In Search of an Ideal Closure Method: A Randomized, Controlled Trial of Octyl-2-Cyanoacrylate and Adhesive Mesh versus Subcuticular Suture in Reduction Mammaplasty

Background: An ideal wound closure system is one that is effective, consistent, and efficient. Recent studies have demonstrated the efficacy of octyl-2-cyanoacrylate and mesh (Dermabond Prineo) in the closure of surgical wounds. This study compared the use of Prineo to use of subcuticular suture closure in reduction mammaplasty. Methods: A prospective, randomized, controlled, single-blind study of patients undergoing bilateral reduction mammaplasty was performed. Each breast per patient was randomized to layered closure with Prineo or subcuticular sutures. Incisions were assessed at 2 weeks, 6 weeks, 6 months, and 1 year. Subjects completed the Patient and Observer Scar Assessment Scale for each breast, and two blinded plastic surgeons evaluated scar quality using the Vancouver Scar Scale at each time point. Results: Twenty-one patients participated in the study. On average, Prineo closure took 58.38 seconds (2.50 seconds/cm) and subcuticular closure took 444.76 seconds (18.94 seconds/cm). Prineo closure was approximately 6.8 times faster (p

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Capsular Biofilm Formation at the Interface of Textured Expanders and Human Acellular Dermal Matrix

No abstract available

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Treatment of Infected Wounds in the Age of Antimicrobial Resistance: Contemporary Alternative Therapeutic Options

Summary: As antibiotic resistance increases and antimicrobial options diminish, there is a pressing need to identify and develop new and/or alternative (non–antimicrobial-based) wound therapies. The authors describe the implications of antibiotic resistance on their current wound treatment paradigms and review the most promising non–antibiotic-based antimicrobial agents currently in research and development, with a focus on preclinical and human studies of therapeutic bacteriophages, antimicrobial peptides, cold plasma treatment, photodynamic therapy, honey, silver, and bioelectric dressings.

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Accuracy of Three Software Applications for Breast Volume Calculations from Three-Dimensional Surface Images

Background: Knowing breast volumes before certain surgeries helps the surgeon to obtain breast symmetry. Calculating breast volumes from three-dimensional surface images is possible with specialized software applications. However, limited data exist concerning the accuracy of such volume calculations. The purpose of this study was to investigate the accuracy of breast volume calculations performed with the 3D BreAST, 3dMD Vultus, and VECTRA software applications. Methods: Twenty-six subjects who underwent 44 mastectomies were enrolled. Preoperative three-dimensional surface images were acquired with a VECTRA-XT stereophotogrammetry device. Breast volumes were calculated from these images with the three software applications. The mastectomy specimens were weighed to derive their actual volume and compared with the software calculations. Results: For all three methods, a positive correlation between the breast volume and absolute calculation error was found (p

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In Search of an Ideal Closure Method: A Randomized, Controlled Trial of Octyl-2-Cyanoacrylate and Adhesive Mesh versus Subcuticular Suture in Reduction Mammaplasty

Background: An ideal wound closure system is one that is effective, consistent, and efficient. Recent studies have demonstrated the efficacy of octyl-2-cyanoacrylate and mesh (Dermabond Prineo) in the closure of surgical wounds. This study compared the use of Prineo to use of subcuticular suture closure in reduction mammaplasty. Methods: A prospective, randomized, controlled, single-blind study of patients undergoing bilateral reduction mammaplasty was performed. Each breast per patient was randomized to layered closure with Prineo or subcuticular sutures. Incisions were assessed at 2 weeks, 6 weeks, 6 months, and 1 year. Subjects completed the Patient and Observer Scar Assessment Scale for each breast, and two blinded plastic surgeons evaluated scar quality using the Vancouver Scar Scale at each time point. Results: Twenty-one patients participated in the study. On average, Prineo closure took 58.38 seconds (2.50 seconds/cm) and subcuticular closure took 444.76 seconds (18.94 seconds/cm). Prineo closure was approximately 6.8 times faster (p

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The Influence of Physician Payments on the Method of Breast Reconstruction: A National Claims Analysis

Background: Flap-based breast reconstruction demands greater operative labor and offers superior patient-reported outcomes compared with implants. However, use of implants continues to outpace flaps, with some suggesting inadequate remuneration as one barrier. This study aims to characterize market variation in the ratio of implants to flaps and assess correlation with physician payments. Methods: Using the Blue Health Intelligence database from 2009 to 2013, patients were identified who underwent tissue expander (i.e., implant) or free-flap breast reconstruction. The implant-to-flap ratio and physician payments were assessed using quadratic modeling. Matched bootstrapped samples from the early and late periods generated probability distributions, approximating the odds of surgeons switching reconstructive method. Results: A total of 21,259 episodes of breast reconstruction occurred in 122 U.S. markets. The distribution of implant-to-flap ratio varied by market, ranging from the fifth percentile at 1.63 to the ninety-fifth percentile at 43.7 (median, 6.19). Modeling the implant-to-flap ratio versus implant payment showed a more elastic quadratic equation compared with the function for flap-to-implant ratio versus flap payment. Probability modeling demonstrated that switching the reconstructive method from implants to flaps with a 0.75 probability required a $1610 payment increase, whereas switching from flaps to implants at the same certainty occurred at a loss of $960. Conclusions: There was a correlation between the ratio of flaps to implants and physician reimbursement by market. Switching from implants to flaps required large surgeon payment increases. Despite a relative value unit schedule over twice as high for flaps, current flap reimbursements do not appear commensurate with physician effort.

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Treatment of Infected Wounds in the Age of Antimicrobial Resistance: Contemporary Alternative Therapeutic Options

Summary: As antibiotic resistance increases and antimicrobial options diminish, there is a pressing need to identify and develop new and/or alternative (non–antimicrobial-based) wound therapies. The authors describe the implications of antibiotic resistance on their current wound treatment paradigms and review the most promising non–antibiotic-based antimicrobial agents currently in research and development, with a focus on preclinical and human studies of therapeutic bacteriophages, antimicrobial peptides, cold plasma treatment, photodynamic therapy, honey, silver, and bioelectric dressings.

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The Influence of Physician Payments on the Method of Breast Reconstruction: A National Claims Analysis

Background: Flap-based breast reconstruction demands greater operative labor and offers superior patient-reported outcomes compared with implants. However, use of implants continues to outpace flaps, with some suggesting inadequate remuneration as one barrier. This study aims to characterize market variation in the ratio of implants to flaps and assess correlation with physician payments. Methods: Using the Blue Health Intelligence database from 2009 to 2013, patients were identified who underwent tissue expander (i.e., implant) or free-flap breast reconstruction. The implant-to-flap ratio and physician payments were assessed using quadratic modeling. Matched bootstrapped samples from the early and late periods generated probability distributions, approximating the odds of surgeons switching reconstructive method. Results: A total of 21,259 episodes of breast reconstruction occurred in 122 U.S. markets. The distribution of implant-to-flap ratio varied by market, ranging from the fifth percentile at 1.63 to the ninety-fifth percentile at 43.7 (median, 6.19). Modeling the implant-to-flap ratio versus implant payment showed a more elastic quadratic equation compared with the function for flap-to-implant ratio versus flap payment. Probability modeling demonstrated that switching the reconstructive method from implants to flaps with a 0.75 probability required a $1610 payment increase, whereas switching from flaps to implants at the same certainty occurred at a loss of $960. Conclusions: There was a correlation between the ratio of flaps to implants and physician reimbursement by market. Switching from implants to flaps required large surgeon payment increases. Despite a relative value unit schedule over twice as high for flaps, current flap reimbursements do not appear commensurate with physician effort.

