No abstract available
https://ift.tt/2Dm0KMK
Παρασκευή 21 Σεπτεμβρίου 2018
Identifying Incidence of and Risk Factors for Fluoroscopy-Guided Lumbar Puncture and Subsequent Persistent Low-Pressure Syndrome in Patients With Idiopathic Intracranial Hypertension
Background: To explore the incidence of and potential risk factors for developing persistent low-pressure syndrome after lumbar puncture (LP) in patients with idiopathic intracranial hypertension (IIH), as measured by use of blood patches. Methods: A retrospective chart review was conducted of patients with definitively diagnosed IIH by clinical examination and LP, comparing them to patients with multiple sclerosis (MS) as controls who also received diagnostic LPs. Demographic, clinical, and radiological data were collected for each patient. The main outcome measure was the rate of post-LP blood patches in IIH patients compared with MS patients. Secondary outcome measures were the likelihood of undergoing an epidural blood patch related to age, body mass index, volume removed, opening pressure, the difference between opening and closing pressure, and the level of puncture within the IIH cohort. Results: One hundred four IIH patients and 149 MS patients were included in the study. Among IIH patients, 12/104 (11.5%) underwent an epidural blood patch after LP as compared to 8/149 (5.4%) of the MS control patients (P = 0.086). Within the IIH population, none of the clinical or LP parameters were significantly correlated with increased risk of needing a blood patch. Conclusions: The incidence of low-pressure syndrome, as measured by blood patches, is similar in IIH patients and MS controls. This suggests that having elevated intracranial pressure before an LP is not protective against developing postpuncture low-pressure syndrome, contrary to common assumptions. Address correspondence to Gregory P. Van Stavern, MD, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8096, St. Louis, MO 63110-1010; E-mail: vanstaverng@vision.wustl.edu Supported by DOVS Core Grant 5 P30 EY02687, Institute for Clinical and Translational Sciences grant RR023496, Biostat Core Grant U54 RR023496, an unrestricted grant from Research to Prevent Blindness, NIH Core Vision Grant P30 EY02687, and Dean's Fellowship (Washington University School of Medicine, Washington University in St. Louis, Missouri). The authors report no conflicts of interest. © 2018 by North American Neuro-Ophthalmology Society
https://ift.tt/2I47hKI
https://ift.tt/2I47hKI
Cosmetics, Vol. 5, Pages 55: Anti-Aging Properties of Plant Stem Cell Extracts
Cosmetics, Vol. 5, Pages 55: Anti-Aging Properties of Plant Stem Cell Extracts
Cosmetics doi: 10.3390/cosmetics5040055
Authors: Małgorzata Miastkowska Elżbieta Sikora
Skin aging is a complex process which involves all the layers of the epidermis and dermis. In order to slow skin aging, methods are researched which would strengthen and protect skin stem cells. Science is in search of the right method to stimulate the proliferation of epidermal stem cells. Plant stem cells show outstanding anti-aging properties, as they can, among other activities, stimulate fibroblasts to synthesise collagen, which, in turn, stimulates skin regeneration. One of the most important agents which give anti-aging properties to plant stem cell extracts is kinetin (6-furfuryladenine). This compound belongs to a cytokine group and is considered to be a strong antioxidant which protects protein and nucleic acids from oxidation and glycoxidation processes. It enables cells to remove the excess of free radicals to protect them from oxidative stress.
