Hermanos Ameijeiras Research Articles

Restauración volumétrica autóloga en pacientes con hemiatrofia adiposa facial

IntroductionFacial lipoatrophy lacks standard clinical criteria for its diagnosis and treatment; however, patients with hemifacial atrophy increase, affecting the mental health of patients who suffer from it. Lipografting has been rescued as an effective and safe treatment option. ObjectiveTo show the results of autologous volumetric restoration in patients with facial adipose hemiatrophy. MethodMulticenter, descriptive, longitudinal and prospective study carried out on 29 patients treated at the Hermanos Ameijeiras Hospital, Cuba and the EIMEC clinic, Spain in the period from July 2018 to July 2023. Both sexes were included, between 19 and 75 years old, with facial asymmetry due to unilateral decrease in subcutaneous cellular tissue. ResultsThe average age was 47.9 years. Women predominated with 79.3%. The most common etiologies were idiopathic, autoimmune and orbital trauma, each accounting for 17.2%. According to the degree of severity, grade II was the highest, with 65.5%, and grade III represented 34.5% of the total. Regarding the amount of grafted adipose tissue, 62.1% of the cases were 31 to 60ml, and 27.6% more than 60ml. According to the number of graft applications, 72.4% required one and 27.6% two applications. 93.1% had no complications and 6.9% reported 50% reabsorption of the graft. Patient satisfaction reached 100% and the results were classified as good in 86.21%; when there was improvement, without complications as well as patient satisfaction. ConclusionAutologous lipotransfer assisted with adipose tissue stem cells is a safe treatment option that offers good results in correcting asymmetry caused by hemifacial lipoatrophy.

Enhanced Surgical Safety through Protective Penetrating Keratoplasty: A Retrospective Analysis of 22 Cases.

To assess the surgical safety, postoperative outcomes, and the impact of PPK on corneal endothelial cell density through a retrospective analysis of 22 cases. Settings and Design. A retrospective cross-sectional observational study was executed at Hermanos Ameijeiras Hospital from February 2018 to December 2021, involving 22 patients (22 eyes) who were unresponsive to other medical treatments and had a corrected distance visual acuity of ≤0.1. Patients underwent PPK, with surgical procedures and postoperative care documented. Statistical analysis was performed on qualitative and quantitative variables to evaluate the surgical outcomes and the corneal endothelial cell density changes postoperation. All surgeries demonstrated a significant improvement in postoperative visual acuity (p ≤ 0.001) and recorded a 9.2% decrease in the corneal endothelial cell density at 12 months. Noteworthy complications included one case of intraoperatively discovered haptic dislocation and one postoperative bacterial keratitis. PPK could potentially mitigate perioperative complications, ensure graft clarity, and reduce corneal endothelial cell loss, presenting itself as a viable alternative to traditional PK. Although the results are encouraging, larger-scale studies are essential to validate the benefits and applicability of PPK in broader clinical settings.

Minimally invasive approach for skull base meningiomas

IntroductionSkull base meningiomas constitute a complex group of skull base tumors. The endoscopic endonasal approaches (EEA) and endoscopic Keyhole have a minimally invasive philosophy with high effectiveness, safety, and a significant decrease in postoperative morbidity in these tumors. ObjectiveTo describe the results of the use of minimally invasive approaches to skull base meningiomas. MethodA descriptive, retrospective study was carried out in 140 patients at the "Hermanos Ameijeiras" Hospital who underwent surgery for cranial base meningiomas using minimally invasive approaches to the cranial base. The degree of tumor resection, tumor recurrence, reinterventions, and complications were evaluated. ResultsESA were used in 72.8% of the study, while endoscopic Keyholes were used in 26.4% and combined approaches in 0.7%. In relation to total tumor resection, 91.9% was generally achieved. Overall tumor recurrence and reinterventions were less than 8.5% and 4%, respectively. Complications in ESA were: cerebrospinal fluid (CSF) fistula (2.1%), diabetes insipidus, hydrocephalus, cerebral infarction, surgical site hematoma, worsening of cranial nerves I-IV (1.4%) respectively. While in the Keyhole type approaches: seizures (2.9%), hydrocephalus (1.4%), CSF fistula (1.4%), worsening of Nerves IX-XII (0.7%). ConclusionsThe following study reaffirms that minimally invasive approaches for skull base meningiomas constitute advanced surgical techniques for these tumors, associated with a low rate of postoperative complications.