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Reply: Noncontrast Magnetic Resonance Lymphography for Evaluation of Lymph Node Transfer for Secondary Upper Limb Lymphedema

No abstract available

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Determining the Oncologic Safety of Autologous Fat Grafting as a Reconstructive Modality: An Institutional Review of Breast Cancer Recurrence Rates and Surgical Outcomes

No abstract available

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Accuracy of Three Software Applications for Breast Volume Calculations from Three-Dimensional Surface Images

Background: Knowing breast volumes before certain surgeries helps the surgeon to obtain breast symmetry. Calculating breast volumes from three-dimensional surface images is possible with specialized software applications. However, limited data exist concerning the accuracy of such volume calculations. The purpose of this study was to investigate the accuracy of breast volume calculations performed with the 3D BreAST, 3dMD Vultus, and VECTRA software applications. Methods: Twenty-six subjects who underwent 44 mastectomies were enrolled. Preoperative three-dimensional surface images were acquired with a VECTRA-XT stereophotogrammetry device. Breast volumes were calculated from these images with the three software applications. The mastectomy specimens were weighed to derive their actual volume and compared with the software calculations. Results: For all three methods, a positive correlation between the breast volume and absolute calculation error was found (p

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Facial Transplantation: Highlighting the Importance of Clinical Vigilance in Donor Selection

No abstract available

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Determining the Oncologic Safety of Autologous Fat Grafting as a Reconstructive Modality: An Institutional Review of Breast Cancer Recurrence Rates and Surgical Outcomes

No abstract available

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Reply: Staying Safe during Gluteal Fat Transplantation

No abstract available

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Preoperative Multimodal Analgesia Decreases Postanesthesia Care Unit Narcotic Use and Pain Scores in Outpatient Breast Surgery

Background: The opioid epidemic demands changes in perioperative pain management. Of the 33,000 deaths attributable to opioid overdose in 2015, half received prescription opioids. Multimodal analgesia is a practice-altering evolution that reduces reliance on opioid medications. Ambulatory breast surgery is an ideal opportunity to implement these strategies. Methods: A retrospective review of 560 patients undergoing outpatient breast procedures was conducted. Patients received (1) no preoperative analgesia (n = 333); (2) intraoperative intravenous acetaminophen (n = 78); (3) preoperative oral acetaminophen and gabapentin (n = 95); or (4) preoperative oral acetaminophen, gabapentin and celecoxib (n = 54). Outcomes included postanesthesia care unit narcotic use, pain scores, postanesthesia care unit length of stay, rescue antiemetic use, and 30-day complications. Results: Both oral multimodal analgesia regimens significantly reduced postanesthesia care unit narcotic use (oral acetaminophen and gabapentin, 14.3 ± 1.7; oral gabapentin, acetaminophen, and celecoxib, 11.9 ± 2.2; versus no drug, 19.2 ± 1.1 mg oral morphine equivalents; p = 0.0006), initial pain scores (oral acetaminophen and gabapentin, 3.9 ± 0.4; oral gabapentin, acetaminophen, and celecoxib, 3.4 ± 0.7; versus no drug, 5.3 ± 0.3 on a 1 to 10 scale, p = 0.0002) and maximum pain scores (oral acetaminophen and gabapentin, 4.3 ± 0.4; oral gabapentin, acetaminophen, and celecoxib, 3.6 ± 0.7; versus no drug, 5.9 ± 0.3 on a 1 to 10 scale; p

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Use of Composite Arterial and Venous Grafts in Microsurgical Breast Reconstruction: Technical Challenges and Lessons Learned

Summary: The success of microvascular reconstruction depends on many factors. Although many factors cannot be dictated by a surgeon, the success of anastomosis can be maximized by honing skill with performing anastomoses. However, size discrepancy of vessels remains a common challenge, given the lack of an ideal technique. In this study, the authors introduce their experience in using composite deep inferior epigastric arterial and venous grafts to overcome the vessel size and pedicle length discrepancy in lateral thigh and superficial inferior epigastric artery (SIEA) flaps. Of the 1095 flaps performed, the authors identified a total of 12 flaps (one lateral thigh flap and 11 SIEA flaps) on nine patients for breast reconstruction. The authors used deep inferior epigastric vessels to act as interposition grafts between the internal mammary artery and flap pedicle. For the SIEA flaps, the authors anastomosed the SIEA system to the deep inferior epigastric arterial system, checked the viability of the flap, and then transferred the flap to the internal mammary artery and flap pedicle. For the SIEA flaps, the authors anastomosed the SIEA system to the deep inferior epigastric arterial system, checked the viability of the flap, and then transferred the flap to the internal mammary artery system in three patients. In the last five patients, the authors anastomosed the deep inferior epigastric vessels to the internal mammary artery system first, and then transferred the SIEA flap. For the lateral thigh flap, the authors anastomosed grafts to the internal mammary artery system first as well. There were no flap losses or fat necrosis. Although the authors' outcomes are limited to only breast reconstruction, they believe this method could be expanded to different types of reconstruction, especially reconstruction of the head and neck.

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Reply: Staying Safe during Gluteal Fat Transplantation

No abstract available

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Use of Composite Arterial and Venous Grafts in Microsurgical Breast Reconstruction: Technical Challenges and Lessons Learned

Summary: The success of microvascular reconstruction depends on many factors. Although many factors cannot be dictated by a surgeon, the success of anastomosis can be maximized by honing skill with performing anastomoses. However, size discrepancy of vessels remains a common challenge, given the lack of an ideal technique. In this study, the authors introduce their experience in using composite deep inferior epigastric arterial and venous grafts to overcome the vessel size and pedicle length discrepancy in lateral thigh and superficial inferior epigastric artery (SIEA) flaps. Of the 1095 flaps performed, the authors identified a total of 12 flaps (one lateral thigh flap and 11 SIEA flaps) on nine patients for breast reconstruction. The authors used deep inferior epigastric vessels to act as interposition grafts between the internal mammary artery and flap pedicle. For the SIEA flaps, the authors anastomosed the SIEA system to the deep inferior epigastric arterial system, checked the viability of the flap, and then transferred the flap to the internal mammary artery and flap pedicle. For the SIEA flaps, the authors anastomosed the SIEA system to the deep inferior epigastric arterial system, checked the viability of the flap, and then transferred the flap to the internal mammary artery system in three patients. In the last five patients, the authors anastomosed the deep inferior epigastric vessels to the internal mammary artery system first, and then transferred the SIEA flap. For the lateral thigh flap, the authors anastomosed grafts to the internal mammary artery system first as well. There were no flap losses or fat necrosis. Although the authors' outcomes are limited to only breast reconstruction, they believe this method could be expanded to different types of reconstruction, especially reconstruction of the head and neck.