https://ift.tt/2xuWrtn
Long-Term Effects on Volume Change in Musculocutaneous Flaps after Head and Neck Reconstruction
J reconstr Microsurg
DOI: 10.1055/s-0038-1672134
Objective Musculocutaneous flap reconstruction surgery is one of the standard procedures following head and neck cancer resection. However, no previous studies have classified flaps in terms of muscle and fat or examined them after long-term follow-up. The purpose of this study was to estimate the fat and muscle volume changes in musculocutaneous flaps during long-term follow-up. Methods We conducted a retrospective analysis of 35 patients after musculocutaneous flap reconstruction. The total, fat, and muscle volumes of the musculocutaneous flaps were measured using 3-dimensional images. Changes in flap volumes over time (1 month, 1 year [POY1], and 5 years [POY5] postoperatively) were assessed. Flap persistence was calculated using flap volumes at 1 month after reconstruction for reference. Results Flap persistence at POY5 was 42.0% in total, 64.1% in fat, and 25.4% in muscle. Muscle persistence was significantly decreased (p < 0.0001). In a multiple regression analysis, decreased body mass index (BMI) of ≥ 5% influenced fat persistence less than muscle persistence at POY1; however, there was no significant difference at POY5. Postoperative radiation therapy was associated with a significant decrease in total flap persistence at POY1 (p = 0.046) and POY5 (p = 0.0097). Muscle persistence significantly decreased at POY5 (p = 0.0108). Age significantly influenced muscle volume at POY1 (p = 0.0072). Conclusion Reconstruction flaps are well-preserved with high fat-to-muscle ratios. Recommendations for weight maintenance are necessary for patients less than 2 years after surgery due to the influence of BMI on fat persistence. Radiation therapy is necessary for some patients based on their disease state. Intensity-modulated radiation therapy can be offered to reduce scattering irradiation to normal tissues.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2OIm94a
Ahead of the Curve: Tracking Progress in Novice Microsurgeons
J reconstr Microsurg
DOI: 10.1055/s-0038-1670652
Background The purpose of this study was to evaluate learning curves for an existing microsurgical training model. We compared efficiency and amount of training needed to achieve proficiency between novice microsurgeons without operative experience versus those who had completed a surgical internship. Methods Ten novice microsurgeons anastomosed a silastic tube model. Time to perform each anastomosis, luminal diameter, and number of errors were recorded. Results First year residents improved up to a brief plateau at 10 repetitions, followed by continued improvement. Second year residents improved up to a plateau at 10 repetitions with no further improvement thereafter. There was no significant difference in luminal area or errors between groups. Conclusion Residents with no operative experience can benefit from early exposure to microsurgical training. These interns continue to improve with additional repetitions while second year residents achieve proficiency with fewer repetitions.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2zm4Hgo
Recycling Full Thickness Skin Graft from Failing Free Flaps in Salvage Procedures
Free flap loss is a dreaded complication in microsurgery. When a second free flap is harvested, the enlarged donor site may not be amenable to primary closure, and a split thickness skin graft (STSG) is necessary. If we salvage the skin portion of the failing flap for subsequent wound closure, we not only minimize additional donor sites, we also reap the many functional and cosmetic advantages of full thickness skin grafts (FTSG) over STSG. The recyclability of salvaged skin is mainly dependent on the warm ischemia time.
https://ift.tt/2Dna17v
Introduction of robotic surgery for endometrial cancer into a Brazilian cancer service: a randomized trial evaluating perioperative clinical outcomes and costs
OBJECTIVE: The purpose of this study was to evaluate the clinical outcome and costs after the implementation of robotic surgery in the treatment of endometrial cancer, compared to the traditional laparoscopic approach. METHODS: In this prospective randomized study from 2015 to 2017, eighty-nine patients with endometrial carcinoma that was clinically restricted to the uterus were randomized in robotic surgery (44 cases) and traditional laparoscopic surgery (45 cases). We compared the number of retrieved lymph nodes, total time of surgery, time of each surgical step, blood loss, length of hospital stay, major and minor complications, conversion rates and costs. RESULTS: The ages of the patients ranged from 47 to 69 years. The median body mass index was 31.1 (21.4-54.2) in the robotic surgery arm and 31.6 (22.9-58.6) in the traditional laparoscopic arm. The median tumor sizes were 4.0 (1.5-10.0) cm and 4.0 (0.0-9.0) cm in the robotic and traditional laparoscopic surgery groups, respectively. The median total numbers of lymph nodes retrieved were 19 (3-61) and 20 (4-34) in the robotic and traditional laparoscopic surgery arms, respectively. The median total duration of the whole procedure was 319.5 (170-520) minutes in the robotic surgery arm and 248 (85-465) minutes in the traditional laparoscopic arm. Eight major complications were registered in each group. The total cost was 41% higher for robotic surgery than for traditional laparoscopic surgery. CONCLUSIONS: Robotic surgery for endometrial cancer presented equivalent perioperative morbidity to that of traditional laparoscopic surgery. The duration and total cost of robotic surgery were higher than those of traditional laparoscopic surgery.
