Fundamentals of the Use of Ozone Therapy in the Treatment of Aesthetic Disorders: A Review

Considering the great interest of many professionals in the foundation that guides the effective use of ozone therapy in the treatment of aesthetic disorders, this study aims to define the physiological and practical aspects of using the oxygen-ozone mixture to solve aesthetic problems. Exploratory research was carried out, presented in a narrative review, to highlight the action of ozone therapy in the treatment of aesthetic affections. The review explored scientific articles, books, theses, and dissertations published and available in the following databases: MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed (National Library of Medicine), SCIELO (Scientific Electronic Library Online), and LILACS (Latin Literature American and the Caribbean in Health Sciences). In addition, elements that characterize the authors’ clinical experience on ozone therapy in various aesthetic treatment protocols were added. We found several reports in the literature that justify the use of ozone and its different therapeutic modalities in various aesthetic affections, mainly in the treatment of localized fat, cellulite, rejuvenation, skin tissue repair, acne, dyschromia, and others. Through its various therapeutic modalities, we conclude that ozone therapy has added a lot to aesthetic procedures, mainly for its effective supporting action or as the main agent of critical physiological changes to enhance clinical results when treating aesthetic conditions.

Effect of Microfocused Ultrasound on Facial Rejuvenation: Clinical and Histological Evaluation

Introduction: Micro focused ultrasound (MFU) is formed by mechanical waves emitted in a focused manner, concentrating thermal energy on a certain point or region, promoting a clinical improvement in wrinkles. Objective: evaluate the effects of micro focused ultrasound on facial rejuvenation. Methodology: This is an experimental study. The sample consisted of 30 volunteers, who were evaluated before treatment, 45 and 90 days after its beginning. A single application of the MFU was performed across the facial region. The parameters used were: 10 MHz cartridge with depth of 1.5 mm, 7 MHz with depth of 3 mm, and 4 MHz with focal depth of 4.5 mm;doses ranged from 0.1 to 2.0 J, according to the sensitivity of the volunteers treated, and the application time was of approximately 90 minutes. Clinical photographic analysis and facial symmetry analysis using Dolphin Imaging software were performed, and validated questionnaires. Two volunteers were submitted to blepharoplasty surgery, and one to rhytidoplasty surgery 45 days after the application of the MFU. Samples of the treated skin were taken after the surgical procedures and submitted to histological and immunohistochemical analyses. The volunteers answered a questionnaire to assess adverse reactions and satisfaction. Results: We observed a visible clinical improvement on the images by photography, and an improvement of facial symmetry in the measurements of the paralateronasal projection (p = 0.007), left lateral mandibular (p = 0.01), and right lateral mandibular (p = 0.008). The histological analysis showed an increase in the amount of fibroblasts (p = 0.02), blood vessels (p = 0.0062) and inflammatory cells (p = 0.0036), in addition to the production of type 1 collagen. In the immunohistochemical analysis, we observed the presence of the macrophage marker IHQ: CD68, indicating phagocytosis of adipose tissue and the presence of fibrosis. In the analysis of adverse reactions, only transient hyperemia was observed with the presence of pain during application. Additionally, the volunteers expressed high level of satisfaction (93%) with the treatment Conclusion: The MFU promoted the production of collagen, reorganization of the dermis and, clinically, a reduction of sagging and wrinkles, with increased facial symmetry.

The Teaching of Sign Language in Undergraduate Nursing Courses: A Descriptive Study as an Attribute to the Integrality of Care

Background: Current and future generations of nurses must be prepared to communicate and properly care for deaf patients. The objective of this study is to describe how Brazilian Sign Language is taught in undergraduate Nursing courses. Method: This was a descriptive study with a qualitative approach, performed with fifteen professors from four universities, two public and two private and in the metropolitan region of Rio de Janeiro, through individual interviews with an analysis procedure guided by Content Analysis. Results: The teaching is restricted to the adoption of planned and established approaches to sign language and procedures to assess theoretical contents and practical domains sign language teaching exclusively in elective course often offered through the online platform. Conclusion: We conclude that professors are not prepared for the teaching of sign language and that curricula need to be appropriate to the demand of full and indistinct assistance to the population’s needs.