Ministernotomy for aortic valve replacement. Results in the diabetic patient

Introduction: aortic valve stenosis (AS), emerges as a new epidemic due to the aging population.Published data relate diabetes mellitus to risk factors involved in the pathogenesis of atherosclerosis. Objectives: to describe the results of aortic valve replacement by ministernotomy in diabetic patients. Methods: an analytical prospective cohort study was carried out on patients with aortic stenosis and diabetes mellitus treated at the Abel Santamaría Hospital and the Hermanos Ameijeiras Hospital from August 2016 to December 2021, the sample included 16 patients. Clinical and postoperative variables were used. Results: 66,7 % of the patients with aortic stenosis had a history of diabetes mellitus. Of these diabetics, 68,8 % were type 2 and only 31,2 % were type 1. Several post-surgical complications were listed and respiratory infections predominated with 12,5 %. Conclusions: Dyslipidemias and diabetes constitute atherogenic risk factors associated with aortic stenosis. Type 1 diabetes is the most frequently associated with aortic stenosis. The predominant symptoms independent of the type of diabetes were dyspnea and angina, and the predominant post-surgical complication was respiratory infections.

Characterisation of Patients with Acute Coronary Syndrome: A 10-Year Experience

Introduction: Coronary intervention is a therapeutic method for acute coronary syndrome. Objectives: Characterise patients with acute coronary syndrome treated by percutaneous coronary intervention. Method: Analytical, observational, retrospective, and cross-sectional study of 1,469 patients with the diagnosis of acute coronary syndrome, treated with percutaneous coronary intervention at the Hermanos Ameijeiras Hospital, Havana, Cuba, between 2010–2019. Results: The mean age of the patients was 61.1±10.6 years, 72% were male, and 68.3% had acute coronary syndrome without persistent ST-segment elevation. The commonest risk factor was hypertension (69%). Radial access was used in 75.0% of procedures, and 82.0% had a single occluded epicardial coronary artery (42.4% anterior descending artery, 29.7% right coronary artery). One (63.3%) bare metal stent was implanted in 70.7% of patients, with a 96.0% angiographic success rate. There were complications in 1.1% of cases. Diabetes was significantly associated with the failure of the procedure. Conclusions: Most of the patients were middle-aged, with hypertension and a diagnosis of non-ST-segment elevation acute coronary syndrome, where the most frequently treated artery is the left anterior descending artery, and the radial artery is the most commonly used vascular access route with an elevated number of successful procedures. The presence of diabetes is significantly associated with the failure of the procedure.

Tumors of Oligodendroglial Origin, Results of a Five-Year Study

Objective: Oligodendrogliomas are intracranial tumors that represent between 5 to 25 % of gliomas in adults. This study reviews the results of treatment in patients with oligodendrogliomas treated at “Hermanos Ameijeiras” Hospital between January 2015 and December 2020. Methods: We made an observational, descriptive and retrospective study type cohort in a series of 31 patients with oligodendroglioma treated at “Hermanos Ameijeiras” Hospital. Results: Predominate male patients with ages between 41 to 60 years (55%), with clinical presentation of seizures in 71% and frontal location in 52%. Total surgical resection was performed in 84% of patient, which supported by adjunctive treatment, achieved total regression of disease in 71 % of patients and postoperative improvement in 100% of the patients according to the Karnofsky functional scale. Conclusions: Oligodendroglia tumors are gliomas with their own imaging, histological and genetic characteristics. Combination of the different therapeutic modalities has an important role in the control of the disease and its survival, associated with a better neurofunctional state of the patient in the pre-surgical and post-surgical period

Glioblastoma, Treatment Strategies at the "Hermanos Ameijeiras" Hospital.