https://ift.tt/2xFXiXo
Survival and prognosis of young adults with gastric cancer
OBJECTIVES: Survival data for young adults (YA) with gastric cancer is conflicting and scarce in Brazil. The aim of this study was to compare the clinicopathological factors and survival rates of younger and older patients with gastric cancer. METHODS: Hospital registries for 294 gastric cancer patients from a reference cancer hospital in São Paulo, Brazil, were consulted for the retrieval of clinicopathological information and follow-up time. Patients were placed into the following groups: YA (≤40 years; N=71), older adult (OA: 41 to 65 years; N=129) and elderly (E: ≥66 years; N=94). Differences were assessed through Pearson's χ2 test, Kaplan-Meier analysis, Log rank test and Cox regression. RESULTS: More YA were diagnosed with advanced disease (clinical stage III/IV: 86.7% YA, 69.9% OA, and 67% E); however, fewer E patients underwent surgery (64.3% YA, 72.7% OA, and 52.4% E). The median overall survival among all patients was 16 months, and the overall survival rate was not significantly different among the age groups (p=0.129). There were no significant differences in the disease-free survival rate. Metastatic disease at diagnosis (HR=4.84; p<0.01) was associated with an increased hazard of death for YA. CONCLUSION: Overall survival was similar among age groups. Metastatic disease at diagnosis was the only factor associated with a poorer prognosis in YA. These results suggest that younger patients deserve special attention regarding the detection of early stage disease.
https://ift.tt/2NZEbBS
Clinical stage and histological type of the most common carcinomas diagnosed in young adults in a reference cancer hospital
OBJECTIVES: Cancer in young adults represents a great challenge, both biologically and socially, and understanding the unique characteristics of neoplasms in this age group is important to improving care. We aimed to evaluate the most common carcinomas and their characteristics, such as histological type and clinical stage, in young adults in the largest cancer hospital in Latin America. METHODS: The hospital registry was consulted for the period between 2008 and 2014. Young adults were defined as individuals aged 18 to 39 years, and older adults were defined as individuals aged 40 years and older. Differences between age groups were assessed through chi-square tests. RESULTS: Of the 39,389 patients included, 3,821 (9.7%) were young adults. Among the young adults, the most frequent cancer types were the following: breast, lymph node, colorectal, thyroid, testicle, hematopoietic and reticuloendothelial, uterine cervix, brain, soft tissue and stomach; these sites accounted for 74.5% of the observed tumors. Breast, colorectal and stomach cancers were more frequently diagnosed at advanced stages in young adults than in older adults (p<0.001). The most common histological types were infiltrating ductal carcinoma (86.12%) for breast cancer, adenocarcinomas not otherwise specified (45.35%) for colorectal cancer, squamous cell carcinoma not otherwise specified (65.26%) for uterine cervix cancer, signet ring cell adenocarcinomas (49.32%) for stomach cancer and adenocarcinomas not otherwise specified (50.79%) for lung cancer. CONCLUSION: Young adults are diagnosed with cancer at more advanced stages, indicating that health professionals should be aware of cancer incidence in this age group. It is necessary to develop a better understanding of cancer in young adults and to implement dedicated health care strategies for these patients.
https://ift.tt/2xE3ten
Lessons and perspectives for applications of stochastic models in biological and cancer research
The effects of randomness, an unavoidable feature of intracellular environments, are observed at higher hierarchical levels of living matter organization, such as cells, tissues, and organisms. Additionally, the many compounds interacting as a well-orchestrated network of reactions increase the difficulties of assessing these systems using only experiments. This limitation indicates that elucidation of the dynamics of biological systems is a complex task that will benefit from the establishment of principles to help describe, categorize, and predict the behavior of these systems. The theoretical machinery already available, or ones to be discovered to help solve biological problems, might play an important role in these processes. Here, we demonstrate the application of theoretical tools by discussing some biological problems that we have approached mathematically: fluctuations in gene expression and cell proliferation in the context of loss of contact inhibition. We discuss the methods that have been employed to provide the reader with a biologically motivated phenomenological perspective of the use of theoretical methods. Finally, we end this review with a discussion of new research perspectives motivated by our results.
https://ift.tt/2NZxz6m
Organization of the cancer network in SUS: evolution of the care model
In the current context of epidemiological transition, demographic changes, changes in consumption and lifestyle habits, and pressure on care costs and organized health systems for acute conditions, the Integrated Care Model by Shortell has become a conceptual reference in the search for new methods to manage chronic conditions by focusing on the health conditions of a given population that must be addressed by a set of institutions organized into networks. Within the last 15 years, cancer has gone from the third- to the second-leading cause of death in the State of São Paulo and has shown a gradual increase in the number of new cases; it has thus become a relevant issue for public health and health management. The model adopted by the State for the organization of the cancer care network was the motivation for this study, which aimed to evaluate the evolution of the model of care for cancer patients within the Unified Health System (Sistema Único de Saúde) based on the integrated care model. Since 1993, the year that cancer was first considered highly complex in the Sistema Único de Saúde by the Ministry of Health, it has been possible to observe a progressive orientation towards the integral and integrated care of patients with cancer. In the State of São Paulo, the active participation of qualified service providers through a Technical Reference Committee showed that experts could contribute to the definition of public policies, thereby providing a technical base for decision making and contributing to the development of clinical management.
