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The ear is one of the most common sites of keloid formation, usually associated with the wearing of earrings. However, although this is a small perforating lesion that is equal on both sides, keloids are bigger and more prevalent on the posterior surface. In this study, 141 keloids were evaluated, most of which were located on the posterior surface of the earlobe and caused by the piercing of the ear. Most of the earrings and piercing jewellery used had metallic backs. The more frequent occurrence of earlobe keloids on the posterior surface of the ear therefore may be associated with the exacerbation of local neurogenic inflammation caused by the metallic backs.

Lidocaine blocks nociceptive fibers, preventing initial wound signaling and mast cell degranulation. It is hypothesized that epinephrine and buffer affect the wound healing by potentiating lidocaine blockage. This double-blind, randomized, self-controlled study investigated this possibility using male Wistar rats, which were injected with 2 mL of different solutions into the left and right sides of the back. Then, each side was incised and sutured. Sixty rats were divided in three groups: saline solution (SS) and lidocaine; lidocaine and lidocaine with buffer; lidocaine with epinephrine and lidocaine with epinephrine and buffer. Half of each group was sacrificed 7 days after surgery and the remaining after 21 days. A sample of each wound was obtained and quantified for the level of collagen present using computer morphometry and for mast cell quantity. There were no differences between animals with regard to the collagen. However, mast cell levels in the same animal significantly differed between SS × lidocaine. Comparison of the same injected substance between animals with different healing dates showed a significant effect on collagen SS and on all mast cells, except SS. Lidocaine affected collagenization and decreased the initial quantity of mast cells at the wound site.

The treatment of calcaneal tendon injuries requires long-term rehabilitation. Ultrasound (US) and low-level laser therapy (LLLT) are the most used and studied physical agents in the treatment of tendon injuries; however, only a few studies examined the effects of the combination of US and LLLT. Therefore, the purpose of this study was to investigate which treatment (the exclusive or combined use of US and LLLT) most effectively contribute to tendon healing.This was a controlled laboratory study with 50 rats whose Achilles tendon was injured by direct trauma. The rats were randomly divided into five groups and treated for 5 consecutive days, as follows: group 1 (control) received no treatment; group 2 was treated with US alone; group 3 was treated with LLLT alone; group 4 was treated first with US followed by LLLT; and group 5 was treated first with LLLT followed by US. On the sixth post-injury day, the tendons were removed and examined by polarized light microscopy. The organization of collagen fibers was assessed by birefringence measurements. Picrosirius-stained sections were examined for the presence of types I and III collagen.There was a significantly higher organization of collagen fibers in group 2 (US) than in the control group (P = 0.03). The amount of type I collagen found in groups 2 (US), 3 (LLLT), and 5 (LLLT + US) was significantly higher than that in the control group (Por= 0.01), but no significant differences were found between treatment groups. There were no differences in the amount of type III collagen between groups.Ultrasound, LLLT, and the combined use of LLLT and US resulted in greater synthesis of type I collagen; US was also effective in increasing collagen organization in the early stages of the healing process.

Mandible fractures can result in esthetic, functional and financial problems and their epidemiological patterns have changed in many locations. This study was carried out to detect these changes, aiming to compare data of patients with mandible fractures treated at the Sao Paulo Hospital (UNIFESP-EPM) from June 1999 to March 2002 with data of patients treated from January 1991 to March 1996.Information on most affected gender and age, most often fractured mandible segment, associated injuries, treatment and complications of 98 victims of mandible fracture admitted from June 1999 to March 2002 were compared to the same data of 166 patients treated from January 1991 to March 1996.the most affected gender and age ranges remain the same. Aggressions surpassed traffic accidents as the main etiology. Incidence of associated injuries and multiple fractures in the mandible decreased, a fact probably related to the change in etiology. The most affected segment is still the body of the mandible. The most used type of treatment in both samples was internal rigid fixation with miniplates and the number of complications decreased, due to the higher standard of patient care.Mandible fractures in the São Paulo population have undergone epidemiological changes and this knowledge enables local authorities to establish adequate measures for prevention and treatment.