Objective: Gliomas are the most common primary malignant tumors of the central nervous system (CNS) and, from them, 45.6 % corresponds to glioblastomas (GB). This work aims to determine the results of treatment for patients with glioblastomas treated at the “Hermanos Ameijeiras” Hospital, Cuba, in the period from January 2015 to December 2020. Method: An observational, descriptive, retrospective cohort assessment was carried out in a population of 45 patients treated at the “Hermanos Ameijeiras” Hospital, Cuba, with a diagnosis of glioblastoma. Results: Male patients aged 40 to 59 years (57.7 %) with white color skin (82 %) were predominant with clinical symptoms of motor deficit syndrome. The survival rate was greater than 12 months in 18 patients (40 %), while for 21 patients (46.7 %) it was between 6 and 12 months. Conclusions: Glioblastoma is a challenge for the multidisciplinary medical team. The best therapeutic results and survival rates are related to the strategies of a multimodal treatment that begins with maximum safe resection of the lesion, followed by radiotherapy, chemotherapy and immunotherapy oncological treatments.

Transcranial Doppler Ultrasonography-Related Research in the Caribbean Region.

Transcranial Doppler (TCD) ultrasonography is a non-invasive ultrasound technique that uses high-frequency sound waves to measure blood flow velocities in the cerebral vasculature. This review analyzes TCD research in the Caribbean region using a bibliometric analysis of 29 articles from PubMed. The articles were analyzed using Microsoft Excel 2016 and the VOSviewer software (Van Eck and Waltman, Leiden University,Centre for Science and Technology Studies(CWTS),www.vosviewer.com) and characterized various aspects of TCD research, including countries, research themes, authorship, journals, affiliations, and keywords. The majority of the 29 publications came from Cuba (38%), followed by the French West Indies (22%) and Jamaica (20%). Most TCD research focused on sickle cell disease (SCD), accounting for 45% of the studies, followed by 21% of articles on vasospasm and subarachnoid hemorrhage. The use of TCD in brain death and neuro-intensive care was also explored, constituting 17% of the studies. Alternative TCD-monitored treatment options for SCD, such as stem cell transplantation and hydroxyurea, were also frequently investigated. The most productive institutions were Hospital Clínico-Quirúrgico Hermanos Ameijeiras in Havana, Cuba, the Sickle Cell Unit at the University of West Indies (UWI) Mona in Jamaica, the Medical-Surgical Research Center (CIMEQ) in Havana, Cuba, and the SCD Reference Center in Guadeloupe and Martinique in the French West Indies. TCD has been identified as a cost-effective tool for real-time monitoring of cerebral blood flow in many clinical settings, including stroke and SCD, which are prevalent in the Caribbean. Although there is an increase in the trend of using TCD for neuromonitoring in the Caribbean, gaps still exist. Capacity-building initiatives, such as training programs for healthcare providers and the development of local TCD research networks, can improve access to TCD in resource-constrained settings to treat and neuromonitor patients cost-effectively.

Cuban Scientific Production on Intensive Care and Emergency Medicine in Scopus (2019-2021)

Introduction: health research is a key link in scientific development. Research in intensive care medicine is essential to improve medical care, generate new treatments, reduce mortality and save resources. Aim: to characterize Cuban scientific production in Intensive Care and Emergency Medicine in Scopus between 2019 and 2021. Method: an observational, descriptive, bibliometric study of articles with Cuban authorship published in Scopus between 2019 and 2021 that responded to the areas Emergency Medicine and Critical Care and Intensive Care Medicine was carried out. SciVal was used to obtain and analyze the data. Results: 18 articles were published and 184 citations were received, with an average of 2.33 and 3.67 articles per year for the areas Emergency Medicine and Critical Care and Intensive Care Medicine respectively; the percentage of excellence was 60 and 37.5 % respectively. For both areas, international collaboration predominated. The most productive author was DrC. Frank Daniel Martos-Benítez and the institution was the Hospital Clínico Quirúrgico "Hermanos Ameijeiras" (Ndoc=4, Authors=8, Ncit=33). Conclusions: there is a discreet increase in the annual scientific production when compared to previous periods, which was centered in first and second quartile journals. Collaboration, especially international collaboration, was shown to be standard in publication.

