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Denadai R, Araujo KM, Samartine H, Denadai R, Raposo-Amaral CE. Public Perceptions of Plastic Surgery Practice in Brazil. Indian J Surg 2015; 78:435-441. [PMID: 28100938 DOI: 10.1007/s12262-015-1388-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Accepted: 10/27/2015] [Indexed: 02/05/2023] Open
Abstract
The perception of medical specialists by the public has a significant effect on health-care decisions, research funding allocation, and implantation of educational measures. The purpose of this survey was to assess the public's perception of the field of plastic surgery practice. General public members (n = 1290) completed a survey where they matched nine specialties with 28 plastic surgery-related scenarios. Response patterns were distributed as "plastic surgeon alone," "plastic surgeon combined with other specialists," or "no plastic surgeon." Sociodemographic data and previous plastic surgery contact were also collected. "Plastic surgeon alone" was identified as an expert by more than 70 % of respondents in four (40 %) aesthetic-related scenarios and in one (5.5 %) general/reconstructive-related scenario. "Plastic surgeon alone" was significantly (all p < 0.05) more recognized as an expert than other response patterns in all aesthetic-related scenarios, except for botulinum toxin for facial wrinkles. There was a significant (all p < 0.05) poor understanding of the role of plastic surgeons in facial fracture surgery, facial paralysis management, chest wall surgery, hand surgery-related scenarios, and tumor surgery-related scenarios. Age, health-care professional, education level, and prior plastic surgery contact were significant (all p < 0.05) determinants of "plastic surgeon" as a response pattern, according to bivariate analysis and multiple linear regression analysis. The public has a poor understanding of the broad field of plastic surgery practice. Therefore, improved public education about the scope of plastic surgery is needed.
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Affiliation(s)
- Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adolpho Lutz, 100, Caixa Postal: 6028, Campinas, São Paulo 13083-880 Brazil
| | - Karin Milleni Araujo
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adolpho Lutz, 100, Caixa Postal: 6028, Campinas, São Paulo 13083-880 Brazil
| | - Hugo Samartine
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adolpho Lutz, 100, Caixa Postal: 6028, Campinas, São Paulo 13083-880 Brazil
| | - Rodrigo Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adolpho Lutz, 100, Caixa Postal: 6028, Campinas, São Paulo 13083-880 Brazil
| | - Cassio Eduardo Raposo-Amaral
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adolpho Lutz, 100, Caixa Postal: 6028, Campinas, São Paulo 13083-880 Brazil
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Denadai R, Muraro CAS, Raposo-amaral CE. Residents’ Perceptions of Plastic Surgeons as Craniofacial Surgery Specialists. J Craniofac Surg 2015; 26:2334-8. [PMID: 26501970 DOI: 10.1097/scs.0000000000002081] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Raposo-amaral CA, Denadai R, Chammas DZ, Marques FF, Pinho AS, Roberto WM, Buzzo CL, Raposo-amaral CE. Cleft Patient-Reported Postoperative Donor Site Pain Following Alveolar Autologous Iliac Crest Bone Grafting: Comparing Two Minimally Invasive Harvesting Techniques. J Craniofac Surg 2015; 26:2099-103. [PMID: 26413958 DOI: 10.1097/scs.0000000000002077] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Raposo-Amaral CE, Tong A, Denadai R, Yalom A, Raposo-Amaral CA, Bertola D, Li A, Jarrahy R. A subcranial Le Fort III advancement with distraction osteogenesis as a clinical strategy to approach pycnodysostosis with midface retrusion and exorbitism. J Craniofac Surg 2013; 24:1327-30. [PMID: 23851800 DOI: 10.1097/SCS.0b013e31829978a5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Pycnodysostosis is a rare autosomal recessive skeletal disorder involving a constellation of craniofacial manifestations including midface retrusion. We report the case of a 13-year-old girl with pycnodysostosis who presented with exorbitism, midface retrusion, malocclusion, and obstructive sleep apnea. Here, we describe the successful use of subcranial Le Fort III advancement using distraction osteogenesis with internal Kawamoto distracters. After a latency of 5 days, distraction for 10 days, and consolidation for 12 weeks, her midface was advanced by 10 mm with slight overcorrection at the occlusion level. At 2 years postoperatively, the patient had complete remission of her sleep apnea, resolution of her exorbitism, and amelioration of her class III malocclusion to class I. To the best of our knowledge, this is the first report of a successful subcranial Le Fort III midface advancement with distraction osteogenesis for craniofacial reconstruction of a pycnodysostosis. Our report highlights the surgical options that have been described for this craniofacial deformity and presents a novel and expedient approach for patients with pycnodysostosis presenting with exorbitism, midface retrusion, and/or sleep apnea.