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Current Approaches to Prepectoral Breast Reconstruction

Summary: Prepectoral prosthetic breast reconstruction has become an acceptable option for women following mastectomy. Benefits include no animation deformity, absence of pectoralis major muscle spasm, and less pain and discomfort. Important aspects of prepectoral reconstruction include working with breast surgeons that are adept at performing an optimal mastectomy. Tissue perfusion and reasonable thickness of the mastectomy are critical components of success. Tissue necrosis, infection, and delayed healing can lead to reconstructive failure. Given the risks and benefits of this procedure, questions regarding indications, patient selection, and specific details related to technique remain because there is no consensus. Whether it is safe to perform prepectoral reconstruction in obese or previously irradiated patients is controversial. The use of acellular dermal matrix is common but not universal. The amount of acellular dermal matrix used is variable, with success being demonstrated with the partial and total wrap techniques. Device selection can vary but is critical in the prepectoral setting. Postoperative care and the management of adverse events are important to understand and can impact surgical and aesthetic outcomes. This article provides current approaches, recommendations, and an algorithm for prepectoral breast reconstruction with an emphasis on patient selection, immediate versus delayed prepectoral reconstruction, specific technical details, and postoperative management.

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Facial Transplantation: Highlighting the Importance of Clinical Vigilance in Donor Selection

No abstract available

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Current Approaches to Prepectoral Breast Reconstruction

Summary: Prepectoral prosthetic breast reconstruction has become an acceptable option for women following mastectomy. Benefits include no animation deformity, absence of pectoralis major muscle spasm, and less pain and discomfort. Important aspects of prepectoral reconstruction include working with breast surgeons that are adept at performing an optimal mastectomy. Tissue perfusion and reasonable thickness of the mastectomy are critical components of success. Tissue necrosis, infection, and delayed healing can lead to reconstructive failure. Given the risks and benefits of this procedure, questions regarding indications, patient selection, and specific details related to technique remain because there is no consensus. Whether it is safe to perform prepectoral reconstruction in obese or previously irradiated patients is controversial. The use of acellular dermal matrix is common but not universal. The amount of acellular dermal matrix used is variable, with success being demonstrated with the partial and total wrap techniques. Device selection can vary but is critical in the prepectoral setting. Postoperative care and the management of adverse events are important to understand and can impact surgical and aesthetic outcomes. This article provides current approaches, recommendations, and an algorithm for prepectoral breast reconstruction with an emphasis on patient selection, immediate versus delayed prepectoral reconstruction, specific technical details, and postoperative management.

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The Public Face of Rhinoplasty: Impact on Perceived Attractiveness and Personality

Background: The authors assess the impact of rhinoplasty on public perception of a patient's appearance and personality. Methods: A survey was created using standardized before-and-after photographs of 10 Caucasian women who had undergone primary rhinoplasty. Photographs of two additional women who had not undergone facial surgery were randomly included as controls, for a total of 12 survey items. Preoperative and postoperative photographs were placed side by side. The survey was administered by means of crowd-sourcing. Respondents were asked to evaluate which photograph better represented 11 traits of appearance or personality, according to a seven-point Likert scale. A score of 1 meant the preoperative photograph was much better, 7 meant the postoperative photograph was much better, and 4 meant no difference. T tests and analyses of variance were used to evaluate rating changes for each trait and differences between demographic groups. Results: There were 264 responses received. Averaged scores across the 10 survey patients produced a value for each appearance or personality trait. In 10 of 11 categories (i.e., symmetry, youthfulness, facial harmony, likeability, trustworthiness, confidence, femininity, attractiveness, approachability, and intelligence), the postoperative photograph was significantly favorable compared with the preoperative photograph (p

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Leaders in Plastic Surgery: The Dingman-Grabb Era 1946–1986

No abstract available

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Comparing Efficacy and Costs of Four Facial Fillers in Human Immunodeficiency Virus-Associated Lipodystrophy: A Clinical Trial

No abstract available

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The Public Face of Rhinoplasty: Impact on Perceived Attractiveness and Personality

Background: The authors assess the impact of rhinoplasty on public perception of a patient's appearance and personality. Methods: A survey was created using standardized before-and-after photographs of 10 Caucasian women who had undergone primary rhinoplasty. Photographs of two additional women who had not undergone facial surgery were randomly included as controls, for a total of 12 survey items. Preoperative and postoperative photographs were placed side by side. The survey was administered by means of crowd-sourcing. Respondents were asked to evaluate which photograph better represented 11 traits of appearance or personality, according to a seven-point Likert scale. A score of 1 meant the preoperative photograph was much better, 7 meant the postoperative photograph was much better, and 4 meant no difference. T tests and analyses of variance were used to evaluate rating changes for each trait and differences between demographic groups. Results: There were 264 responses received. Averaged scores across the 10 survey patients produced a value for each appearance or personality trait. In 10 of 11 categories (i.e., symmetry, youthfulness, facial harmony, likeability, trustworthiness, confidence, femininity, attractiveness, approachability, and intelligence), the postoperative photograph was significantly favorable compared with the preoperative photograph (p

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Discussion: The Public Face of Rhinoplasty Impact on Perceived Attractiveness and Personality

No abstract available

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Comparing Efficacy and Costs of Four Facial Fillers in Human Immunodeficiency Virus-Associated Lipodystrophy: A Clinical Trial

No abstract available

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Macrotextured Breast Implants with Defined Steps to Minimize Bacterial Contamination around the Device: Experience in 42,000 Implants

No abstract available

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Discussion: The Public Face of Rhinoplasty Impact on Perceived Attractiveness and Personality

No abstract available

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The Orbital Oval Balance Principle: A Morphometric Clinical Analysis

Background: The aim of this study was to test the validity of the "orbital oval balance principle," a system of analysis and guideline that is used among aestheticians, artists, and makeup artists to create and design aesthetically pleasing eyebrows for optimal upper facial appearance. According to this principle, a face is optimally attractive when the eye is centered in an "oval" defined by the lid-cheek junction and the eyebrow. Methods: One hundred participants were asked to rank digital morphed images of four female models with four different periorbital proportions: higher or lower lid-cheek junction versus higher or lower eyebrow position. In addition, the participants were asked to quantify seven emotions on these morphed images. Results: A higher lid-cheek junction was rated as significantly more attractive with a lower eyebrow position, and a lower lid-cheek junction was regarded far more attractive in combination with a higher eyebrow position. Moreover, a higher lid-cheek junction was rated as more attractive than a lower lid-cheek junction, and elevation of the lid-cheek junction improved the perception of emotions such as tiredness and sadness. Conclusions: This study lends support to the orbital oval balance principle that can provide important insight into facial attractiveness to surgeons undertaking procedures intended to improve and rejuvenate facial appearance. Moreover, this study has also shown not only that a high(er) lid-cheek junction is regarded as more youthful and attractive, but that it also may reduce the appearance of tiredness and sadness.