Vulvar Rejuvenation Using High-Intensity Focused Ultrasound (HIFU): Fundamentals and Technique

Background: The unaesthetic appearance of the female intimate area (vulva, “mound of venus” and perianal region) is a triggering factor of negative psychological responses, embarrassment, anxiety and insecurity in many women. Using rejuvenating equipment for vaginal structure or for the intimate area as a whole is already widespread in the literature, and High-Intensity Focused Ultrasound (HIFU) has proven to be very effective in the clinical practice of many professionals. This study, therefore, aims to describe the fundamentals and applicability that guide the use of HIFU in vulvar rejuvenation. Materials and Methods: Exploratory research was carried out, presented in a narrative review, to highlight the action of HIFU in female intimate rejuvenation. The review explored scientific articles published and available in the following databases: MEDLINE (Medical Literature Analysis and Retrieval System Online), PubMed (National Library of Medicine), SCIELO (Scientific Electronic Library Online), and LILACS (Latin Literature American and the Caribbean in Health Sciences). In addition, some clinical findings obtained through a retrospective analysis of medical records were added to describe the authors’ clinical experience in the use of Focused Ultrasound (HIFU) for vulvar rejuvenation. Results: We verified that the tissues of female external genitalia respond very well to the stimuli of the focused sound waves of the HIFU, being able to produce immediate and lasting results through isolated applications or in association with intradermotherapy or other therapeutic resources. Conclusion: We conclude that using High Intensity Focused Ultrasound aimed at vulvar rejuvenation is safely indicated and assures excellent aesthetic results at the end of the treatment because similarly to other treatment techniques, the thermal stimuli of HIFU are also able to produce an excellent therapeutic response in the dermal tissue of the female intimate area, promoting intense neocollagenesis and generating great aesthetic improvement.

Searching for the Lost Ostium: A Morphometric Analysis of the Ureteral Ostia Distribution in Normal and Thickened Bladders and Its Applications in Endourology

Introduction: The ureteral ostia may not be easily identified in urological endoscopic procedures, leading to an incomplete diagnosis of urinary tract diseases or a predisposition to iatrogenic lesions. The purpose of our study is to evaluate the anatomical distribution of ureteralostia in normal bladders and those with thickened walls. Materials and Methods: We dissected 30 vesical-prostate blocks from human cadavers and identified the ostia of the bladder trigone. A computerized morphometric analysis was performed to measure the thickness of the detrusor muscle, the distances between the ureteral ostia themselves and the distances between each ureteral ostium (left—LUO and right—RUO) and the internal urethral ostium (IUO). The angle formed between the IUO and LUO/RUO was also recorded as well as the volume of the prostates. Results: Fifteen bladders with a non-thickened detrusor (6 mm) were identified. The average prostatic volume of the dissected blocks was 23.7 cm3. The distance between ureteral ostia, the distance from IUO to LUO, the distance from IUO to RUO and the angle formed between IUO and LUO/RUO in normal and thickened bladder were, respectively, 1.9 cm/2.2 cm (p = 0.09), 1.6 cm/1.6 cm (p = 0.82), 1.6 cm/1.7 cm (p = 0.79) and 77/91 (p = 0.17). Conclusions: Our study shows that there is no significant difference in the position of bladder ostia in healthy and thickened bladders. We believe that our findings may facilitate locating the ureteral orifices in situations where endoscopic identification is difficult.

Comparative Study of Collagen Stimulation Using Semi-Ablative and Non-Ablative Radiofrequency

Objective: Comparison between semi-ablative and non-ablative radiofrequency for collagen stimulation. Method: Three volunteers with scheduled surgical procedures of abdominoplasty were selected. After the evaluation, the abdominal area was divided into three quadrants, with the right region receiving monopolar non-ablative radiofrequency (RF) application. In contrast, the left region received fractionated radiofrequency (FRF) application, using three different needle sizes (0.5, 1.5, and 3.0 mm), and the intermediate area was kept as a control. After 24 hours, surgery was performed, and the skin flaps were collected for histological and immunohistochemical analyses. Results: An increase in total collagen and type I collagen was observed in the treated groups. There was also an increase in the expression of COX-2, CD68 positive cells (macrophages), and lymphocyte markers (CD3, CD20, and NK-CD57). Furthermore, it was seen that only the use of 3.0-mm needles kept the channels open in the superficial tissue after 24 hours. There were no significant differences between the modalities. Conclusion: Non-ablative and sub-ablative radiofrequency have positive and effective results for flaccidity, demonstrating the success in collagen production. Furthermore, this study is the first to present channel opening and permanence time, which are important to optimize the action of drug delivery.

