complicações Pós-Operatórias/etiologia
Estudos Prospectivos
Desenho de Prótese
Reoperação
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Silicone Elastomers); 0 (Silicone Gels)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003846


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[PMID]:28457080
[Au] Autor:Levy Y; Ruhrman-Shahar N
[Ad] Endereço:Department of Medicine E, Meir Medical Center, Kfar Saba, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
[Ti] Título:The Ongoing Debate regarding Long-Term Safety of Silicone Breast Augmentation Rages.
[So] Source:Isr Med Assoc J;18(12):754-755, 2016 Dec.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Mh] Termos MeSH primário: Implante Mamário/efeitos adversos
Implantes de Mama/efeitos adversos
Géis de Silicone/efeitos adversos
[Mh] Termos MeSH secundário: Implante Mamário/métodos
Doenças do Tecido Conjuntivo/etiologia
Doenças do Tecido Conjuntivo/patologia
Feminino
Seres Humanos
Desenho de Prótese
Falha de Prótese
[Pt] Tipo de publicação:EDITORIAL
[Nm] Nome de substância:
0 (Silicone Gels)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  9 / 1726 MEDLINE  
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[PMID]:28457073
[Au] Autor:Klang E; Amitai MM; Raskin S; Rozendorn N; Keddel N; Pickovsky J; Sklair-Levy M
[Ad] Endereço:Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
[Ti] Título:Association between Enlarged Axillary Lymph Nodes and Silicone Breast Implant Ruptures seen on Magnetic Resonance Imaging.
[So] Source:Isr Med Assoc J;18(12):719-724, 2016 Dec.
[Is] ISSN:1565-1088
[Cp] País de publicação:Israel
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Silicone breast augmentation is a common cosmetic surgery. Previous case reports demonstrated lymphadenopathy in the presence of implant ruptures. OBJECTIVES: To investigate the association between enlarged axillary lymph nodes and silicone implant ruptures as seen on breast magnetic resonance imaging (MRI). METHODS: Two groups were derived retrospectively from breast MRI reports in our institution for the period December 2011-May 2014. A search of our hospital records for "silicone" and "lymph node" was performed (group A), and the relationship between the presence of enlarged nodes and ruptures was evaluated. The prevalence of ruptures in the presence of nodes was calculated and the association between MRI imaging features and ruptures evaluated. A search for "silicone" and "implant rupture" was performed (group B) and, as for group A, the relationship between the presence of ruptures and nodes was evaluated and the prevalence of enlarged nodes in the presence of ruptures calculated. RESULTS: Group A comprised 45 women with enlarged nodes. Intracapsular ruptures were associated with nodes (P = 0.005), while extracapsular ruptures showed a trend of association with nodes (P = 0.08). The prevalence of ruptures in the presence of nodes was 31.4%. Nodes associated with ruptures showed a strong silicone signal (P = 0.008) and absent enhancement (P = 0.005). Group B comprised 73 women with ruptures. Enlarged nodes were associated with both intra- and extracapsular ruptures (P < 0.001 and P = 0.002 respectively). The prevalence of nodes in the presence of ruptures was 22.2%. CONCLUSIONS: Enlarged axillary nodes were associated with ruptures in two groups of patients. This finding can guide clinical decisions when either enlarged nodes or ruptures are encountered in patients with silicone implants. The association between silicone lymphadenopathy and implant rupture raises concerns regarding the role of rupture in silicone-induced systemic disease.
[Mh] Termos MeSH primário: Implante Mamário/métodos
Implantes de Mama/efeitos adversos
Linfonodos/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Meia-Idade
Falha de Prótese
Estudos Retrospectivos
Ruptura
Géis de Silicone
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Silicone Gels)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


  10 / 1726 MEDLINE  
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[PMID]:29068919
[Au] Autor:Danino MA; Nizard N; Paek LS; Govshievich A; Giot JP
[Ad] Endereço:Montreal, Quebec, Canada; and Grenoble, France From the Division of Plastic Surgery, Centre Hospitalier de l'Université de Montréal, Université de Montréal; and the Division of Plastic Surgery, Centre Hospitalier Universitaire Grenoble Alpes.
[Ti] Título:Do Bacteria and Biofilm Play a Role in Double-Capsule Formation around Macrotextured Implants?
[So] Source:Plast Reconstr Surg;140(5):878-883, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The double capsule is a complication mostly described in aggressive macrotextured implants. Mechanical shear stress applied onto an immature periprosthetic capsule has been linked to their formation. The authors aim to demonstrate the role of bacterial phenotype and biofilm in the development of the double capsule. METHODS: Seven double capsules formed at the interface of macrotextured breast expander implants were studied using scanning electron microscopy. Two samples for each surface of the inner capsule layer (the prosthesis interface and the intercapsular space) were analyzed for bacteria cell size, bacterial density, and biofilm deposition. RESULTS: Although all routine bacterial cultures were negative, the prosthesis interface had both higher bacteria load and biofilm deposition compared with the intercapsular space (Mann-Whitney U test, p = 0.004 and p = 0.008, respectively). Moreover, bacteria cell sizes were significantly smaller at the prosthesis interface in six of seven samples. Comparison of bacteria density and biofilm dispersion showed an increase of biofilm extracellular matrix deposition over 2000 cells/mm (linear regression, p = 0.0025). These results indicate a common trend among bacteria species. CONCLUSIONS: Bacterial expression between the different surfaces of the double capsule displays significant differences; bacteria at the prosthesis interface are mostly in a biofilm state, whereas they demonstrate a planktonic phenotype at the intercapsular space. When a sufficient amount of bacteria are present at a specific location, quorum sensing may trigger a biofilm phenotypic switch in planktonic bacteria cells. Biofilm formation may alter capsule formation through immune response, thereby weakening capsule strength and facilitating extracellular matrix delamination and double-capsule formation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
[Mh] Termos MeSH primário: Biofilmes
Implantes de Mama/microbiologia
Reação a Corpo Estranho/microbiologia
Complicações Pós-Operatórias/microbiologia
Dispositivos para Expansão de Tecidos/microbiologia
[Mh] Termos MeSH secundário: Adulto
Implante Mamário/instrumentação
Implante Mamário/métodos
Feminino
Reação a Corpo Estranho/patologia
Seres Humanos
Microscopia Eletrônica de Varredura
Meia-Idade
Complicações Pós-Operatórias/patologia
Estudos Prospectivos
Expansão de Tecido/instrumentação
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003767



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