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Macrotextured Breast Implants with Defined Steps to Minimize Bacterial Contamination around the Device: Experience in 42,000 Implants

No abstract available

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Reply: Lower Body Lift in the Massive Weight Loss Patient A New Classification and Algorithm for Gluteal Augmentation

No abstract available

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The Orbital Oval Balance Principle: A Morphometric Clinical Analysis

Background: The aim of this study was to test the validity of the "orbital oval balance principle," a system of analysis and guideline that is used among aestheticians, artists, and makeup artists to create and design aesthetically pleasing eyebrows for optimal upper facial appearance. According to this principle, a face is optimally attractive when the eye is centered in an "oval" defined by the lid-cheek junction and the eyebrow. Methods: One hundred participants were asked to rank digital morphed images of four female models with four different periorbital proportions: higher or lower lid-cheek junction versus higher or lower eyebrow position. In addition, the participants were asked to quantify seven emotions on these morphed images. Results: A higher lid-cheek junction was rated as significantly more attractive with a lower eyebrow position, and a lower lid-cheek junction was regarded far more attractive in combination with a higher eyebrow position. Moreover, a higher lid-cheek junction was rated as more attractive than a lower lid-cheek junction, and elevation of the lid-cheek junction improved the perception of emotions such as tiredness and sadness. Conclusions: This study lends support to the orbital oval balance principle that can provide important insight into facial attractiveness to surgeons undertaking procedures intended to improve and rejuvenate facial appearance. Moreover, this study has also shown not only that a high(er) lid-cheek junction is regarded as more youthful and attractive, but that it also may reduce the appearance of tiredness and sadness.

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Abdominoplasty with Circumferential Liposuction: A Review of 1000 Consecutive Cases

Background: The authors present the technique called "abdominoplasty with concurrent circumferential liposuction," where the whole trunk is addressed as a single aesthetic unit. Methods: Between January of 2008 and June of 2016, abdominoplasty with circumferential liposuction was performed in 1000 patients (984 women and 16 men) by the senior author. Patients had a mean body mass index of 27.5 kg/m2 (range, 18.1 to 34.5 5 kg/m2). Liposuction was performed circumferentially and the abdominal flap was detached up to the costal margins. Simultaneous fat grafting was also performed if required. Outcomes and complications were documented. Results: Traditional abdominoplasty incisions were used in 359 patients, whereas extended incisions were used in 641 patients. The mean duration of follow-up was 27 months (range, 12 days to 61 months), and the mean duration of surgery was 154 minutes (range, 109 to 260 minutes). The mean amount of simultaneously aspired supernatant lipoaspirate was 1940 cc (range, 1700 to 4580 cc). Simultaneous gluteal fat grafting was performed in 34 percent. None of the patients had any skin necrosis. The most common complication was seroma (19 percent). Conclusions: In abdominoplasty, the entire central body should be considered as a single unit. Circumferential widespread liposuction with standard undermining of the abdominal flap up to the costal margins is safe and yields superior aesthetic outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Reply: Lower Body Lift in the Massive Weight Loss Patient A New Classification and Algorithm for Gluteal Augmentation

No abstract available

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Abdominoplasty with Circumferential Liposuction: A Review of 1000 Consecutive Cases

Background: The authors present the technique called "abdominoplasty with concurrent circumferential liposuction," where the whole trunk is addressed as a single aesthetic unit. Methods: Between January of 2008 and June of 2016, abdominoplasty with circumferential liposuction was performed in 1000 patients (984 women and 16 men) by the senior author. Patients had a mean body mass index of 27.5 kg/m2 (range, 18.1 to 34.5 5 kg/m2). Liposuction was performed circumferentially and the abdominal flap was detached up to the costal margins. Simultaneous fat grafting was also performed if required. Outcomes and complications were documented. Results: Traditional abdominoplasty incisions were used in 359 patients, whereas extended incisions were used in 641 patients. The mean duration of follow-up was 27 months (range, 12 days to 61 months), and the mean duration of surgery was 154 minutes (range, 109 to 260 minutes). The mean amount of simultaneously aspired supernatant lipoaspirate was 1940 cc (range, 1700 to 4580 cc). Simultaneous gluteal fat grafting was performed in 34 percent. None of the patients had any skin necrosis. The most common complication was seroma (19 percent). Conclusions: In abdominoplasty, the entire central body should be considered as a single unit. Circumferential widespread liposuction with standard undermining of the abdominal flap up to the costal margins is safe and yields superior aesthetic outcomes. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Postmortem computed tomography angiography (PMCTA) and traditional autopsy in cases of sudden cardiac death due to coronary artery disease: a systematic review and meta-analysis

Abstract

Introduction

Several studies have been performed to assess the efficacy of postmortem computed tomography angiography (PMCTA) in solving cases of sudden cardiac death, even in comparison with the traditional autopsy. However, the results were often inconsistent and inconclusive. Therefore, a global discussion on the subject through a systematic review of the literature and a meta-analysis is necessary.

Methods

A systematic search of PubMed was performed up to April 23, 2018. Studies exploring the role of PMCTA in cases of sudden cardiac death and the accuracy of this method in diagnosing the cause of death compared to traditional autopsy were included.

Results

The overall sensitivity and specificity of the seven included studies, using conventional autopsy as a reference standard, were 92% and 95%, respectively. The positive and negative likelihood ratios were, respectively, 20.76 (95% CI 1.16–370.2) and 0.08 (95% CI 0.03–0.17), showing that PMCTA represents a strong indicator of the posttest probability of disease. The diagnostic odds ratio and the area under the curve were, respectively, 261.54 (95% CI 1.87–5760.53) and 0.93 (95% CI 0.90–0.95), indicating a high diagnostic power of the test.

Conclusion

PMCTA demonstrated a high accuracy in the diagnosis of parietal and luminal coronary changes but was less effective in detecting myocardial ischemia and necrosis. Therefore, the only radiological investigation is often insufficient to determine the cause of sudden death and the conventional autopsy remains the gold standard. However, PMCTA can improve the performance of the autopsy, serving as an aid and guide in the sampling phase for histopathological investigations.

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Postmortem computed tomography angiography (PMCTA) and traditional autopsy in cases of sudden cardiac death due to coronary artery disease: a systematic review and meta-analysis

Abstract

Introduction

Several studies have been performed to assess the efficacy of postmortem computed tomography angiography (PMCTA) in solving cases of sudden cardiac death, even in comparison with the traditional autopsy. However, the results were often inconsistent and inconclusive. Therefore, a global discussion on the subject through a systematic review of the literature and a meta-analysis is necessary.

Methods

A systematic search of PubMed was performed up to April 23, 2018. Studies exploring the role of PMCTA in cases of sudden cardiac death and the accuracy of this method in diagnosing the cause of death compared to traditional autopsy were included.