https://ift.tt/2xANPR4
Treatment of patients with metastatic colorectal cancer and poor performance status: current evidence and challenges
Patients with unresectable metastatic colorectal cancer live for a median of three years when treated with standard therapies. While the evidence guiding cancer-directed treatment of this disease comes from phase III trials that have mostly enrolled patients with good performance status, some patients present with poor clinical conditions. The best treatment for these patients remains to be determined. We performed a systematic review of the treatment outcomes of patients with metastatic colorectal cancer and poor performance status, defined as Eastern Cooperative Oncology Group performance status ≥2. Eligible articles were prospective or retrospective studies or case reports published in English, Portuguese or Spanish. We searched PubMed, EMBASE, LILACS and the Cochrane Library from onset until October 2017 using specific keywords for each search. We found a total of 18 publications, mostly case reports and retrospective studies (14 articles). One was an uncontrolled prospective trial, two were observational studies and one was an individual patient meta-analysis. Although some studies suggested benefits in terms of symptomatic response with standard chemotherapy, with good safety profiles when dose-reduced regimens were administered, a true survival gain could not be demonstrated. The scientific evidence for treating metastatic colorectal cancer patients with poor performance status is scarce, and more studies evaluating treatment for this population are necessary since this condition is not uncommon in clinical practice, particularly in the public healthcare system and developing countries and among destitute populations.
https://ift.tt/2NTQQGv
Clinical perspectives of PSMA PET/MRI for prostate cancer
Prostate cancer imaging has become an important diagnostic modality for tumor evaluation. Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has been extensively studied, and the results are robust and promising. The advent of the PET/magnetic resonance imaging (MRI) has added morphofunctional information from the standard of reference MRI to highly accurate molecular information from PET. Different PSMA ligands have been used for this purpose including 68gallium and 18fluorine-labeled PET probes, which have particular features including spatial resolution, imaging quality and tracer biodistribution. The use of PSMA PET imaging is well established for evaluating biochemical recurrence, even at low prostate-specific antigen (PSA) levels, but has also shown interesting applications for tumor detection, primary staging, assessment of therapeutic responses and treatment planning. This review will outline the potential role of PSMA PET/MRI for the clinical assessment of PCa.
https://ift.tt/2xFXiqm
Epidemiological science and cancer control
Epidemiological methods are essential for the discovery of cancer risks and prognostic factors as well as for the evaluation of cancer prevention measures. In this review, we discuss epidemiological surveillance procedures for data collection and processing to guide and evaluate the consequences of anticancer efforts for populations, assess the identification of cancer risk factors, examine barriers to cancer screening and recommended rules for early diagnosis programs. Epidemiological studies have shown that hindrances to cancer information assessment are currently encountered in developing countries. Known cancer risk factors include social determinants, lifestyle factors, occupational exposures, infectious agents, and genetic and epigenetic alterations. Challenges remain in studying the effectiveness of cancer screening; screening can have detrimental effects, and few cancers clearly benefit from screening. Currently, epidemiology faces the challenge of dealing with distinct levels of data, including factors related to social status, lifestyle and genetics, to reconstruct the causal traits of cancer. Additionally, translating epidemiological knowledge into cancer control demands more implementation studies in the population.
https://ift.tt/2NZDWqs
Academic health centers: integration of clinical research with healthcare and education. Comments on a workshop
Epidemiological methods are essential for the discovery of cancer risks and prognostic factors as well as for the evaluation of cancer prevention measures. In this review, we discuss epidemiological surveillance procedures for data collection and processing to guide and evaluate the consequences of anticancer efforts for populations, assess the identification of cancer risk factors, examine barriers to cancer screening and recommended rules for early diagnosis programs. Epidemiological studies have shown that hindrances to cancer information assessment are currently encountered in developing countries. Known cancer risk factors include social determinants, lifestyle factors, occupational exposures, infectious agents, and genetic and epigenetic alterations. Challenges remain in studying the effectiveness of cancer screening; screening can have detrimental effects, and few cancers clearly benefit from screening. Currently, epidemiology faces the challenge of dealing with distinct levels of data, including factors related to social status, lifestyle and genetics, to reconstruct the causal traits of cancer. Additionally, translating epidemiological knowledge into cancer control demands more implementation studies in the population.
https://ift.tt/2xDjyRN
Scholar : Eating Disorders, Volume 26, Issue 5, September-October 2018 is now available online on Taylor & Francis Online
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Scholar : AJOB Neuroscience, Volume 9, Issue 3, July-September 2018 is now available online on Taylor & Francis Online
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Prevalence of gingival recession after orthodontic treatment of infraversion and open bite
Abstract
Purpose
Aim of the present study was to investigate the prevalence of gingival recession and related factors in teeth with low occlusal function (open bite and infraversion) after orthodontic treatment.
