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OBJECTIVE: To analyze the morbidity trend and space-time distribution clusters of confirmed COVID-19 cases in children and adolescents. METHOD: An ecological study of COVID-19 cases confirmed in the Information System from 2020 to 2022 in the age group from 0 to 19 years old, residents in Mato Grosso municipalities, Brazilian Midwest region. A trend analysis of the monthly morbidity rate of cases/100,000 inhabitants was used, following Prais-Winsten's regression. A space-time distribution of the Bayesian incidence rate per 100,000 inhabitants was performed, in addition to a space-time scan to identify high-risk clusters. RESULTS: Of all 79,592 COVID-19 cases studied, 51.6% were in females and 44.21% in people aged 15-19 years old. The mean monthly rate was 265.87 cases per 100,000 inhabitants, with a stationary trend in the period analyzed (Monthly Percentage Variation [MPV]) = 12.15; CI95%[MPV]: -0.73;26.70). The morbidity rate due to COVID-19 was higher in the female gender (283.14/100,000 inhabitants) and in the age group from 15 to 19 years old (485.90/100,000 inhabitants). An increasing trend was observed with a greater monthly time variation of 14.42% (CI95%[MPV]: 1.28;29.28)] among those aged from 10 to 14 years old. The primary cluster, which was also the one with the highest Relative Risk (RR = 5,16, p-value = 0.001), included 19 municipalities located in the North health macro-region. CONCLUSION: The findings indicated a monthly stationary trend in the study population, an increase in the age group from 10 to 14 years old, and areas at a higher risk for the disease in the North health macro-region of the state.

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Lymph node microcalcifications are rare events, and when they are accompanied by neoplasia, they usually seem to be associated with a metastatic condition. We present a case of a patient with breast cancer and lymph node microcalcifications undergoing neoadjuvant chemotherapy (NCT). A change in the calcification pattern towards becoming coarse was observed. Calcification represented a marker of axillary disease, and it was resected after NCT. This is the first report of a patient with lymph node microcalcification undergoing NCT. We observed a change in the calcification format, which facilitated lymph node sentinel identification. Pathological evaluation indicated metastatic disease.

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INTRODUCTION: The aging process occurs in all anatomical layers of the face; therefore, rejuvenation should not be limited to the dermic signs of aging (Aesthet Surg J. 2018;38:73) The treatment with fillers in strategic points can reconstruct young anatomy, providing natural results (Aesthet Surg J. 2018;38:73). There are two instruments used for facial application of hyaluronic acid: cannula and needle. Both of them have advantages and disadvantages. OBJECTIVE: In this study, we aim to compare the limitations of application with cannula by cutaneous ultrasound when compared to the needle by ultrasound, since some injectors suggest that one of the disadvantages would be the inability to reach certain application plans (periosteum). MATERIALS AND METHODS: A 52-year-old female patient was treated with 22 mg/ml hyaluronic acid (Juvéderm® Voluma), guided by high-frequency ultrasound (LogicE device, Logic brand (GE Healthcare), with high-frequency linear probe (L8-L18i-RS). The left hemiface was treated with a 27G needle and the right hemiface with a 5 cm 22G cannula (SoftFil®). CONCLUSION: This study proved that, in the malar/zygomatic and the chin region, it is possible the cannula and needle reached the supraperiosteal region. In the temporal region, the cannula did not reach the supraperiosteal plane.

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Ultraviolet B (UVB) irradiation causes free radical production, increase inflammation and oxidative stress, thus, supporting the use of antioxidants by topical administration as therapeutic approaches. Quercetin (QC) is a flavonoid with antioxidant activity, however, high liposolubility makes it difficult to remain in the viable skin layer. Thus, this study evaluated whether microencapsulation of QC would enhance its activity in comparison with the same dose of free QC (non-active dose) and unloaded-microcapsules added in formulation for topical administration in a mouse model of UVB irradiation targeting the skin. Topical formulation containing Quercetin-loaded microcapsules (TFcQCMC) presents physico-chemical (colour, consistence, phase separation and pH) and functional antioxidant stability at 4 °C, room temperature and 40 °C for 6 months. TFcQCMC inhibited the UVB-triggered depletion of antioxidants observed by GSH (reduced glutathione), ability to reduce iron, ability to scavenge 2,2'-azinobis radical and catalase activity. TFcQCMC also inhibited markers of oxidation (lipid hydroperoxides and superoxide anion production). Concerning inflammation, TFcQCMC reduced the production of inflammatory cytokines, matrix metalloproteinase-9 activity, skin edoema, collagen fibre damage, myeloperoxidase activity/neutrophil recruitment, mast cell and sunburn cell counts. The pharmacological activity of TFcQCMC was not shared by the same pharmaceutical form containing the same dose of free QC or unloaded control microcapsules.