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Rodrigues L, dos Reis LM, Denadai R, Raposo-Amaral CE, Alonso N, Ferreira MC, Jorgetti V. Prefabricated bone flap: an experimental study comparing deep-frozen and lyophilized-demineralized allogenic bones and tissue expression of transforming growth factor β. J Craniofac Surg 2013; 24:1914-21. [PMID: 24220373 DOI: 10.1097/SCS.0b013e3182a41be2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Extensive bone defects are still a challenge for reconstructive surgery. Allogenic bones can be an alternative with no donor area morbidity and unlimited amount of tissue. Better results can be achieved after allogenic bone preparation and adding a vascular supply, which can be done along with flap prefabrication. The purpose of this study was to evaluate demineralized/lyophilized and deep-frozen allogenic bones used for flap prefabrication and the tissue expression of transforming growth factor β (TGF-β) in these bone fragments. METHODS Fifty-six Wistar rat bone diaphyses were prepared and distributed in 4 groups: demineralized/lyophilized (experimental group 1 and control group 2) and deep freezing (experimental group 3 and control group 4). Two bone segments (one of each group) were implanted in rats to prefabricate flaps using superficial epigastric vessels (experimental groups) or only transferred as grafts (control groups). These fragments remained in their respective inguinal regions until the death that occurred at 2, 4, and 6 weeks after the operation. Semiquantitative histologic (tetracycline marking, cortical resorption, number of giant cells, and vascularization) and histomorphometrical quantitative (osteoid thickness, cortical thickness, and fibrosis thickness) analyses were performed. Transforming growth factor β immunohistochemistry staining was also performed. RESULTS Group 1 fragments presented an osteoid matrix on their external surface in all periods. Cartilage formation and mineralization areas were also noticed. These findings were not observed in group 3 fragments. Group 1 had more mineralization and double tetracycline marks, which were almost not seen in group 3. Cortical resorption and the number of giant cells were greater in group 3 in all periods. Vascularization and fibrosis thickness were similar in both experimental groups. Group 1 had more intense TGF-β staining within 2 weeks of study. Nevertheless, from 4 weeks onward, group 3 presented statistically significant stronger staining. CONCLUSIONS Although there are some differences between the preparation methods of allogenic bone, it is possible to prefabricate flaps with demineralized/lyophilized and deep-frozen bones.
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Ghizoni E, Raposo-Amaral CA, Mathias R, Denadai R, Raposo-Amaral CE. Superior sagittal sinus thrombosis as a treatment complication of nonsyndromic Kleeblattschädel. J Craniofac Surg 2013; 24:2030-3. [PMID: 24220397 DOI: 10.1097/01.scs.0000436681.74443.17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A patient with nonsyndromic Kleeblattschädel, who underwent a craniotomy involving a constricting calvarial ring and frontal calvarial remodeling, developed a superior sagittal sinus thrombosis. The superior sagittal sinus venous outflow was obstructed as a consequence of the rapid brain expansion, along with a conflict of a remaining posterior bone crest. A successful second operation was performed to remove the posterior bone crest and facilitate the venous outflow. Meticulous preoperative planning should be carried out before addressing this complex craniofacial deformity.
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Raposo-Amaral CE, Denadai R, Alonso N. Three-Dimensional Changes of Maxilla after Secondary Alveolar Cleft Repair: Differences Between rhBMP-2 and Autologous Iliac Crest Bone Grafting. Plast Reconstr Surg Glob Open 2015; 3:e451. [PMID: 26301140 DOI: 10.1097/GOX.0000000000000417] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 05/13/2015] [Indexed: 02/05/2023]
Abstract
Background: Recombinant human bone morphogenetic protein (rhBMP)-2 has been used as an alternative to autologous bone transferring, a standard method of treatment. However, its potential adverse effect on anterior maxillary arch is unknown. Thus, the purpose of this study was to quantify sagittal and transversal changes of anterior maxilla after secondary alveolar cleft repair using traditional iliac crest bone grafting versus rhBMP-2. Methods: Twelve unilateral complete cleft lip and palate patients were randomly divided into 2 groups. In group 1, patients underwent traditional iliac crest bone grafting transferring (n = 4), and in group 2, patients underwent alveolar cleft reconstruction using collagen matrix with lyophilized rhBMP-2 (n = 8). Computed tomography (CT) imaging was performed preoperatively and at 1 year postoperatively, using a previously standardized protocol. A three-dimensional (3D) CT cephalometric analysis of the linear and angular measurements of the sagittal and transverse maxilla planes was performed to assess intra- and intergroup maxillary changes. Results: Intra- and intergroup comparisons of the pre- and postoperative 3D CT cephalometric linear and angular measurements of the sagittal and transverse maxilla planes showed no significant (all P > 0.05) differences among all studied variables. Conclusions: There were no significant anterior maxilla changes after maxillary cleft repair either using iliac crest bone grafting or rhBMP-2.
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Denadai R, Raposo-Amaral CE, Buzzo CL, Raposo-Amaral CA. Functional lower lip reconstruction with the modified Bernard-Webster flap. J Plast Reconstr Aesthet Surg 2015; 68:1522-8. [PMID: 26243196 DOI: 10.1016/j.bjps.2015.07.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 07/06/2015] [Accepted: 07/12/2015] [Indexed: 02/05/2023]
Abstract
BACKGROUND Lower lip defects after squamous cell carcinoma (SCC) excisions have been repaired by several surgical techniques. However, the functional reconstruction of full-thickness defects of the lower lip remains a therapeutic challenge. We therefore evaluated functional results of the modified Bernard-Webster flap for the reconstruction of full-thickness lower lip defects after SCC excisions. METHODS A prospective study was performed on all patients with lower lip full-thickness defects after SCC excisions greater than 1/3 of the lip, reconstructed with the modified Bernard-Webster flap in 2011-2013. Functional (sphincter, motor, and sensory functions) postoperative results were evaluated according to criteria previously adopted. RESULTS Twelve lower lip defects were reconstructed without complications, except for two (16.7%) wound dehiscence successfully managed. Ten (83.3%) patients presented transient and permanent functional abnormalities in the recent and late postoperative assessments. Ten (83.3%) patients classified the late functional results as satisfactory. CONCLUSIONS The modified Bernard-Webster flap proved to be an excellent alternative to repair full-thickness lower lip defects with more than 1/3 of the lower lip length, as it allowed the use of similar neighboring tissues, could be performed in one stage, and was functionally effective.