Educational needs in patients with knee osteoarthritis using the SpENAT questionnaire

IntroductionKnee osteoarthritis (KOA) is a major public health issue because it causes pain and functional limitation in patients. Engagement with self-management may, however, minimize the impact of KOA on the health of patients suffering this illness. To be fully engaged with self-management activities, knowledge about KOA is a prerequisite. There is data on people’s understanding of KOA and their needs for information about KOA. The Educational Needs Assessment Tool-Spanish version (SpENAT) is a self-reported questionnaire that assesses educational needs (Ned) in order to provide information adapted and focused on patients with knee KOA. It comprises 39 questions grouped into seven domains: Pain, Movement, Feelings, Osteoarthritis, Medical treatment, Non-medical treatment, Help. ObjectivesTo estimate the Ned in patients with knee KOA using the SpENAT. Material and methodAn observational, descriptive, and cross-sectional study was carried out in 215 patients with a diagnosis of knee KOA according to the criteria of the American College of Rheumatology who attended the service’s protocolized consultation of knee conditions of rheumatology at the “Hermanos Ameijeiras” Surgical Clinical Hospital during the study period between January 2017 and August 2020. Demographic data, educational level and characteristics of the disease were recorded. All patients completed the SpENAT and were questioned about the sources they turn to obtain information on their disease. ResultsWomen over 50 years of age and overweight with a diagnosis of OA predominated. Major Ned were observed in the domains of movement, help, pain, feeling, KOA. Patients over 50 years of age, female, normal weight, and active workers showed greater interest in the movement domain. The most used source of information was the rheumatologist (91.60%). ConclusionThe Ned in patients with knee KOA are high, and are higher in the domains of movement, pain, help and feeling. The rheumatologist is the main source of information for patients with KOA, it seems wise to design a targeted strategy to educate people about KOA to provide, support and prepare them for self-management.

Treatment of cutaneous photoaging lesions with autologous platelet concentrate

Background: Facial aging causes a devastating physical and mental impact on quality of life. Objective: To evaluate the efficacy and safety of autologous platelet concentrate (APC) in the treatment of cutaneous photoaging (SCF). Method: Between March 1, 2017 and March 31, 2021, at the “Hermanos Ameijeiras” hospital, a randomized, single-center, double-blind and controlled clinical trial was carried out in 164 patients with ECF. A group treated with CPA was compared to another treated with fresh autologous plasma (AFP). The treatment was applied monthly for 1 year. Results: Three months after the end of the treatment, there were significant differences between the patients treated with CPA compared to those treated with PFA in terms of the improvement in the degree of photodamage and the degree of satisfaction (p <0.001). All adverse events were of mild intensity, did not imply changes before the intervention and were completely resolved. Conclusions: The autologous platelet concentrate proved to be effective and safe to reduce the signs of skin aging, associated with a high degree of patient satisfaction.

Depresión mayor en ancianos de 85 y más años

Depression is considered the most frequent mental illness; it is a cause of disability and constitutes a modifiable risk factor for the future development of dementia. The objective of tis study was to determine the frequency of major depression in elderly aged 85 and over and its possible association with dementia and with sociodemographic and clinical aspects. A descriptive cross-sectional study was carried out in 202 elderly who were treated in the protocolized consultation ¨The care of cognitive disorders in the elderly ¨, of the Hermanos Ameijeiras hospital, during the period between February 2016 and May 2016. 2020. 55.9% of the elderly were women and 64.9% were between 85 and 89 years old. A significant association was found between major depression and having comorbidity (p = 0.001), being a smoker (p = 0.003) and being a drinker (p <0.001). Major depression and dementia were diagnosed in 12.9% of the elderly, with no significant relationship (p = 0.731). The frequency of major depression in elderly aged 85 and over who were treated in a care consultation for cognitive disorders in the elderly is considered high. An association was identified between factors that deteriorated health and the presence of major depression, but not between it and dementia.