Results

The overall sensitivity and specificity of the seven included studies, using conventional autopsy as a reference standard, were 92% and 95%, respectively. The positive and negative likelihood ratios were, respectively, 20.76 (95% CI 1.16–370.2) and 0.08 (95% CI 0.03–0.17), showing that PMCTA represents a strong indicator of the posttest probability of disease. The diagnostic odds ratio and the area under the curve were, respectively, 261.54 (95% CI 1.87–5760.53) and 0.93 (95% CI 0.90–0.95), indicating a high diagnostic power of the test.

Conclusion

PMCTA demonstrated a high accuracy in the diagnosis of parietal and luminal coronary changes but was less effective in detecting myocardial ischemia and necrosis. Therefore, the only radiological investigation is often insufficient to determine the cause of sudden death and the conventional autopsy remains the gold standard. However, PMCTA can improve the performance of the autopsy, serving as an aid and guide in the sampling phase for histopathological investigations.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zyiMrq

Chronic back pain and its association with quality of life in a large French population survey

Chronic back pain is associated with significant burden, yet few epidemiological studies have provided data on chronic back pain, its predictors and correlates in France.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2In6yVq

Patients with Indeterminate Thyroid Nodules at Cytology and Cancer at Histology Have a More Favorable Outcome Compared with Patients with Suspicious or Malignant Cytology

Thyroid, Volume 28, Issue 10, Page 1318-1324, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHtAfn

Current Thyrotropin Immunoassays Recognize Macro-Thyrotropin Leading to Hyperthyrotropinemia in Females of Reproductive Age

Thyroid, Volume 28, Issue 10, Page 1252-1260, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHt2WR

Hyperthyroidism and Papillary Thyroid Carcinoma in Thyrotropin Receptor D633H Mutant Mice

Thyroid, Volume 28, Issue 10, Page 1372-1386, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHsAb7

Deep Learning–Based Computer-Aided Diagnosis System for Localization and Diagnosis of Metastatic Lymph Nodes on Ultrasound: A Pilot Study

Thyroid, Volume 28, Issue 10, Page 1332-1338, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N632z8

Intermediate-Risk Papillary Thyroid Cancer: Risk Factors for Early Recurrence in Patients with Excellent Response to Initial Therapy

Thyroid, Volume 28, Issue 10, Page 1311-1317, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NLhG4g

Diagnostic Performance of Technetium-99m Methoxy-Isobutyl-Isonitrile for Differentiation of Malignant Thyroid Nodules: A Systematic Review and Meta-Analysis

Thyroid, Volume 28, Issue 10, Page 1339-1348, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHsv7j

Using the American Thyroid Association Risk-Stratification System to Refine and Individualize the American Joint Committee on Cancer Eighth Edition Disease-Specific Survival Estimates in Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1293-1300, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N3JXOk

Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women

Thyroid, Volume 28, Issue 10, Page 1359-1371, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NIX6kY

Survival in Differentiated Thyroid Cancer: Comparing the AJCC Cancer Staging Seventh and Eighth Editions

Thyroid, Volume 28, Issue 10, Page 1301-1310, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N56qKB

Anticonvulsant and Neuroprotective Effects of the Thyroid Hormone Metabolite 3-Iodothyroacetic Acid

Thyroid, Volume 28, Issue 10, Page 1387-1397, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NIWyvq

Patients with Indeterminate Thyroid Nodules at Cytology and Cancer at Histology Have a More Favorable Outcome Compared with Patients with Suspicious or Malignant Cytology

Thyroid, Volume 28, Issue 10, Page 1318-1324, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHtAfn

Immune-Related Thyroiditis with Immune Checkpoint Inhibitors

Thyroid, Volume 28, Issue 10, Page 1243-1251, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N2K6S9

Current Thyrotropin Immunoassays Recognize Macro-Thyrotropin Leading to Hyperthyrotropinemia in Females of Reproductive Age

Thyroid, Volume 28, Issue 10, Page 1252-1260, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHt2WR

Future Meetings

Thyroid, Volume 28, Issue 10, Page 1398-1399, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N36bzS

Hyperthyroidism and Papillary Thyroid Carcinoma in Thyrotropin Receptor D633H Mutant Mice

Thyroid, Volume 28, Issue 10, Page 1372-1386, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHsAb7

Intermediate-Risk Papillary Thyroid Cancer: Risk Factors for Early Recurrence in Patients with Excellent Response to Initial Therapy

Thyroid, Volume 28, Issue 10, Page 1311-1317, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NLhG4g

Dynamic Risk Stratification in the Follow-Up of Children and Adolescents with Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1285-1292, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N5MbwD

Diagnostic Performance of Technetium-99m Methoxy-Isobutyl-Isonitrile for Differentiation of Malignant Thyroid Nodules: A Systematic Review and Meta-Analysis

Thyroid, Volume 28, Issue 10, Page 1339-1348, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHsv7j

Using the American Thyroid Association Risk-Stratification System to Refine and Individualize the American Joint Committee on Cancer Eighth Edition Disease-Specific Survival Estimates in Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1293-1300, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N3JXOk

Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women

Thyroid, Volume 28, Issue 10, Page 1359-1371, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NIX6kY

Survival in Differentiated Thyroid Cancer: Comparing the AJCC Cancer Staging Seventh and Eighth Editions

Thyroid, Volume 28, Issue 10, Page 1301-1310, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N56qKB

Anticonvulsant and Neuroprotective Effects of the Thyroid Hormone Metabolite 3-Iodothyroacetic Acid

Thyroid, Volume 28, Issue 10, Page 1387-1397, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NIWyvq

Patients with Indeterminate Thyroid Nodules at Cytology and Cancer at Histology Have a More Favorable Outcome Compared with Patients with Suspicious or Malignant Cytology

Thyroid, Volume 28, Issue 10, Page 1318-1324, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHtAfn

Patients with Indeterminate Thyroid Nodules at Cytology and Cancer at Histology Have a More Favorable Outcome Compared with Patients with Suspicious or Malignant Cytology

Thyroid, Volume 28, Issue 10, Page 1318-1324, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHtAfn

Immune-Related Thyroiditis with Immune Checkpoint Inhibitors

Thyroid, Volume 28, Issue 10, Page 1243-1251, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N2K6S9

Immune-Related Thyroiditis with Immune Checkpoint Inhibitors

Thyroid, Volume 28, Issue 10, Page 1243-1251, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N2K6S9

Current Thyrotropin Immunoassays Recognize Macro-Thyrotropin Leading to Hyperthyrotropinemia in Females of Reproductive Age

Thyroid, Volume 28, Issue 10, Page 1252-1260, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHt2WR

Current Thyrotropin Immunoassays Recognize Macro-Thyrotropin Leading to Hyperthyrotropinemia in Females of Reproductive Age

Thyroid, Volume 28, Issue 10, Page 1252-1260, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHt2WR

Future Meetings

Thyroid, Volume 28, Issue 10, Page 1398-1399, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N36bzS

Future Meetings

Thyroid, Volume 28, Issue 10, Page 1398-1399, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N36bzS

Hyperthyroidism and Papillary Thyroid Carcinoma in Thyrotropin Receptor D633H Mutant Mice

Thyroid, Volume 28, Issue 10, Page 1372-1386, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHsAb7