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Affiliation(s)
- Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil
| | | | - Celso Luiz Buzzo
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil
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Denadai R, Raposo-Amaral CE, Marques FF, Raposo-Amaral CA. Posttraumatic eyebrow reconstruction with hair-bearing temporoparietal fascia flap. ACTA ACUST UNITED AC 2015; 13:106-9. [PMID: 25993077 PMCID: PMC4946816 DOI: 10.1590/s1679-45082015rc2834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 12/01/2013] [Indexed: 02/08/2023]
Abstract
The temporoparietal fascia flap has been extensively used in craniofacial reconstructions. However, its use for eyebrow reconstruction has been sporadically reported. We describe a successfully repaired hair-bearing temporoparietal fascia flap after traumatic avulsion of eyebrow. Temporoparietal fascia flap is a versatile tool and should be considered as a therapeutic option by all plastic surgeons.
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Affiliation(s)
- Rafael Denadai
- Hospital de Crânio e Face, Instituto de Cirurgia Plástica Craniofacial, Campinas, SP, Brazil
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DENADAI RAFAEL, SAMARTINE JUNIOR HUGO, DENADAI RODRIGO, PINHO ANDRESILVEIRA, RAPOSO-DO-AMARAL CASSIOEDUARDO. Hand surgery as a working area of plastic surgeons. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2015. [DOI: 10.5935/2177-1235.2015rbcp0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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161
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DENADAI RAFAEL, SARMENTO GEYSONSOUZA, BUZZO CELSOLUIZ, RAPOSO-AMARAL CASSIOEDUARDO, RAPOSO-DO-AMARAL CESARAUGUSTO. Use of Bernard-Webster flap for lower lip reconstruction after excision of squamous cell carcinoma: analysis of functional results. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2015. [DOI: 10.5935/2177-1235.2015rbcp0110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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162
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Denadai R, Stelini RF, Roberto WM, Raposo-Amaral CA, Raposo-Amaral CE. Brooke-Spiegler syndrome clinically misdiagnosed as neurofibromatosis type 1. J Craniofac Surg 2015; 26:323-5. [PMID: 25502717 DOI: 10.1097/SCS.0000000000001227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Affiliation(s)
- R Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil E-mail: ,
| | - Ce Raposo-Amaral
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil E-mail: ,
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Denadai R, Saad-hossne R, Raposo-amaral CE. Simulation-Based Rhomboid Flap Skills Training During Medical Education: Comparing Low- and High-Fidelity Bench Models. J Craniofac Surg 2014; 25:2134-8. [PMID: 25329848 DOI: 10.1097/scs.0000000000001094] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To assess if the bench model fidelity interferes in the acquisition of rhomboid flap skills by medical students. METHODS Sixty novice medical students were randomly assigned to 5 practice conditions with instructor-directed Limberg rhomboid flap skills training: didactic materials (control group 1), low-fidelity rubberized line (group 2) or ethylene-vinyl acetate (group 3) bench models; high-fidelity chicken leg skin (group 4) or pig foot skin (group 5) bench models. Pretests and posttests were applied, and Global Rating Scale, effect size, and self-perceived confidence were used to evaluate all flap performances. RESULTS Medical students from groups 2 to 5 showed better flap performances based on the Global Rating Scale (all P < 0.05) and felt more confident to perform rhomboid flaps (all P < 0.05) compared to their peers from control group 1, regardless of bench model fidelity (all P > 0.05). The magnitude of the effect was considered large (>0.80) in all measurements. CONCLUSION There was acquisition of rhomboid flap skills regardless of bench model fidelity.
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Alonso N, Risso GH, Denadai R, Raposo-Amaral CE. Effect of maxillary alveolar reconstruction on nasal symmetry of cleft lip and palate patients: a study comparing iliac crest bone graft and recombinant human bone morphogenetic protein-2. J Plast Reconstr Aesthet Surg 2014; 67:1201-8. [PMID: 24909628 DOI: 10.1016/j.bjps.2014.05.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 04/18/2014] [Accepted: 05/10/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Recombinant human bone morphogenetic protein (rhBMP)-2 has been used in some craniofacial centers worldwide. However, its influence on nasal morphology is unknown. Thus, the objective of this investigation was to assess the effect of maxillary alveolar reconstruction on nasal position and symmetry in unilateral complete cleft lip patients who underwent traditional iliac crest bone grafting transferring versus reconstruction using rhBMP-2. METHODS Nineteen unilateral complete cleft lip patients were randomly divided into two groups. In group 1, patients underwent traditional iliac crest bone grafting transferring (n = 11) and in group 2, patients underwent alveolar reconstruction using collagen matrix with lyophilized rhBMP-2 (n = 8). Computerized tomography (CT) imaging was performed preoperatively and at 6 months postoperatively using a previously standardized protocol. Linear distances using anatomic landmarks were performed using tridimensional CT data reformatted by the OsiriX(®) software. Quantitative and qualitative measurements to assess intra- and inter-group nasal position modifications were performed. RESULTS Intra-group pre- and postoperative comparisons showed significant differences (p < 0.05) in two linear measurements of group 1, while group 2 did not present a difference (p > 0.05). Group 2 presented significant postoperative enhancement (p < 0.05) in the quantitative nasal symmetry in one measurement. Qualitative analysis showed postoperative nasal symmetry enhancement in 75% of the measurements of group 2 and 36% of group 1. There was no statistically significant difference in the inter-group comparisons. CONCLUSIONS Our study demonstrated that both groups showed similar effect on nasal symmetry.
