ABSTRACT Introduction: Liposuction is the second most commonly performed surgical procedure worldwide. However, many liposuction procedures are controversial. In this context, expert opinion surveys may help elucidate topics lacking consensus. The objective of this survey was to interview plastic surgeons who are members of the Brazilian Society of Plastic Surgery (Sociedade Brasileira de Cirurgia Plástica [SBCP]), the Update Liposuction Survey (ULS/SBCP), to assess their opinions about controversial topics in liposuction. Methods: A link to a questionnaire containing 11 questions involving liposuction (ULS/SBCP) was sent electronically to all SBCP members. The email was sent in three instances and with the provision of incentives to promote a higher response rate. Results: Of the 4,957 contacted plastic surgeons, 917 responded (response rate, 18.5%). The results are being analyzed for publication in full.

RESUMO Introdução: A lipoaspiração é o segundo procedimento cirúrgico estético mais realizado no mundo. Entretanto, muitas condutas envolvendo a lipoaspiração permanecem controversas. As pesquisas de opinião com especialistas podem elucidar quais áreas encontram-se sem consenso. O objetivo é realizar uma pesquisa de opinião com cirurgiões plásticos membros da Sociedade Brasileira de Cirurgia Plástica, o Update Liposuction Survey (ULS/SBCP), a fim de esclarecer suas condutas em temas controversos em lipoaspiração. Métodos: Um link para um questionário contendo 11 perguntas envolvendo a lipoaspiração (ULS/SBCP) foi enviado eletronicamente a todos os membros da SBCP. O e-mail foi enviado em três momentos e com a oferta de incentivos para promover maior taxa de resposta. Resultados: Dos 4957 cirurgiões plásticos contatados, 917 responderam, resultando em uma taxa de resposta de 18,5%. Os resultados estão sendo analisados para posterior publicação na íntegra.

ABSTRACT Introduction: Breast reconstruction with expanders/implants is one of the most common techniques used for the treatment of mastectomy-induced sequelae, due to the reduced surgical time and morbidity. However, the maintenance of long-term symmetrization in the contralateral breast remains a major challenge. The procedure of reduction mastoplasty has been developed, and is performed by positioning a submuscular implant in the contralateral breast of patients undergoing breast reconstruction. Methods: A total of 31 patients were included in the study. Their primary characteristics were glandular resection, combined with implant insertion in the subpectoral plane. Complications, shape, symmetry, and volume were subsequently evaluated. Results: A low incidence of complications and surgical revisions was observed, with no cases of implant loss. Good breast symmetry was achieved. Conclusion: Reduction mastoplasty with submuscular implants proved to be a safe procedure, and resulted in good breast symmetry in patients who underwent mastectomy.

RESUMO Introdução: A reconstrução mamária com uso de expansores/implantes é uma das técnicas mais empregadas para tratamento das sequelas de mastectomia devido ao menor tempo cirúrgico e menor morbidade. No entanto, a manutenção da simetria com a mama contralateral a longo prazo continua a ser um grande desafio. É proposta, então, técnica de mastoplastia redutora com colocação de implante submuscular na mama contralateral de pacientes com reconstrução mamária. Métodos: Foram incluídas 31 pacientes submetidas a esta técnica, cujas características principais são ressecção glandular associada à inclusão de prótese em plano subpeitoral total. Foram avaliadas as complicações e simetria de forma e volume obtida. Resultados: Observou-se baixa incidência de complicações e revisões cirúrgicas, nenhum caso de perda do implante e bons resultados de simetria. Conclusão: A mastoplastia redutora com implante submuscular mostrou-se técnica segura, com bons resultados de simetria em pacientes mastectomizadas.

ABSTRACT Introduction: Patients who undergo radical mastectomy with extensive tissue loss require a surgical procedure for rapid and simple closure of the lesion, with good skin coverage and minimal morbidity, to make them eligible for early complementary treatments. We evaluated the efficacy and safety of a new format of thoracoepigastric flap with patients in the Semi-Fowler position during surgery. We hypothesized that this procedure would achieve proper closure of large lesions and ensure the survival of the flap. Methods: All consecutive patients who underwent radical mastectomy between 2009 and 2014 and had chest wall reconstruction were evaluated. The main outcomes evaluated were the viability of the flap and effectiveness of the surgical closure. Results: During the study period, we operated on 29 patients with locally advanced (90%) or recurrent tumor (10%), and one patient was operated on bilaterally (total of 30 flaps). Of the study sample, 23 patients (79%) were at stage III and 6 (21%), at stage IV. The dimensions of the resected areas varied from 20 x 15 cm to 13 x 9 cm (average 15.5 x 11.6 cm). The dimensions of the thoracoepigastric flaps varied from 25 x 12 to 18 x 8 cm (average 21.3 x 10.4 cm). There were only 2 cases of dehiscence (7%), which resolved without surgical intervention, and one case of hematoma, which was drained surgically. One patient died on the eleventh postoperative day. Conclusion: Thoracoepigastric flaps were effective and safe, did not require the use of other flaps or skin grafting, and adequately closed the donor areas in all cases. All patients, except the patient who died, were eligible for complementary treatment one month after surgery.