Hyperthyroidism and Papillary Thyroid Carcinoma in Thyrotropin Receptor D633H Mutant Mice

Thyroid, Volume 28, Issue 10, Page 1372-1386, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHsAb7

Deep Learning–Based Computer-Aided Diagnosis System for Localization and Diagnosis of Metastatic Lymph Nodes on Ultrasound: A Pilot Study

Thyroid, Volume 28, Issue 10, Page 1332-1338, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N632z8

Intermediate-Risk Papillary Thyroid Cancer: Risk Factors for Early Recurrence in Patients with Excellent Response to Initial Therapy

Thyroid, Volume 28, Issue 10, Page 1311-1317, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NLhG4g

Dynamic Risk Stratification in the Follow-Up of Children and Adolescents with Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1285-1292, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N5MbwD

Diagnostic Performance of Technetium-99m Methoxy-Isobutyl-Isonitrile for Differentiation of Malignant Thyroid Nodules: A Systematic Review and Meta-Analysis

Thyroid, Volume 28, Issue 10, Page 1339-1348, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NHsv7j

Using the American Thyroid Association Risk-Stratification System to Refine and Individualize the American Joint Committee on Cancer Eighth Edition Disease-Specific Survival Estimates in Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1293-1300, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N3JXOk

Using the American Thyroid Association Risk-Stratification System to Refine and Individualize the American Joint Committee on Cancer Eighth Edition Disease-Specific Survival Estimates in Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1293-1300, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N3JXOk

Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women

Thyroid, Volume 28, Issue 10, Page 1359-1371, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NIX6kY

Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women

Thyroid, Volume 28, Issue 10, Page 1359-1371, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NIX6kY

Survival in Differentiated Thyroid Cancer: Comparing the AJCC Cancer Staging Seventh and Eighth Editions

Thyroid, Volume 28, Issue 10, Page 1301-1310, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N56qKB

Anticonvulsant and Neuroprotective Effects of the Thyroid Hormone Metabolite 3-Iodothyroacetic Acid

Thyroid, Volume 28, Issue 10, Page 1387-1397, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NIWyvq

Patients with Indeterminate Thyroid Nodules at Cytology and Cancer at Histology Have a More Favorable Outcome Compared with Patients with Suspicious or Malignant Cytology

Thyroid, Volume 28, Issue 10, Page 1318-1324, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QaJ5ZY

Immune-Related Thyroiditis with Immune Checkpoint Inhibitors

Thyroid, Volume 28, Issue 10, Page 1243-1251, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxUptE

Current Thyrotropin Immunoassays Recognize Macro-Thyrotropin Leading to Hyperthyrotropinemia in Females of Reproductive Age

Thyroid, Volume 28, Issue 10, Page 1252-1260, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qdn9O4

Future Meetings

Thyroid, Volume 28, Issue 10, Page 1398-1399, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxLQPB

Hyperthyroidism and Papillary Thyroid Carcinoma in Thyrotropin Receptor D633H Mutant Mice

Thyroid, Volume 28, Issue 10, Page 1372-1386, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Q8fFMb

Deep Learning–Based Computer-Aided Diagnosis System for Localization and Diagnosis of Metastatic Lymph Nodes on Ultrasound: A Pilot Study

Thyroid, Volume 28, Issue 10, Page 1332-1338, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxeyQF

Intermediate-Risk Papillary Thyroid Cancer: Risk Factors for Early Recurrence in Patients with Excellent Response to Initial Therapy

Thyroid, Volume 28, Issue 10, Page 1311-1317, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qa8vXH

Dynamic Risk Stratification in the Follow-Up of Children and Adolescents with Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1285-1292, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zwOeGh

Diagnostic Performance of Technetium-99m Methoxy-Isobutyl-Isonitrile for Differentiation of Malignant Thyroid Nodules: A Systematic Review and Meta-Analysis

Thyroid, Volume 28, Issue 10, Page 1339-1348, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Q6GgsW

Using the American Thyroid Association Risk-Stratification System to Refine and Individualize the American Joint Committee on Cancer Eighth Edition Disease-Specific Survival Estimates in Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1293-1300, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxVotW

Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women

Thyroid, Volume 28, Issue 10, Page 1359-1371, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Q6GdgK

Survival in Differentiated Thyroid Cancer: Comparing the AJCC Cancer Staging Seventh and Eighth Editions

Thyroid, Volume 28, Issue 10, Page 1301-1310, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxLKYf

Anticonvulsant and Neuroprotective Effects of the Thyroid Hormone Metabolite 3-Iodothyroacetic Acid

Thyroid, Volume 28, Issue 10, Page 1387-1397, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QaIUhg

Patients with Indeterminate Thyroid Nodules at Cytology and Cancer at Histology Have a More Favorable Outcome Compared with Patients with Suspicious or Malignant Cytology

Thyroid, Volume 28, Issue 10, Page 1318-1324, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QaJ5ZY

Immune-Related Thyroiditis with Immune Checkpoint Inhibitors

Thyroid, Volume 28, Issue 10, Page 1243-1251, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxUptE

Current Thyrotropin Immunoassays Recognize Macro-Thyrotropin Leading to Hyperthyrotropinemia in Females of Reproductive Age

Thyroid, Volume 28, Issue 10, Page 1252-1260, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qdn9O4

Future Meetings

Thyroid, Volume 28, Issue 10, Page 1398-1399, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxLQPB

Deep Learning–Based Computer-Aided Diagnosis System for Localization and Diagnosis of Metastatic Lymph Nodes on Ultrasound: A Pilot Study

Thyroid, Volume 28, Issue 10, Page 1332-1338, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxeyQF

Intermediate-Risk Papillary Thyroid Cancer: Risk Factors for Early Recurrence in Patients with Excellent Response to Initial Therapy

Thyroid, Volume 28, Issue 10, Page 1311-1317, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Qa8vXH

Dynamic Risk Stratification in the Follow-Up of Children and Adolescents with Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1285-1292, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zwOeGh

Diagnostic Performance of Technetium-99m Methoxy-Isobutyl-Isonitrile for Differentiation of Malignant Thyroid Nodules: A Systematic Review and Meta-Analysis

Thyroid, Volume 28, Issue 10, Page 1339-1348, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Q6GgsW

Using the American Thyroid Association Risk-Stratification System to Refine and Individualize the American Joint Committee on Cancer Eighth Edition Disease-Specific Survival Estimates in Differentiated Thyroid Cancer

Thyroid, Volume 28, Issue 10, Page 1293-1300, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxVotW

Iodine Intake is Associated with Thyroid Function in Mild to Moderately Iodine Deficient Pregnant Women

Thyroid, Volume 28, Issue 10, Page 1359-1371, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Q6GdgK

Survival in Differentiated Thyroid Cancer: Comparing the AJCC Cancer Staging Seventh and Eighth Editions

Thyroid, Volume 28, Issue 10, Page 1301-1310, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxLKYf

Anticonvulsant and Neuroprotective Effects of the Thyroid Hormone Metabolite 3-Iodothyroacetic Acid