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Denadai R, Oshiiwa M, Saad-Hossne R. Teaching elliptical excision skills to novice medical students: a randomized controlled study comparing low- and high-fidelity bench models. Indian J Dermatol 2014; 59:169-75. [PMID: 24700937 PMCID: PMC3969678 DOI: 10.4103/0019-5154.127679] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The search for alternative and effective forms of training simulation is needed due to ethical and medico-legal aspects involved in training surgical skills on living patients, human cadavers and living animals. AIMS To evaluate if the bench model fidelity interferes in the acquisition of elliptical excision skills by novice medical students. MATERIALS AND METHODS Forty novice medical students were randomly assigned to 5 practice conditions with instructor-directed elliptical excision skills' training (n = 8): didactic materials (control); organic bench model (low-fidelity); ethylene-vinyl acetate bench model (low-fidelity); chicken legs' skin bench model (high-fidelity); or pig foot skin bench model (high-fidelity). Pre- and post-tests were applied. Global rating scale, effect size, and self-perceived confidence based on Likert scale were used to evaluate all elliptical excision performances. RESULTS The analysis showed that after training, the students practicing on bench models had better performance based on Global rating scale (all P < 0.0000) and felt more confident to perform elliptical excision skills (all P < 0.0000) when compared to the control. There was no significant difference (all P > 0.05) between the groups that trained on bench models. The magnitude of the effect (basic cutaneous surgery skills' training) was considered large (>0.80) in all measurements. CONCLUSION The acquisition of elliptical excision skills after instructor-directed training on low-fidelity bench models was similar to the training on high-fidelity bench models; and there was a more substantial increase in elliptical excision performances of students that trained on all simulators compared to the learning on didactic materials.
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Affiliation(s)
- Rafael Denadai
- Department of Surgery, Botucatu Medical School, University of the State of São Paulo, Botucatu, Brazil ; Institute of Plastic and Craniofacial Surgery, Brazilian Society of Research and Assistance to Craniofacial Rehabilitation Hospital, Campinas, Brazil
| | - Marie Oshiiwa
- Department of Statistics, Faculty of Technology, São Paulo State Technological Colleges, Marilia, SP, Brazil
| | - Rogério Saad-Hossne
- Department of Surgery, Botucatu Medical School, University of the State of São Paulo, Botucatu, Brazil
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Denadai R, Saad-Hossne R, Todelo AP, Kirylko L, Souto LRM. Low-fidelity bench models for basic surgical skills training during undergraduate medical education. Rev Col Bras Cir 2014; 41:137-45. [PMID: 24918729 DOI: 10.1590/s0100-69912014000200012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Accepted: 01/15/2013] [Indexed: 02/08/2023] Open
Abstract
It is remarkable the reduction in the number of medical students choosing general surgery as a career. In this context, new possibilities in the field of surgical education should be developed to combat this lack of interest. In this study, a program of surgical training based on learning with models of low-fidelity bench is designed as a complementary alternative to the various methodologies in the teaching of basic surgical skills during medical education, and to develop personal interests in career choice.