Oncoplastic Surgery of Phyllodes Tumor of the Breast: Experience at Hermanos Ameijeiras Hospital

Introduction: Oncoplastic surgery of the breast in the treatment of Phyllodes Tumor allows wider oncological margins with better aesthetic results. Objective: To evaluate the different oncoplastic surgical techniques in the treatment of Phyllodes tumor. Method: Descriptive, longitudinal and ambispective study in 21 patients operated on for Phyllodes Tumor at the Ameijeiras Hospital from January 2006 to December 2018. Results: The average age was 49 years. There was a predominance of 42.9% of tumors with intermediate grade of malignancy, 14.3% benign and 43% malignant. The predominant tumor size was greater than 5 cm with 52.7%, followed by tumors between 2 and 5 cm with 28.6%. The surgical technique that prevailed was simple mastectomy in 57.1% and conservative surgery in 42.9%. 47.6% had free surgical margins, 33.3% undefined, 14.3% narrow, and 4.8% infiltrated. This corresponds to a Ki 67 ≤10% in 38.1% of the total. 80% underwent flap reduction mastoplasty, followed by breast implants with mastopexy of the healthy breast and Toreck technique with 9.5% each. Local recurrence occurred in only one patient 3 months after surgery, 2 years later, and then 3 years later. No complications were reported. All patients were satisfied and there were no deaths. Conclusion: Oncoplasty techniques constitute a fundamental pillar in the treatment of Phyllodes Tumor as part of multidisciplinary therapy.

Treatment of Cutaneous Photoaging of Glabella with Autologous Platelet Concentrate

Introduction: Platelet rich plasma (PRP) is an autologous blood product obtained after centrifugation of the blood. Contains high concentrations of platelets and growth factors. It is currently a very popular therapy in dermatology; however, few studies objectively evaluate its efficacy. Objective: To evaluate the efficacy and safety of intradermal microinjection of autologous platelet concentrate (APC) in the treatment of glabella rejuvenation. Method: An observational, analytical and longitudinal study was carried out in 60 patients from the Hospital Clínico Quirúrgico: “Hermanos Ameijeiras”, in the period between March 1, 2017 and March 31, 2020. The treatment was applied monthly. for 1 year. The final evaluation was carried out 3 months after the end of the treatment. Results: 60 women with an average age of 45 ± 4.3 years were treated. After treatment, there were significant changes in the Glogau Photo Damage Scale (P = 0.012), in the Photo numeric Scale for evaluating the severity of glabella wrinkles (P = 0.031) and in the Global Aesthetic Improvement Scale (P = 0.012). The adverse events found were pain, inflammation and ecchymosis. The degree of satisfaction reported by the patients was good (25.0%) and very good (75.0%) (P = 0.027). Conclusions: The autologous platelet concentrate proved to be effective and safe in reducing the signs of skin aging in glabella, associated with a high degree of patient satisfaction.