Thyroid, Volume 28, Issue 10, Page 1387-1397, October 2018.


from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QaIUhg

The Video Head Impulse Test: Our Experience in 45 Cases

Abstract

To evaluate the role of video head impulse test in the diagnosis of peripheral vestibular disorders, we performed an observational study in the outpatient department in a tertiary setup in which the clinical head impulse test and the video head impulse test were performed on 45 patients with clinically suspected peripheral vestibular disorders, and their results were correlated. To analyse our results, each ear was counted individually and hence, among 45 patients, 12 out of 90 ears showed abnormal clinical head impulse test for lateral semicircular canals and 27 out of 90 ears showed abnormal video head impulse test for lateral semicircular canals. This gave us an additional diagnostic accuracy of 21.1% on using video head impulse test for the lateral semicircular canals as compared to the clinical head impulse test. Video head impulse test is a physiological, quick and well tolerated test for assessing the vestibular function, and the only practical test for assessing the vertical semicircular canal function. Video head impulse test provides valuable information in localising the site of lesion as it assesses the semicircular canals individually. Video head impulse is merely not an objectification and registration system for the clinical head impulse test as it provides additional information such as vestibulo–ocular reflex gain, and occurrence of covert refixation saccades which cannot be picked up by naked eyes.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DyFu6M

Physicians’ Perception on Allergic Rhinitis and Its Management: A Questionnaire Based Survey

Abstract

Despite high prevalence and impact on quality of life, Allergic Rhinitis (AR) is undertreated. Furthermore, existence of a relationship between AR and upper respiratory tract infection (URTI) is less explored. This Pan-India survey intended to assess physicians' perception about AR and URTI, and management practices in Indian setting. This questionnaire-based survey was conducted by telephonically interviewing 300 physicians [Consultant Physicians (CP): 33%; General Physicians (GP): 32%; ENT surgeons: 16%; pediatricians: 11%; allergy specialists: 8%] across India. CPs (33%) and GPs (32%) treated more AR patients in a month, versus other specialties. According to physicians, about 29.6% of patients with AR develop URTI in a month. Majority of the physicians (98%) believed that recurrent URTI can be considered as an indicator of undiagnosed AR. Majority of the physicians (98%) also considered AR to be a predisposing factor for increased risk of URTI. About 62% agreed that prompt diagnosis and treatment of AR can reduce the risk of complications such as URTI. Most preferred first- and second-line of treatment (alone or in combination) in AR management were oral antihistamines (41%) and intranasal corticosteroids (40%), respectively. Similar treatment preferences were observed irrespective of physicians' specialization and years of experience. This survey sheds light on the need to implement clear guidelines for the diagnosis and management of AR.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R1w3PR

The Video Head Impulse Test: Our Experience in 45 Cases

Abstract

To evaluate the role of video head impulse test in the diagnosis of peripheral vestibular disorders, we performed an observational study in the outpatient department in a tertiary setup in which the clinical head impulse test and the video head impulse test were performed on 45 patients with clinically suspected peripheral vestibular disorders, and their results were correlated. To analyse our results, each ear was counted individually and hence, among 45 patients, 12 out of 90 ears showed abnormal clinical head impulse test for lateral semicircular canals and 27 out of 90 ears showed abnormal video head impulse test for lateral semicircular canals. This gave us an additional diagnostic accuracy of 21.1% on using video head impulse test for the lateral semicircular canals as compared to the clinical head impulse test. Video head impulse test is a physiological, quick and well tolerated test for assessing the vestibular function, and the only practical test for assessing the vertical semicircular canal function. Video head impulse test provides valuable information in localising the site of lesion as it assesses the semicircular canals individually. Video head impulse is merely not an objectification and registration system for the clinical head impulse test as it provides additional information such as vestibulo–ocular reflex gain, and occurrence of covert refixation saccades which cannot be picked up by naked eyes.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DyFu6M

Physicians’ Perception on Allergic Rhinitis and Its Management: A Questionnaire Based Survey

Abstract

Despite high prevalence and impact on quality of life, Allergic Rhinitis (AR) is undertreated. Furthermore, existence of a relationship between AR and upper respiratory tract infection (URTI) is less explored. This Pan-India survey intended to assess physicians' perception about AR and URTI, and management practices in Indian setting. This questionnaire-based survey was conducted by telephonically interviewing 300 physicians [Consultant Physicians (CP): 33%; General Physicians (GP): 32%; ENT surgeons: 16%; pediatricians: 11%; allergy specialists: 8%] across India. CPs (33%) and GPs (32%) treated more AR patients in a month, versus other specialties. According to physicians, about 29.6% of patients with AR develop URTI in a month. Majority of the physicians (98%) believed that recurrent URTI can be considered as an indicator of undiagnosed AR. Majority of the physicians (98%) also considered AR to be a predisposing factor for increased risk of URTI. About 62% agreed that prompt diagnosis and treatment of AR can reduce the risk of complications such as URTI. Most preferred first- and second-line of treatment (alone or in combination) in AR management were oral antihistamines (41%) and intranasal corticosteroids (40%), respectively. Similar treatment preferences were observed irrespective of physicians' specialization and years of experience. This survey sheds light on the need to implement clear guidelines for the diagnosis and management of AR.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2R1w3PR

VideoEndocrinology™ High-Impact Videos

VideoEndocrinology™
The Official Journal of: American Thyroid Association

FREE ACCESS through October 8, 2018.
Watch now:

Transoral Endoscopic Thyroidectomy Vestibular Approach: Technical Tips and Tricks
Gustavo G. Fernandez Ranvier, Patrick Neshiwat, William B. Inabnet III

Central Neck Dissection: The Five Key Steps
Nathaniel J. Walsh, Asif M. Talukder, David J. Terris 

Transoral and Submental Thyroidectomy
Yufei Chen, Kathryn H. Chomsky-Higgins, Iheoma Nwaogu, Carolyn D. Seib, Jessica E. Gosnell, Wen T. Shen, Quan-Yang Duh, Insoo Suh 

Robotic Resection of an 8 mm Nonexophitic Pancreatic Insulinoma
Colleen M. Kiernan, Paula Marincola Smith, Zuliang Feng, Carmen C. Solórzano 

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxc8Sa

VideoEndocrinology™ High-Impact Videos

VideoEndocrinology™
The Official Journal of: American Thyroid Association

FREE ACCESS through October 8, 2018.
Watch now:

Transoral Endoscopic Thyroidectomy Vestibular Approach: Technical Tips and Tricks
Gustavo G. Fernandez Ranvier, Patrick Neshiwat, William B. Inabnet III

Central Neck Dissection: The Five Key Steps
Nathaniel J. Walsh, Asif M. Talukder, David J. Terris 

Transoral and Submental Thyroidectomy
Yufei Chen, Kathryn H. Chomsky-Higgins, Iheoma Nwaogu, Carolyn D. Seib, Jessica E. Gosnell, Wen T. Shen, Quan-Yang Duh, Insoo Suh 

Robotic Resection of an 8 mm Nonexophitic Pancreatic Insulinoma
Colleen M. Kiernan, Paula Marincola Smith, Zuliang Feng, Carmen C. Solórzano 

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zxc8Sa

Editorial Board

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2xDEzwo

Training Groups

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Editorial Board

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Training Groups

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Tooth crown discoloration induced by endodontic sealers: a 3-year ex vivo evaluation

Abstract

Objectives

The aim of this study was to evaluate the tooth crown discoloration induced by commonly used and new-generation endodontic sealers after 1 month and 1 and 3 years.