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Nonsurgical rhinoplasty is a good treatment choice when surgery is not a viable option. However, serious complications, including blindness or cerebral ischemia, can occur given this area is one of external and internal carotid anastomosis. Here, we describe a case of a patient with a septum ulcer secondary to local ischemia postnasal fillling with hyaluronic acid without skin lesion. Due to the rarity of the condition, her diagnosis was made late, but she was treated with hyaluronidase and showed total resolution.

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While the injection of botulinum toxin type A (BoNTA) in the neck area, for face contouring through the blockade of the platysmal bundles, and in the mandibular body line has previously been explored, reports of its application for the demarcation of the mandibular angle are more limited. This article described a new technique of BoNTA injection in the mandibular angle for the improvement of contour and definition. At roughly 15 days after application in 30 patients, better visualization of the mandibular angle and its contours was evident and, consequently, smoothing of the appearance of sagging around the mandible with no adverse effects was noted. Further investigation of this technique is warranted.

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The nose is an essential feature when considering the aesthetic appeal of the face. As aesthetic preferences vary from person to person, the concept of the "ideal" nose must be applied on a case-by-case basis, with respect to the classical patterns of anthropometry, sex, ethnic group, and psychosocial factors. Interest in less invasive procedures for nasal correction has increased considerably, among which is the emerging use of hyaluronic acid for nonsurgical rhinoplasty. In this article, the authors present an objective review of the anatomy of the nasal region, the evaluation and indications of nasal filling with hyaluronic acid, a description of the technique, and brief discussion of associated complications.

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Vascular lesions such as hemangiomas can be found in the oral cavity. Some therapeutic modalities can be used in the treatment of these lesions and Nd:YAG 1064 nm long pulse laser shows good results with easy application, fewer complications and satisfactory results. This study describes the technique and outcome of a case of hemangioma located on the tongue treated with Nd:YAG laser.

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UNLABELLED: Injectable silicone has been used illegally for more than 60 years. Siliconoma is the term used to describe a foreign body reaction in the human body caused by the presence of silicone. The aim of this study is to report two cases of patients who underwent application of large volumes of injectable silicone with non-medical and unqualified professionals, which led to serious complications sometime after the procedure. LEVEL OF EVIDENCE V: 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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The growing use of dermal fillers, specifically the use of hyaluronic acid, can be explained by their effectiveness and versatility as well as their favorable safety profiles. Nevertheless, early and late complications with varying levels of severity may occur. The incidence of complications is low and the majority of adverse events are mild (edema, erythema, and local ecchymosis) and of limited duration. However, more severe events, such as ischemia and necrosis, may occur. The symptoms of ischemia can occur immediately after the injection or several hours after the procedure. Here, the authors report three cases of necrosis after hyaluronic acid injection with the first symptoms presenting only several hours after the procedure. The patients were treated immediately after the diagnosis. The aim of this review is to communicate the possibility of the delayed-type presentation of necrosis, present the signs and symptoms that lead to early diagnosis, and review the treatment possibilities of this severe complication.

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Polycyclic aromatic hydrocarbons (PAHs) were determined in water samples collected in two streams and a lake located at Niteroi City, Rio de Janeiro State, Brazil between October 2008 and September 2009. Samples were extracted using liquid-liquid extraction and analyzed using high performance liquid chromatography with fluorescence detection. The limits of quantification were sufficiently low to accomplish PAH determination below the maximum concentration levels established by the Brazilian (50 ng/L) and USEPA legislations, with recoveries larger than 81.6%. Phenanthrene, fluoranthene, pyrene and benz[a]anthracene predominated among PAHs. Total concentrations of PAHs were well correlated with rainfall indicating a possible role of runoff to local pollution of water by PAHs and showed a seasonal variation in wet and dry seasons. Our results highlight the contribution of the widespread streams located around Guanabara Bay to the PAH burden found in its waters.

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