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Affiliation(s)
- Rafael Denadai
- Institute of Craniofacial Plastic Surgery; Dr. Mario Gatti County Hospital, Brazil
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Raposo-Amaral CE, Denadai R, Raposo-Amaral CA. Degloving injury of the abdomen and external genitalia successfully treated with full-thickness degloved skin graft in a child: a 10-year follow-up. J Plast Reconstr Aesthet Surg 2014; 67:735-7. [PMID: 24485102 DOI: 10.1016/j.bjps.2013.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 11/28/2013] [Accepted: 12/17/2013] [Indexed: 02/05/2023]
Affiliation(s)
| | - Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, Brazil
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Raposo-amaral CE, Neto JGJ, Denadai R, Raposo-amaral CM, Raposo-amaral CA. Patient-Reported Quality of Life in Highest-Functioning Apert and Crouzon Syndromes: A Comparative Study. Plast Reconstr Surg 2014; 133:182e-91e. [PMID: 24469189 DOI: 10.1097/01.prs.0000437260.31693.75] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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171
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Denadai R, Toledo AP, Bernades DM, Diniz FD, Eid FB, Lanfranchi LMMDM, Amaro LC, Germani NM, Parise VG, Pacheco Filho CN, Saad-Hossne R. Simulation-based ultrasound-guided central venous cannulation training program. Acta Cir Bras 2014; 29:132-44. [PMID: 24604318 DOI: 10.1590/s0102-86502014000200010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 01/20/2014] [Indexed: 02/08/2023] Open
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Denadai R, Raposo-Amaral CE. The level of evidence published in a partner Journal of Plastic and Reconstructive Surgery: Revista Brasileira de Cirurgia Plástica. Plast Reconstr Surg 2014; 133:242e-4e. [PMID: 24469216 DOI: 10.1097/01.prs.0000437232.15553.b2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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173
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Silva RDP, da Silva Cavalcante JE, Miranda EQ, Lopes DF, Souto LRM. Giant hemangioma presenting as a scalp mass leading to a craniofacial deformity. J Maxillofac Oral Surg 2014; 12:218-23. [PMID: 24431843 DOI: 10.1007/s12663-011-0218-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 03/22/2011] [Indexed: 02/05/2023] Open
Abstract
Hemangioma is the most common vascular tumor during childhood. However, cases of giant hemangiomas determining deformities in the craniofacial region are not reported frequently. Craniofacial giant hemangiomas are challenging for surgeons since they cause aesthetic and/or functional problems and may be associated with important complications such as ulcerations, infections and bleedings. The present report is aimed at describing a rare case of craniofacial asymmetry in a 30-year-old patient, secondary to an extensive mass whose growth deformed the scalp in the frontal-parietal-temporal region. The lesion was completely surgically removed with good aesthetic results, and the anatomopathological examination revealed that it was a cavernous hemangioma.
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Affiliation(s)
| | - José Edson da Silva Cavalcante
- Department of Neurosurgery, School of Medical Sciences, Universidade Federal de Goiás (UFG), Goiânia, Goiás Brazil ; Service of Residency in Neurosurgery, Hospital Santa Mônica, Aparecida de Goiânia, Goiânia, Goiás Brazil
| | - Eduardo Queiroz Miranda
- Service of Residency in Neurosurgery, Hospital Santa Mônica, Aparecida de Goiânia, Goiânia, Goiás Brazil
| | - Dionísio Figueiredo Lopes
- Service of Residency in Neurosurgery, Hospital Santa Mônica, Aparecida de Goiânia, Goiânia, Goiás Brazil
| | - Luís Ricardo Martinhão Souto
- Division of Plastic Surgery, Department of Surgery, School of Medical Sciences, Universidade de Marília (UNIMAR), Av. Rio Branco, 1132-Cj. 41, CEP 17502-000 Marília, São Paulo Brazil
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RAPOSO-DO-AMARAL CASSIOEDUARDO, DENADAI RAFAEL, BUZZO CELSOLUIZ, RAPOSO-DO-AMARAL CESARAUGUSTO. Therapeutic approTherapeutic Approach To The Parry-Romberg Syndrome Based On A Severity Grading System. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2014. [DOI: 10.5935/2177-1235.2014rbcp0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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DENADAI RAFAEL, SOUTO LUÍSRICARDOMARTINHÃO. Objective assessment of simulation-based microvascular surgical training. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2014. [DOI: 10.5935/2177-1235.2014rbcp0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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176
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DENADAI RAFAEL, GOLDENBERG DOVCHARLES, RAPOSO-DO-AMARAL CASSIOEDUARDO. Bibliometric analysis of articles published in the Brazilian Journal of Plastic Surgery between 2005 and 2012. Part I: quantitative analysis of articles, authors, and geographical distribution. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2014. [DOI: 10.5935/2177-1235.2014rbcp0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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177
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DENADAI RAFAEL, GOLDENBERG DOVCHARLES, RAPOSO-DO-AMARAL CASSIOEDUARDO. Bibliometric analysis of articles published in the Brazilian Journal of Plastic Surgery between 2005 and 2012. Part III: study designs and levels of evidence. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2014. [DOI: 10.5935/2177-1235.2014rbcp0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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178
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DENADAI RAFAEL, MURARO CARLOSALBERTOSOLOMON, RAPOSO-DE-AMARAL CASSIOEDUARDO. Plastic surgeons as hand surgeons: residents' perceptions. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2014. [DOI: 10.5935/2177-1235.2014rbcp0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Raposo-Amaral CE, Raposo-Amaral CM, Marques FF, Denadai R, Raposo-Amaral CA. The inverted-T mammaplasty: a modified winch suture to reduce horizontal scar length. Aesthet Surg J 2014; 34:183-8. [PMID: 24334501 DOI: 10.1177/1090820x13515703] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Mammaplasty performed with an inverted-T skin resection pattern is a useful technique to treat moderately or severely ptotic breasts. This method of skin resection is conducted via 3 incisional components: periareolar, vertical, and horizontal. In this report, the authors describe a simple modified winch suture that can be inserted with the inverted-T technique to reduce the length of the horizontal incision.