Facial Skin Changes Produced by Treatment with Autologous Platelet Concentrate

Background: The tireless search for therapeutic options that alleviate the signs of skin aging is a challenge for the aesthetic practitioner. Objective: To evaluate the efficacy and safety of autologous platelet concentrate (APC) in the treatment of facial cutaneous aging (FCA). Method: Between March 1, 2017 and March 31, 2021 at the “Hermanos Ameijeiras” hospital, a randomized, singlecenter, double-blind and controlled clinical trial was carried out in 164 patients with FCA. A group treated with APC was compared to another treated with fresh autologous plasma (FAP). The treatment was applied monthly for 1 year. Results: Three months after the end of the treatment, there were significant differences between the patients treated with APC compared to those treated with FAP in terms of improvement in the texture, tone, elasticity, hydration, pores, homogeneity of the skin, the global aesthetic improvement scale (GAIS) and degree of satisfaction (p <0.001). All adverse events were of mild intensity, did not imply changes before the intervention and were completely resolved. Conclusions: The autologous platelet concentrate proved to be effective and safe in reducing the signs of skin aging, associated with a high degree of patient satisfaction.

Unusual increase in the incidence of unilateral Optic Neuritis: Case presentation

Optic neuritis presents as an acute or subacute inflammatory episode. Objective: Describe the clinical-epidemiological characteristics in 7 cases with unilateral optic neuritis and evaluate the therapeutic results obtained. Material and method: A series of cases with a diagnosis of unilateral optic neuritis who attended the Neurophthalmology consultation at the Hermanos Ameijeiras Hospital in Havana, Cuba, from August 6 to November 16, 2018, from Havana and Matanzas, were studied. An unusual increase in the incidence of NO was recorded in the period analyzed. Results: An unusual increase in the incidence of unilateral optic neuritis was recorded. The average age was 33.5 years. All reported unilateral painless visual loss. Four patients reported general signs and symptoms suggestive of having suffered a respiratory disease of viral origin, between 7 and 15 days before optic neuritis. In the examination carried out, great impairment of visual acuity (≤0.05) and colors (0/21) was found. The centro-caecal scotoma was the most frequent campimetric defect. Optical Coherence Tomography (OCT) in the affected eye showed increased neuroretinal thickness, decreased nerve fiber layer, and ganglion cell damage. Treatment was with intravenous methylprednisolone and B vitamins. Conclusions: An unusual increase in patients with unilateral optic neuritis was observed. The OCT revealed damage to the structures at the level of the retina and the optic nerve. The therapeutic effectiveness was conditioned by the time of evolution of the neuritis.

Unusual increase in the incidence of unilateral Optic Neuritis: Case presentation

Optic neuritis presents as an acute or subacute inflammatory episode. Objective: Describe the clinical-epidemiological characteristics in 7 cases with unilateral optic neuritis and evaluate the therapeutic results obtained. Material and method: A series of cases with a diagnosis of unilateral optic neuritis who attended the Neurophthalmology consultation at the Hermanos Ameijeiras Hospital in Havana, Cuba, from August 6 to November 16, 2018, from Havana and Matanzas, were studied. An unusual increase in the incidence of NO was recorded in the period analyzed. Results: An unusual increase in the incidence of unilateral optic neuritis was recorded. The average age was 33.5 years. All reported unilateral painless visual loss. Four patients reported general signs and symptoms suggestive of having suffered a respiratory disease of viral origin, between 7 and 15 days before optic neuritis. In the examination carried out, great impairment of visual acuity (≤0.05) and colors (0/21) was found. The centro-caecal scotoma was the most frequent campimetric defect. Optical Coherence Tomography (OCT) in the affected eye showed increased neuroretinal thickness, decreased nerve fiber layer, and ganglion cell damage. Treatment was with intravenous methylprednisolone and B vitamins. Conclusions: An unusual increase in patients with unilateral optic neuritis was observed. The OCT revealed damage to the structures at the level of the retina and the optic nerve. The therapeutic effectiveness was conditioned by the time of evolution of the neuritis.