Methods
From January 2014 to December 2017, 403 patients received orthodontic treatment. Their gingival recession and related factors before and after treatment were retrospectively analyzed.
Results
The prevalence of gingival recession in patients with infraversion and open bite after orthodontic treatment were 80.6 and 75.0%, respectively; these values were 43.4 and 47.5% before treatment, respectively. Notably, the Miller index of gingival recession increased after orthodontic treatment (P < 0.05). The risk of gingival recession in patients with infraversion or open bite after orthodontic treatment was remarkably higher than the risk in other patients (odds ratio [OR] = 16.712 and 5.073, respectively); the gingival recession rate was related to treatment with tooth extraction (OR = 2.043), as well as gingival biotype (OR = 0.341) and gingival index (GI) before orthodontic treatment (OR = 97.404; P < 0.05).
Conclusions
Patients with these two types of low occlusal function are more likely to exhibit gingival recession after orthodontic treatment. Moreover, the prevalence of gingival recession after orthodontic treatment is higher among patients who have undergone tooth extraction during orthodontic treatment, and among those who exhibit thin gingival biotype and high gingival index before orthodontic treatment.
https://ift.tt/2QMakLH
Effect of Reversed Tracking Method for Identification of EBSLN in Thyroid Surgery
Conditions: Thyroid Cancer; Recurrent Laryngeal Nerve Injuries
Intervention: Procedure: Reversed Tracking Method
Sponsor: Fujian Medical University
Not yet recruiting
https://ift.tt/2xGNn3B
Intervention: Procedure: Reversed Tracking Method
Sponsor: Fujian Medical University
Not yet recruiting
https://ift.tt/2xGNn3B
Resting parasympathetic dysfunction predicts prosocial helping deficits in behavioral variant frontotemporal dementia
Publication date: Available online 20 September 2018
Source: Cortex
Author(s): Virginia E. Sturm, Isabel J. Sible, Samir Datta, Alice Y. Hua, David C. Perry, Joel H. Kramer, Bruce L. Miller, William W. Seeley, Howard J. Rosen
Abstract
In the behavioral variant of frontotemporal dementia (bvFTD), left-lateralized salience network dysfunction reduces basal activity in the parasympathetic nervous system, a branch of the autonomic nervous system that reduces arousal and fosters empathy and prosociality. Here we examined whether resting parasympathetic deficits in bvFTD related to diminished prosocial behavior. Eighty participants (30 with bvFTD, 25 with Alzheimer's disease [AD], and 25 healthy controls) completed a "helping task" in which we quantified participants' spontaneous reactions to an experimenter who struggled to find a lost key. Participants also underwent an assessment of baseline autonomic nervous system activity and structural magnetic resonance imaging. An exploratory factor analysis of participants' behaviors during the helping task revealed four factors: empathic concern, consolation, disengagement, and impatience. Patients with bvFTD had lower empathic concern and greater disengagement and impatience than the AD and healthy control groups. Patients with bvFTD had lower resting respiratory sinus arrhythmia and faster respiration and heart rates than patients with AD and healthy controls, a pattern consistent with parasympathetic dysfunction. Skin conductance level was also lower in bvFTD than in the other groups. Lower baseline respiratory sinus arrhythmia and faster baseline respiration rates, but not skin conductance level, predicted lower prosocial helping behaviors. Voxel-based morphometry analyses revealed that atrophy in the bilateral medial pulvinar nucleus of the thalamus, midcingulate cortex, and caudate was associated with lower empathic concern and consolation, and atrophy in the bilateral medial pulvinar nucleus of the thalamus, left frontoinsula, and left ventral striatum was associated with greater disengagement and impatience. Left-lateralized frontoinsula atrophy was associated with not only lower respiratory sinus arrhythmia but also with lower consolation and greater disengagement. This study offers evidence for prosocial behavior deficits in bvFTD and suggests that left-lateralized salience network atrophy reduces patients' resting parasympathetic activity and motivation to help others in need.
https://ift.tt/2MSORgK
Prevalence of gingival recession after orthodontic treatment of infraversion and open bite
Abstract
Purpose
Aim of the present study was to investigate the prevalence of gingival recession and related factors in teeth with low occlusal function (open bite and infraversion) after orthodontic treatment.