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CHAMMAS DANILOZANARDO, DENADAI RAFAEL, MARQUE FREDERICOFIGUEIREDO, BUZZO CELSOLUIZ, RAPOSO-DO-AMARAL CASSIOEDUARDO, RAPOSO-DO-AMARAL CESARAUGUSTO. Assessment of donor area pain in patients with cleft lip and palate undergoing alveolar bone defects repairs using iliac crest autogenous grafting: a prospective randomized comparison of two bone extractors. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2014. [DOI: 10.5935/2177-1235.2014rbcp0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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181
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DENADAI RAFAEL, GOLDENBERG DOVCHARLES, RAPOSO-DO-AMARAL CASSIOEDUARDO. Bibliometric analysis of articles published in the Brazilian Journal of Plastic Surgery from 2005 to 2012. Part II: source, previous presentations, and types of articles. Revista Brasileira de Cirurgia Plástica (RBCP) – Brazilian Journal of Plastic Sugery 2014. [DOI: 10.5935/2177-1235.2014rbcp0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Raposo-amaral CE, Giancolli AP, Denadai R, Somensi RS, Raposo-amaral CA. Late Cutaneous Lip Height in Unilateral Incomplete Cleft Lip Patients Does Not Differ From the Normative Data: . J Craniofac Surg 2014; 25:308-13. [PMID: 24406595 DOI: 10.1097/scs.0000000000000521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Denadai R, Souto RM, Auada-Souto MP. Generalized acanthosis nigricans without systemic disease associated. Dermatol Online J 2013; 19:19614. [PMID: 24050288 DOI: pmid/24050288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 09/13/2013] [Indexed: 02/08/2023] Open
Abstract
Acanthosis nigricans (OMIM ID % 100600) is a dermatosis characterized by velvety hyperpigmentation, skin thickening, and papillomatosis. It mainly affects flexural areas. In most cases, the generalized form is related to malignancy in adults; it is rarely reported in the absence of systemic disease in children and adolescents. The present report is aimed at describing an unusual case of generalized acanthosis nigricans in a 17 year-old patient, in which, after extensive investigation (clinical, laboratorial and by imaging methods) no association with systemic disease was found.
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Denadai R, Medeiros CC, Toledo AP, Carvalho AF, Muraro CAS. Rectal perforation after colonoscopic polypectomy presented as subcutaneous emphysema, pneumomediastinum and pneumoretroperitoneum successfully treated conservatively in an elderly adult. J Am Geriatr Soc 2013; 61:1433-5. [PMID: 23937504 DOI: 10.1111/jgs.12374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Raposo-Amaral CE, Denadai R, Camargo DN, Artioli TO, Gelmini Y, Buzzo CL, Raposo-Amaral CA. Parry-Romberg syndrome: severity of the deformity does not correlate with quality of life. Aesthetic Plast Surg 2013; 37:792-801. [PMID: 23720075 DOI: 10.1007/s00266-013-0142-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 04/21/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND The aims of this study were to (1) describe the main clinical findings of Parry-Romberg syndrome (PRS), (2) evaluate surgical strategies and outcomes, and (3) investigate the quality of life of patients according to their disease severity. METHODS This retrospective observational study involved 14 patients treated between 2005 and 2011. The surgical treatment strategies were based on the proposed system for grading severity, and postoperative outcomes were assessed. The patients answered two questionnaires that covered the clinical manifestations of the syndrome and their quality of life in the postoperative period. A comparative analysis between the severity of the deformity and the quality of life was performed using the Kruskal-Wallis and Mann-Whitney tests. RESULTS The most prevalent clinical manifestation of PRS was progressive hemifacial atrophy (85.71 %). The surgical strategy was individualized based on the severity of disease of each patient. Surgical strategies included free-fat grafts, dermal fat grafts, and bone grafts associated with a temporoparietal fascia flap. Regardless of approach, all patients had an overall improvement in their facial appearance and were free of complications during the follow-up period. Our data showed no association between the severity of the deformity and the quality of life of these patients (all p > 0.05). CONCLUSIONS In this series, there was a predominance of clinical features of PRS that had been previously reported. Satisfactory outcomes were obtained using different surgical strategies that varied according to the severity of the deformity. The severity of the deformity did not impose a reduced quality of life on PRS patients. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Denadai R, Teixeira FV, Steinwurz F, Romiti R, Saad-Hossne R. Induction or exacerbation of psoriatic lesions during anti-TNF-α therapy for inflammatory bowel disease: a systematic literature review based on 222 cases. J Crohns Colitis 2013; 7:517-24. [PMID: 22960136 DOI: 10.1016/j.crohns.2012.08.007] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 08/09/2012] [Accepted: 08/10/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Paradoxical cases of psoriatic lesions induced or exacerbated by anti-tumor necrosis factor (TNF)-α therapy have been reported more frequently in recent years, but data related to inflammatory bowel disease (IBD) are rare. A systematic literature review was performed to provide information about this adverse effect in patients with IBD who receive anti-TNF therapy. METHODS Published studies were identified by a search of Medline, Embase, Cochrane, SciELO, and LILACS databases. RESULTS A total of 47 studies (222 patients) fulfilled the inclusion criteria and were selected for analysis. Clinical and therapeutic aspects varied considerably among these reports. Of the 222 patients, 78.38% were diagnosed with Crohn's disease, and 48.20% were female. The mean patient age was 26.50 years, and 70.72% of patients had no history of psoriasis. Patients developed psoriasiform lesions (55.86%) more often than other types of psoriatic lesions, and infliximab was the anti-TNF-α therapy that caused the cutaneous reaction in most patients (69.37%). Complete remission of cutaneous lesions was observed in 63.96% of the cases. CONCLUSIONS We found that psoriatic lesions occurred predominantly in adult patients with Crohn's disease who received infliximab and had no previous history of psoriasis. Most patients can be managed conservatively without discontinuing anti-TNF-α therapy.