Transnationalization on the Technique of Assisted Human Reproduction

This paper＇s purpose is to present a reflective analysis about the process of transnationalization in which the technique of assisted human reproduction has been going to the extent that such a procedure has been revealed as a true ＂fertility tourism＂, offered through packages for those people who have financial conditions, but cannot through natural means to realize the dream of membership. Through the dialectic method of discourse, promoting the comparison of the thought of many authors who focus on issues such as globalization, commodification of human, technical exacerbation detriment of humans, and their interpersonal relations, the author seeks to introduce issues that are the order of day with respect to this global market arising from the tremendous advances reproductive techniques in a society marked by economic interests, it turns much more to the consumer and considers the human being as an additional asset to be sold, since its conception. The author acknowledges that they cease for tourism human reproduction is a trade that is worth of human frailty, because relying on one of the most intimate aspects of life： the desire to be a mother or father or ultimately, the perpetuation of the species.

Effects of Semi-Ablative Fractional Radiofrequency Associated with Growth Factors in Stretch Marks: A Randomized Controlled Trial

Background: To investigate the effects of the association of semi-ablative fractional radiofrequency (RFF) with growth factors in stretch marks. Methods: This is a randomized controlled trial. The sample consisted of 28 female patients with complaints of gluteus or abdomen striae and divided into 2 equitable groups, named G1 (semi-ablative RFF without active principle association) and G2 (semi-ablative RFF with active principle association), being subdivided into G-1A and G-2A (abdominal applications) and G-1B and G-2B (gluteus applications). A photographic and histological analysis was performed using questionnaires about inflammation, presence of adverse effects and satisfaction of volunteers. Photographic analysis showed a reduction in the amount of striae alba in all groups. Results: The histological analysis showed an increase in fibroblast activity, collagen type I, and blood vessels, especially in the groups that associated the RFF with the active principle. In the inflammation analysis, the groups that performed intervention with active ingredients showed lower inflammatory signal. All groups had a reasonable level of satisfaction after the interventions;however, the group that used active ingredients reported greater results. Conclusion: The association of semi ablative RFF with growth factors showed a reduction in clinical inflammatory signs, mainly in the first 15 days, as well as higher collagen production, verified in 30 days, with satisfactory clinical results in all groups.

Effects of Hydrolysed Collagen Associated or Not with Physical Agents on Tissue and Muscle Flaccidity—Firmez Method: Case Study

The combination of therapies may be the promising future for the treatment of esthetic alterations more efficiently and in less time, in order to obtain an excellent result. Our objective was to evaluate the effectiveness of hydrolysed collagen associated with radiofrequency and electrostimulation in the treatment of flaccidity in the abdominal and gluteal regions. The sample consisted of 6 women, evaluated through evaluation protocols, questionnaires, dynamometry, ultrasound exams, and histological analysis. The volunteers were distributed into three subgroups: hydrolysed collagen group (G-1), radiofrequency + hydrolysed collagen group (G-2) and radiofrequency + hydrolysed collagen + electrostimulation group (G-3). The ultrasound analysis of the abdominal muscles showed an increase in muscle thickness in all groups, but not significant (p > 0.05). The histological analysis showed an evident increase in type I collagen in groups G-2 and G-3, with proliferating cells (Ki67+). The results of dynamometry showed significant values in different times (p < 0.05). There was a significant result in the infraumbilical perimetry analysis, when compared between the groups with 30 days (p = 0.03) and with 60 days (p = 0.04). All participants rated the treatment positively. The use of combined therapies has shown superior results for the treatment of abdominal and gluteal flaccidity when compared with its isolated use, being the combination of therapies important in the treatment of flaccidity.