Methods
From January 2014 to December 2017, 403 patients received orthodontic treatment. Their gingival recession and related factors before and after treatment were retrospectively analyzed.
Results
The prevalence of gingival recession in patients with infraversion and open bite after orthodontic treatment were 80.6 and 75.0%, respectively; these values were 43.4 and 47.5% before treatment, respectively. Notably, the Miller index of gingival recession increased after orthodontic treatment (P < 0.05). The risk of gingival recession in patients with infraversion or open bite after orthodontic treatment was remarkably higher than the risk in other patients (odds ratio [OR] = 16.712 and 5.073, respectively); the gingival recession rate was related to treatment with tooth extraction (OR = 2.043), as well as gingival biotype (OR = 0.341) and gingival index (GI) before orthodontic treatment (OR = 97.404; P < 0.05).
Conclusions
Patients with these two types of low occlusal function are more likely to exhibit gingival recession after orthodontic treatment. Moreover, the prevalence of gingival recession after orthodontic treatment is higher among patients who have undergone tooth extraction during orthodontic treatment, and among those who exhibit thin gingival biotype and high gingival index before orthodontic treatment.
https://ift.tt/2QMakLH
Prevalence of potential contact allergens in baby cosmetic products
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2OIjZBF
HASAN: Highly Accurate Sensitivity for Auto-contrast-corrected pMRI Reconstruction
Publication date: Available online 21 September 2018
Source: Magnetic Resonance Imaging
Author(s): Md. Sakibur Rahman Sajal, Md. Kamrul Hasan
Abstract
A novel method for highly accurate coil sensitivity-map estimation, based on a constrained image-domain multi-channel LMS (c-iMCLMS) algorithm, is proposed for image reconstruction using self-calibrating SENSE. The sensitivity information is extracted by developing an image-domain cross-relation equation using the low-resolution images constructed from the fully sampled central region of the variable density MR data. Then this formulation is solved in an iterative way using a novel sum-of-squares (SOS) constraint. The improvement of the convergence speed of the c-iMCLMS algorithm is accomplished by SOS normalization of the low resolution image data and using a variable step-size in the update equation. The salient feature of the proposed technique is that it does not require any prior selection of the basis function and/or simultaneous estimation of the object image and the coil sensitivity-map. Only the low resolution images are re-filtered for the compensation of the data truncation effect to improve the consistency of the estimated coil maps. Besides, the application of the novel SOS-constraint, estimated using the pixel position-wise variance of the coil maps, gives closest to the true sensitivity-map. As a result, true object image with auto-corrected contrast is reconstructed without adopting any traditional post-contrast correction techniques. For minimization of the process noise, regularized conjugate gradient (CG) based SENSE reconstruction algorithm is used for image reconstruction using the estimated coil sensitivity-map. The proposed technique is tested on various simulation, synthetic and in-vivo datasets and significant signal-to-artifact-noise-ration (SANR) improvement closest to the theoretical limit set by coil geometric factor is obtained as compared to some noted techniques in the literature both visually and numerically.
https://ift.tt/2pr9c3z
Scholar : New articles have been published for AIDS Care, Volume 30, Issue sup1
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Serum irisin: A prognostic marker for severe acne vulgaris
Journal of Cosmetic Dermatology, EarlyView.