Eficacia y seguridad de la lipotransferencia en el tratamiento del fotoenvejecimiento cutáneo

IntroductionAging is an inevitable process that depends on genetic and environmental factors. Facial photoaging is an expression of the effect of ultraviolet radiation and can be prevented in many ways, among which fat transfer has become popular. ObjectiveTo evaluate the efficacy and safety of fat transfer in the treatment of skin photoaging. Patients and methodAn observational, analytical and longitudinal study was carried out in 43 patients with cutaneous photoaging at the Hospital Clínico Quirúrgico «Hermanos Ameijeiras», in the period between February 1st, 2019 and February 28th, 2020. Lipoblotting was performed by the Coleman method. The nano-fat type adipose tissue was processed and administered. The response to treatment was used from the clinical point of view (3 months after having performed the procedure) using the Glogau Photo Damage Classification Scale, the Global Esthetic Improvement Scale and the Evaluative Scale of the severity range of the nasolabial fold (WSRS), with photographic evidence and with a surface microscope. ResultsAfter treatment, there were significant changes in the Glogau photodamage classification scale (P = 0.0002), in the Global Esthetic Improvement Scale (P = 0.019) and in the Evaluative Scale of the range of severity of the nasolabial fold (P = 0.0231). The adverse events found were pain, inflammation and ecchymosis; of mild or moderate intensity, without permanent consequences in individuals. The degree of satisfaction reported by the patients was good (4.7%) and very good (95.3%) (P = 0.0011). ConclusionsStem cell assisted fat transfer is effective and safe in correcting the signs of facial photoaging, with a high degree of patient satisfaction.

Peeling with 25% trichloroacetic acid in the treatment of facial skin photoaging

Introduction: The chemical peel consists of the application of chemical exfoliants that eliminate the layers of the skin so that it can regenerate with an improved texture and pigmentation. It is currently a valuable therapy in dermatology, however, few studies objectively evaluate its efficacy. Objective: To evaluate the efficacy and safety of peeling with 25% trichloroacetic acid in the treatment of facial skin rejuvenation. Method: An observational, analytical and longitudinal study was carried out in 250 patients from two hospitals (Surgical Clinic: “Hermanos Ameijeiras” and General Teaching: “Enrique Cabrera”), in the period between January 2010 and January 2020. Treatment It was applied monthly for 6 months. The final evaluation was carried out 3 months after the end of the treatment. Results: 238 women and 12 men were treated with an average age of 30.5 (± 8.4) years. After treatment, there were significant changes in the Glogau Photo Damage Scale (P=0.012), in the Lemperle Wrinkle Assessment Scale (P=0.016) and in the Global Aesthetic Improvement Scale (P=0.021). The adverse events found were burning, inflammation and scaling. The degree of satisfaction reported by the patients was good (4.4%) and very good (95.6%) (P=0.011). Conclusion: The 25% trichloroacetic acid peel proved to be effective and safe to reduce the signs of facial skin aging, associated with a high degree of patient satisfaction.

Efficacy and Safety of Autologous Platelets Concentrate in the Treatment of Crow's Feet Photo Aging

Introduction: Platelet rich plasma (PRP) is an autologous serum that contains high concentrations of platelets and growth factors. It is currently a versatile therapy in dermatology; however, few studies objectively evaluate its efficacy. Objective: To evaluate the efficacy and safety of intradermal microinjection of autologous platelet concentrate (APC) in the treatment of crow's feet rejuvenation. Method: An observational, analytical and longitudinal study was carried out in 60 patients from the Hospital Clínico Quirúrgico: “Hermanos Ameijeiras”, in the period between March 1, 2017 and March 31, 2020. The treatment was applied monthly. for 1 year. The final evaluation was carried out 3 months after the end of the treatment. Results: 60 women with an average age of 45 ± 4.3 years were treated. After treatment, there were significant changes in the Glogau Photo Damage Scale (P = 0.0022), in the Photonumeric Scale to assess the severity of crow's feet (P = 0.0111) and in the Global Aesthetic Improvement Scale. (P = 0.0033). The adverse events found were pain, inflammation and ecchymosis. The degree of satisfaction reported by the patients was good (16.6%) and very good (83.3%) (P = 0.0021). Conclusions: The autologous platelet concentrate proved to be effective and safe in reducing the signs of cutaneous aging of crow's feet, associated with a high degree of patient satisfaction.