RESUMO Introdução: Pacientes submetidas à mastectomia radical, com extensa perda tecidual, necessitam de procedimento cirúrgico de fechamento rápido e simples da lesão, com boa cobertura cutânea e mínima morbidade, para que possam receber precocemente tratamentos complementares. Estudamos a eficácia e a segurança de um novo formato do retalho toracoepigástrico com o posicionamento semissentado (Fowler) da paciente durante a cirurgia. A hipótese é de que o procedimento, além de obter adequado fechamento de grandes lesões, permita garantir a sobrevivência do retalho. Métodos: Foram analisadas todas as pacientes consecutivamente operadas com mastectomias radicais entre 2009 e 2014 submetidas a reconstruções torácicas. Os principais desfechos analisados foram a viabilidade do retalho e a eficácia no fechamento cirúrgico. Resultados: No período do estudo, foram operadas 29 pacientes com tumor localmente avançado (90%) ou recidivado (10%), uma operada bilateralmente (30 retalhos); vinte e três (79%) com estadiamento III e seis (21%), estadiamento IV. A extensão das áreas ressecadas variou de 20 x 15 cm a 13 x 9 cm (média 15,5 x 11,6 cm). Retalho toracoepigástrico foi utilizado com dimensões variando de 25 x 12 cm a 18 x 8 cm (média de 21,3 x 10,4 cm). Houve apenas duas deiscências (7%), que cicatrizaram sem necessidade de intervenção cirúrgica, e um hematoma, drenado cirurgicamente. Uma paciente faleceu no 11º dia pós-operatório. Conclusão: O retalho toracoepigástrico foi eficaz e seguro, sem necessidade do uso de outros retalhos ou enxertos cutâneos, fechando a área doadora adequadamente em todos os casos. Todas as pacientes, excluindo o óbito, estavam aptas para o tratamento complementar após um mês.

Due to the relevance of the critical cooling rate, Rc, for glasses, Barandiarán and Colmenero (BC) developed a method for calculating Rc as a function of the crystallization temperature on cooling obtained from thermal analysis. The critical cooling rate is obtained by the extrapolation method to conditions of infinity undercooling. However, for polymers, there is a strong reason for modifying the original BC method. In this case, the extrapolation must be extended only to the undercooling associated to the glass transition temperature, Tg, because no crystallization can occur below this temperature. Following this modified method (MBC) proposed by the present authors, the critical cooling rate for PP, PEEK, P10MS and PET were determined. The results showed that the new values are much lower than those obtained by the original BC method.

Sepsis is a systemic inflammatory response commonly caused by bacterial infection. We demonstrated that the outcome of sepsis induced by cecal ligation and puncture (CLP) correlates with the severity of the neutrophil migration failure towards infectious focus. Failure appears to be due to a decrease in the rolling and adhesion of neutrophil to endothelium cells. It seems that neutrophil migration impairment is mediated by the circulating inflammatory cytokines, such as TNF-alpha and IL-8, which induce the nitric oxide (NO) production systemically. It is supported by the fact that intravenous administration of these cytokines reduces the neutrophil migration induced by different inflammatory stimuli, and in severe sepsis the circulating concentrations of the cytokines and chemokines are significantly increased. Moreover, the neutrophil migration failure and the reduction in the rolling/adhesion were not observed in iNOS-/- mice and, aminoguanidine prevented this event. We also demonstrated that the failure of neutrophil migration is a Toll-4 receptor (TLR4) dependent mechanism, since it was not observed in TLR4 deficient mice. Furthermore, it was also observed that circulating neutrophils obtained from septic patients present failure of neutrophil chemotaxis toward fMLP, IL-8, and LTB4 and an increased in sera concentrations of NO3 and cytokines. In conclusion, we demonstrated that, in sepsis, failure of neutrophil migration is critical for the outcome and that NO is involved in the process.