https://ift.tt/2xrikK8
SWEET SYNDROME FOLLOWING A POSITIVE MANTOUX TEST DUE TO PULMONARY TUBERCULOSIS
Dermatologic Therapy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2xBh0n7
Topical diltiazem for ulceration of striae distensae associated with bevacizumab therapy
Dermatologic Therapy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2QOVljX
“Chemical” surgery in treating basal cell carcinoma in elderly
Dermatologic Therapy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2xGEEOS
A Randomized Trial of Early Endovenous Ablation in Venous Ulceration: a critical appraisal
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2psSG3g
Identifying Predictors of Time to Soft Tissue Reconstruction Following Open Tibia Fractures
INTRODUCTION: Controversy remains regarding the optimal timing of soft tissue coverage following severe lower extremity trauma. This study identifies nationwide practice patterns and factors associated with discrepancies in time to first flap surgery following open tibia fractures. METHODS: A retrospective analysis was performed on the National Trauma Databank from 2008-2015 to identify patients who presented with an open tibia fracture and underwent subsequent flap reconstruction. A lasso algorithm was performed, revealing those factors most significantly associated with differences in time to flap surgery from hospitalization. RESULTS: A total of 3,297 patients were included in the analysis. Mean and median times to first flap surgery were 230.1 hours (SD; 246.7 hours), and 169.1 hours, respectively. Older age, a non-white race, treatment in the South, and a non-private insurance status were all independently associated with an increased time to flap surgery. In addition, more surgical debridements, a higher injury severity and/or abbreviated injury score, and a nerve, vascular, and/or crush injury were independent predictors of an increased time to flap surgery. CONCLUSION: Most patients who present with open tibia fractures requiring soft tissue coverage undergo flap reconstruction after the historical 72-hour window. Specific sociodemographic and clinical factors were independently predictive of an increased time to flap surgery. These findings suggest that not all patients in the United States are receiving the same level of care in lower extremity trauma reconstruction, emphasizing the need to develop more explicit national standards. * These authors contributed equally to this work Financial Disclosure Statement: None of the authors have a financial disclosure Corresponding Author Contact Information: Scott T. Hollenbeck, MD, Associate Professor, Division of Plastic and Reconstructive Surgery, Duke University Medical Center, Box 3945, Durham, NC 27710, USA. Phone: (919) 681-5079 | Fax: (919) 681-2670, Email: scott.hollenbeck@duke.edu ©2018American Society of Plastic Surgeons
https://ift.tt/2ppVMVx
https://ift.tt/2ppVMVx
Optimal Sites for Supermicrosurgical Lymphaticovenular Anastomosis: An Analysis of Lymphatic Vessel Detection Rates on 840 Surgical Fields in Lower Extremity Lymphedema Patients
Background: Supermicrosurgical lymphaticovenular anastomosis (LVA) is becoming a useful treatment option for progressive lower extremity lymphedema (LEL) with its minimal invasiveness. Finding lymphatic vessel is a minimum requirement for LVA surgery, but no study has reported comprehensive analysis on factors associated with lymphatic vessel detection (LVD). Methods: One hundred thirty-four female secondary LEL patients who underwent indocyanine green (ICG) lymphography and LVA without past history of lymphedema surgery were included. Medical charts were reviewed to obtain clinical, ICG lymphographic, and intraoperative findings. LVD was defined as positive when one or more lymphatic vessels were found in a surgical field of LVA. Logistic regression analysis was used to identify independent factors associated with LVD. Results: Patients' age ranged from 36 to 81 years, duration of edema from 3 to 324 months, and BMI from 16.2 to 33.3 kg/m2. Forty-eight patients (35.8%) had past history of radiation, and 76 patients (56.7%) had past history of cellulitis. LVAs were performed in 840 surgical fields, among which LVD was positive in 807 fields; overall LVD rate was 96.1%. Multivariate analysis revealed inverse associations in higher body mass index (odds ratio [OR] 0.323; P = 0.008) and S-region/D-region on ICG lymphography compared with L-region (OR 1.049 x 10-8/1.724 x 10-9; P
https://ift.tt/2MQWnsO
https://ift.tt/2MQWnsO
“Towards the Assessment of Core Procedural Competencies amongst Canadian Plastic Surgery Residents.”
Background: Plastic surgery residency training programs are working towards integrating competency-based education into program curriculum and training, a key component of which involves establishing Core Procedural Competencies. This study aims to determine the exposure of graduating Canadian plastic surgery residents to established Core Procedural Competencies. Methods: A retrospective review of case log procedure data using three databases (T-Res, POWER, New Innovations) from graduating residents at all 10 Canadian English-speaking plastic surgery training programs between 2004-2014 was completed. Case logs were coded according to 177 Core Procedural Competencies identified as 'Core' by the Delphi Method amongst an expert panel of Canadian plastic surgeons. Results: A total of 59,405 procedures were logged by 55 graduating residents across Canada between 2004-2014 (average 1,080 ± 352 procedures per resident). Of thirteen plastic surgery domains, 