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Affiliation(s)
- Rafael Denadai
- Division of Coloproctology, Department of Surgery, School of Medical Sciences, University of the State of São Paulo, Botucatu, SP, Brazil.
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Saad-Hossne R, Teixeira FV, Denadai R. In vivo assessment of intratumoral aspirin injection to treat hepatic tumors. World J Hepatol 2013; 5:372-378. [PMID: 23898370 PMCID: PMC3724965 DOI: 10.4254/wjh.v5.i7.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 05/19/2013] [Accepted: 06/04/2013] [Indexed: 02/06/2023] Open
Abstract
AIM: To study the antineoplastic efficacy of 10% aspirin intralesional injection on VX2 hepatic tumors in a rabbit model.
METHODS: Thirty-two male rabbits (age: 6-9 wk; body weight: 1700-2500 g) were inoculated with VX2 hepatic tumor cells (104 cells/rabbit) via supra-umbilical median laparotomy. On day 4 post-implantation, when the tumors were about 1 cm in diameter, the rabbits were randomly divided into the following groups (n = 8 each group) to assess early (24 h) and late (7 d) antineoplastic effects of intratumoral injection of 10% bicarbonate aspirin solution (experimental groups) in comparison to intratumoral injection of physiological saline solution (control groups): group 1, 24 h control; group 2, 24 h experimental; group 3, 7 d control; group 4, 7 d experimental. The serum biochemistry profile (measurements of glycemia, alkaline phosphatase, gamma-glutamyl transferase, aspartate aminotransferase, and alanine aminotransferase) and body weight measurements were obtained for all animals at the following time points: D0, before tumor implant; D4, day of treatment; D5, day of sacrifice for groups 1 and 2; D11, day of sacrifice for groups 3 and 4. Gross assessments of the abdominal and thoracic cavities were carried out upon sacrifice. The resected liver tissues, including hepatic tumors, were qualitatively (general morphology, signs of necrosis) and quantitatively (tumor area) assessed by histopathological analysis.
RESULTS: Gross examination showed no alterations, besides the left hepatic lobe tumors, had occurred in the thoracic and abdominal cavities of any animal at any time point evaluated. However, the features of the tumor foci were distinctive between the groups. Compared to the control groups, which showed normal unabated tumor progression, the aspirin-treated groups showed imprecise but limited tumor boundaries and a general red-white coloration (indicating hemorrhaging) at 24 h post-treatment, and development of yellow-white areas of a cicatricial aspect at 7 d after treatment. At all time points evaluated, all except one biochemical parameters tested within the reference range (P > 0.05); a significant increase was detected in the alkaline phosphatase level of the control group 3 on D11 (P < 0.05). At 24 h post-treatment, the aspirin-treated groups showed extensive coagulation necrosis accompanied by a remarkable absence of viable tumor foci; at 7 d after treatment, the tumors had completely disappeared in these animals and fibrous necrotic nodules had developed. In contrast, throughout the study course, the tumors of the control groups remained unchanged, showing tumor nodules without necrosis at the time point corresponding to 24 h post-treatment and increased amounts of tumor nodules at the time point corresponding to 7 d post-treatment. Quantitative analysis of the remaining tumor area revealed that the aspirin-treated groups had significantly smaller tumor foci at 24 h post-treatment (8.5% ± 0.7%) and at 7 d after treatment (11.0% ± 4.2%), compared to those in the control groups (24 h: 98.5% ± 1.5% and 7 d: 94.0% ± 2.7%; both, P < 0.005).
CONCLUSION: Intralesional injection of a 10% aspirin solution causes destruction of VX2 hepatic tumors in rabbits without evidence of relapse at 7 d after treatment administration.
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Denadai R, Raposo-Amaral CE, Fraianella L. Large inflamed branchial cleft cyst presenting as a diagnostic challenge. J Craniofac Surg 2013; 24:1500-1. [PMID: 23851847 DOI: 10.1097/SCS.0b013e3182902c40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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189
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Batista RP, Denadai R, Saad-Hossne R. Effects of aspirin on mesenteric lymph nodes of rabbits as basis for its use on lymph nodes metastases. Acta Cir Bras 2013; 27:795-801. [PMID: 23117612 DOI: 10.1590/s0102-86502012001100009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 09/27/2012] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To evaluate the effects of aspirin 10% and 20% on mesenteric lymph nodes of rabbits as basis for its use on lymph nodes metastases. METHODS A total of 20 lymph nodes from 20 rabbits (randomized in four groups) were evaluated. Aspirin solutions 10% (groups A and C) and 20% (groups B and D) were injected into mesenteric lymph nodes of healthy rabbits and had its gross and histological effects evaluated at 24 hours (groups A and B) and at seven days (groups C and D). RESULTS In the groups A and B evaluated at 24 hours it was observed extensive necrosis and hemorrhage, a significant increase in apoptosis throughout the lymph node with medullary sinuses enlargement and an increase in germinal centers. In the groups C and D evaluated at seven days of solution injection there was also an increase in apoptosis with higher elevation of histiocytes and a significant decrease of necrosis and an increase of giant cells was noticed causing a foreign body chronic inflammation. In all comparisons, there were no differences between the concentrations used (10 and 20%). CONCLUSIONS The injection of aspirin on lymph nodes caused necrosis and an increase of apoptosis after 24 hours and after seven days of treatment there was regeneration of the lymph nodes, with intense decrease of necrosis and a great elevation of apoptosis. These experimental results support future clinical studies on application of aspirin in the treatment of lymphatic metastases, since the increase of apoptosis is one of the pillars of cancer therapy.