44% of all procedures were within either Hand, Upper Extremity & Peripheral Nerve (28.3%) or Non-Aesthetic Breast (16.1%). The most frequently performed Core Procedural Competencies (average case logs per resident) included: breast reduction (65.3 ± 33.9), open carpal tunnel release (46.7 ± 34.2), breast reconstruction – implant-based (39.6 ± 20.5), and wound management (35.7 ± 28.6). Sixty-two of 177 procedures were logged on average less than once in 5 years of residency, including: escharotomy, temporal parietal fascia flap, Guyon's canal release and soft tissue fillers. Conclusions: This study identifies areas of exposure and underexposure to plastic surgery Core Procedural Competencies, and can help focus surgical education on areas of greater need for surgical skills training and acquisition. Financial Disclosure Statement:D Courtemanche is a shareholder and board member of Resilience Software. Resilience Software makes and supports T-Res. Presented at: 70th Annual Meeting of the Canadian Society of Plastic Surgeons 2016 in Ottawa, Ontario. Acknowledgements: We would like to thank the Postgraduate Medical Education Office, program directors and database vendors at University of Toronto and Western University for their assistance and support in extracting data from the POWER (©Knowledge4YouCorporation) and New Innovations (©New Innovations, Inc.) databases, respectively. In addition to participating in the research involved in this study, Dr. Courtemanche also generated the anonymous data set for the other 9 Canadian plastic surgery training programs that use T-Res. Corresponding Author: Jessica G. Shih, MD, The Division of Plastic & Reconstructive Surgery, 149 College Street, 5th Floor, Suite 508, Toronto, Ontario M5T 1P5, e-mail address: jessica.shih@utoronto.ca ©2018American Society of Plastic Surgeons
https://ift.tt/2psQGIi
https://ift.tt/2psQGIi
The Osteoseptocutaneous Fibula Flap: Concise Review, Goal-Oriented Surgical Technique, and Tips and Tricks
The fibula osteoseptocutaneous flap is a workhorse flap for bone reconstruction. Mastery of the flap is essential for a rewarding reconstruction. Yet, there's no complete work on this versatile flap. The authors provide concise review of the literature, address the myths and challenges associated with the flap, and describe their refined techniques for different reconstruction scenarios and possible anatomic variations. Conflict of interest: The authors have no conflict of interest to declare. Correspondence Author and Requests for Reprints: Fu-Chan Wei. MD, FACS, Distinguished Chair Professor, Chang Gung University Medical College, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, 199 Tun-Hwa North Road, Taipei 10591, Taiwan, E-mail: ,Tel: +886- 3-328-1200 ext 3535 or 2007 ©2018American Society of Plastic Surgeons
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https://ift.tt/2MTIQ3L
Microvascular Hepatic Artery Anastomosis in Pediatric Living Donor Liver Transplantation: 73 Consecutive Cases by a Single Surgeon
Background: Living donor liver transplantation (LDLT) is an important strategy of procuring segmental liver allografts for pediatric patients with liver failure, as suitably sized whole donor organs are scarce. Early pediatric LDLT experience was associated with high rates of hepatic artery thrombosis, graft loss, and mortality. Collaboration with microsurgeons for hepatic artery anastomosis in pediatric LDLT has decreased rates of arterial complications; however, reported outcomes are limited. Methods: A 14-year retrospective review was undertaken of children at our institution who underwent LDLT with hepatic artery anastomosis performed by a single microsurgeon using an operating microscope. Data were collected on demographics, etiology of liver failure, graft donor, vessel calibre, vessel anastomosis, arterial complications, and long-term follow up. Results: Seventy-three children with end stage liver failure underwent LDLT with microvascular hepatic artery anastomosis. The commonest etiology for liver failure was biliary atresia (63%). A total of 83 end to end hepatic artery anastomoses were completed using an operating microscope. Hepatic artery complications occurred in 5 patients, consisting of 3 cases of kinked anastomoses that were revised without complications and 2 cases of hepatic artery thrombosis (3%), of which one resulted in graft loss and patient death. Patient survival was 94% at 1 year and 90% at 5 years. Conclusions: Microvascular hepatic artery anastomosis in pediatric patients undergoing LDLT is associated with a low hepatic artery complication rate and excellent long-term liver graft function. Collaboration between microsurgeons and transplant surgeons can significantly reduce technical complications and improve patient outcomes. Financial Disclosure Statement: none Presented at the 2017 Annual Meeting of the American Society of Reconstructive Microsurgery in Waikoloa, HI, USA, January 14-17, 2017 and the 71st Annual Meeting of the Canadian Society of Plastic Surgeons in Winnipeg, MB, Canada, June 20-24, 2017. Corresponding Author: Dr. Ronald M. Zuker MD, FRCS(C), FACS, FAAP, Professor, Division of Plastic & Reconstructive Surgery, Department of Surgery, University of Toronto, The Hospital for Sick Children , 555 University Avenue, Toronto, ON M5G 1X8, Phone: 416-813-6447, Fax: 416-813-6147, E-mail: ronald.zuker@sickkids.ca ©2018American Society of Plastic Surgeons
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https://ift.tt/2MTIjyN
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