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Affiliation(s)
- Rafael Denadai
- Department of Surgery, School of Medical Sciences, University of Marília, Marília, São Paulo, Brazil. E-mail:
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Denadai R, Saad-Hossne R, Martinhão Souto LR. Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program. Indian J Dermatol 2013; 58:200-7. [PMID: 23723471 PMCID: PMC3667283 DOI: 10.4103/0019-5154.110829] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. AIMS To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. MATERIALS AND METHODS One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. RESULTS A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. CONCLUSION The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.
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Affiliation(s)
- Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, Brazilian Society of Research and Assistance to Craniofacial Rehabilitation Hospital (SOBRAPAR), Campinas Brazil ; Department of Surgery, Botucatu Medical School, University of the State of São Paulo (UNESP), Botucatu, Brazil ; Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medical Sciences, Marilia University (UNIMAR), Marilia, SP, Brazil
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193
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Denadai R, Toledo AP, Raposo-Amaral CE. Spontaneous cutaneous endometriosis: a diagnostic challenge in plastic surgery. Aesthetic Plast Surg 2013; 37:483-4. [PMID: 23361955 DOI: 10.1007/s00266-013-0058-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 12/16/2012] [Indexed: 02/08/2023]
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Denadai R, Raposo-Amaral CE. The role of training phases on knowledge related to request of preoperative tests by oral and maxillofacial surgeons. J Craniomaxillofac Surg 2013; 41:545-6. [PMID: 23466125 DOI: 10.1016/j.jcms.2013.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 01/03/2013] [Accepted: 01/03/2013] [Indexed: 02/08/2023] Open
Affiliation(s)
- Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Av. Adopho Lutz, 100, CEP 13084-880, Caixa Postal 6028, 13084-880 Campinas, São Paulo, Brazil.
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196
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Denadai R, Souto LRM. Comments on the giant basal cell carcinoma. An Bras Dermatol 2013; 88:316. [PMID: 23894757 DOI: pmid/23894757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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197
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Denadai R, Toledo AP, Eid FB, Germani NM, de Aveiro WC, Cassim WS. Giant ovarian cystadenofibroma mimicking ascites in an elderly adult. J Am Geriatr Soc 2013; 61:304-6. [PMID: 23405932 DOI: 10.1111/jgs.12081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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198
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Denadai R, Toledo AP, Oshiiwa M, Saad-hossne R. Acquisition of suture skills during medical graduation by instructor-directed training: a randomized controlled study comparing senior medical students and faculty surgeons. Updates Surg 2013; 65:131-40. [PMID: 23404432 DOI: 10.1007/s13304-013-0199-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 01/16/2013] [Indexed: 02/08/2023]
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199
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Souto LRM, Silva RDP. Super giant squamous cell carcinomas. Cutis 2013; 91:78-80. [PMID: 23513555 DOI: pmid/23513555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Squamous cell carcinomas (SCCs) larger than 2 cm in diameter are associated with a greater risk for disfigurement, local recurrence, and metastasis. Giant SCCs are rare. They may develop near aesthetically and functionally important structures and infiltrate them. Treatment may be difficult with the need for large tissue resections and complex surgical reconstruction, with important repercussions on the quality of life of patients. We report 2 cases of super giant SCCs with long-standing evolution that were successfully treated with surgical excision and followed for 24 months posttreatment without signs of local recurrence and/or metastasis.
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Denadai R, Toledo AP, Martinhão Souto LR. Basic Plastic Surgery Skills Training Program on Inanimate Bench Models during Medical Graduation. Plast Surg Int 2012; 2012:651863. [PMID: 23326659 PMCID: PMC3544258 DOI: 10.1155/2012/651863] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 11/12/2012] [Accepted: 11/19/2012] [Indexed: 02/05/2023]
Abstract
Due to ethical and medical-legal drawbacks, high costs, and difficulties of accessibility that are inherent to the practice of basic surgical skills on living patients, fresh human cadaver, and live animals, the search for alternative forms of training is needed. In this study, the teaching and learning process of basic surgical skills pertinent to plastic surgery during medical education on different inanimate bench models as a form of alternative and complementary training to the teaching programs already established is proposed.
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Affiliation(s)
- Rafael Denadai
- Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Avenue Adolpho Lutz 100, Caixa Postal 6028, 13084-880 Campinas, SP, Brazil
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medical Sciences, University of Marίlia (UNIMAR), 17525-902 Marίlia, SP, Brazil
| | - Andréia Padilha Toledo
- School of Medical Sciences, University São Francisco (USF), 12916-900 Bragança Paulista, SP, Brazil
| | - Luis Ricardo Martinhão Souto
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medical Sciences, University of Marίlia (UNIMAR), 17525-902 Marίlia, SP, Brazil
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