Materials and methods

The crowns of 60 extracted incisors were cut and the pulp chambers were cleaned. The specimens were divided randomly into four groups (n = 15 each). Pulp chambers were filled with Pulpispad in group 1, AH26 in group 2, MTA Fillapex in group 3, and EndoREZ in group 4. Specimen color was measured with a spectrophotometer before and after sealer placement. Commission International de L'Eclairage's (CIE's) lighteness (L*), red-green (a*), yellow-blue (b*) color system values and color difference (ΔE) were recorded at 1 month and 1 and 3 years. Data were analyzed using repeated-measures analysis of variance and Tukey's honestly significant difference test (α = 0.05).

Results

All sealers caused discoloration. At 1 month, ΔE values were significantly higher in groups 1 and 2 than in groups 3 and 4 (p < 0.05). At 1 year, ΔE values were significantly lower in group 3 than in the other groups (p < 0.05). At 3 years, ΔE values were significantly higher in group 1 than in the other groups (p < 0.05).

Conclusions

All tested sealers induced varying chromatic alterations. After root canal obturation, thorough debridement of sealers from the pulp chamber is essential for the prevention of sealer-induced discoloration.

Clinical relevance

Tooth discoloration induced by endodontic materials is a problem for clinicians and patients and may impair the esthetic of endodontically treated teeth. Therefore, evaluation of long-term discoloration effects commonly used, and new-generation endodontic sealers were purposed in this study.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Od9dWW

Tooth crown discoloration induced by endodontic sealers: a 3-year ex vivo evaluation

Abstract

Objectives

The aim of this study was to evaluate the tooth crown discoloration induced by commonly used and new-generation endodontic sealers after 1 month and 1 and 3 years.

Materials and methods

The crowns of 60 extracted incisors were cut and the pulp chambers were cleaned. The specimens were divided randomly into four groups (n = 15 each). Pulp chambers were filled with Pulpispad in group 1, AH26 in group 2, MTA Fillapex in group 3, and EndoREZ in group 4. Specimen color was measured with a spectrophotometer before and after sealer placement. Commission International de L'Eclairage's (CIE's) lighteness (L*), red-green (a*), yellow-blue (b*) color system values and color difference (ΔE) were recorded at 1 month and 1 and 3 years. Data were analyzed using repeated-measures analysis of variance and Tukey's honestly significant difference test (α = 0.05).

Results

All sealers caused discoloration. At 1 month, ΔE values were significantly higher in groups 1 and 2 than in groups 3 and 4 (p < 0.05). At 1 year, ΔE values were significantly lower in group 3 than in the other groups (p < 0.05). At 3 years, ΔE values were significantly higher in group 1 than in the other groups (p < 0.05).

Conclusions

All tested sealers induced varying chromatic alterations. After root canal obturation, thorough debridement of sealers from the pulp chamber is essential for the prevention of sealer-induced discoloration.

Clinical relevance

Tooth discoloration induced by endodontic materials is a problem for clinicians and patients and may impair the esthetic of endodontically treated teeth. Therefore, evaluation of long-term discoloration effects commonly used, and new-generation endodontic sealers were purposed in this study.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2Od9dWW

Evaluation of risk factors for a fulminant Clostridium difficile infection after cardiac surgery: a single-center, retrospective cohort study

Abstract

Background

Clostridium difficile (CD) is the most common pathogen causing nosocomial diarrhea. The clinical presentation ranges from mild diarrhea to severe complications, including pseudomembranous colitis, toxic megacolon, sepsis, and multi-organ failure. When the disease takes a fulminant course, death ensues rapidly in severe and complex cases. Preventive screening or current prophylactic therapies are not useful. Therefore, this study was conducted to detect risk factors for a fulminant CD infection (CDI) in patients undergoing cardiac surgery.

Methods

Between April 1999 and April 2011, a total of 41,466 patients underwent cardiac surgery at our institution. A review of our hospital database revealed 1256 patients (3.0%) with post-operative diarrheal disease who tested positive for CD; these patients comprised the cohort of this observational study. A fulminant CDI occurred in 153 of these patients (12.2%), which was diagnosed on the basis of gastrointestinal complications, e.g. pseudomembranous colitis, and/or the need for post-cardiac surgery laparotomy. Demographic, peri-operative, and survival data were analyzed, and predictors of a fulminant CDI were assessed by binary logistic regression analysis.

Results

The 30-day mortality was 6.1% (n = 77) for the entire cohort, with significantly higher mortality among patients with a fulminant CDI (21.6% vs. 4.0%, p <  0.001). Overall mortality (27.7%, n = 348) was also higher for patients with a fulminant course of the disease (63.4% vs. 22.8%, p <  0.001), and a laparotomy was required in 36.6% (n = 56) of the fulminant cases. Independent predictors of a fulminant CDI were: diabetes mellitus type 2 (OR 1.74, CI 1.15–2.63, p = 0.008), pre-operative ventilation (OR 3.52, CI 1.32–9.35, p = 0.012), utilization of more than 8 units of red blood cell concentrates (OR 1.95, CI 1.01–3.76, p = 0.046) or of more than 5 fresh-frozen plasma units (OR 3.38, CI 2.06–5.54, p <  0.001), and a cross-clamp time > 130 min (OR 1.93, CI 1.12–3.33, p = 0.017).

Conclusions

We identified several independent risk factors for the development of a fulminant CDI after cardiac surgery. Close monitoring of high-risk patients is important in order to establish an early onset of therapy and thus to prevent a CDI from developing a fulminant course after cardiac surgery.

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VideoEndocrinology™ High-Impact Videos

VideoEndocrinology™
The Official Journal of: American Thyroid Association

FREE ACCESS through October 8, 2018.
Watch now:

Transoral Endoscopic Thyroidectomy Vestibular Approach: Technical Tips and Tricks
Gustavo G. Fernandez Ranvier, Patrick Neshiwat, William B. Inabnet III

Central Neck Dissection: The Five Key Steps
Nathaniel J. Walsh, Asif M. Talukder, David J. Terris 

Transoral and Submental Thyroidectomy
Yufei Chen, Kathryn H. Chomsky-Higgins, Iheoma Nwaogu, Carolyn D. Seib, Jessica E. Gosnell, Wen T. Shen, Quan-Yang Duh, Insoo Suh 

Robotic Resection of an 8 mm Nonexophitic Pancreatic Insulinoma
Colleen M. Kiernan, Paula Marincola Smith, Zuliang Feng, Carmen C. Solórzano 

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.

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Evaluation of risk factors for a fulminant Clostridium difficile infection after cardiac surgery: a single-center, retrospective cohort study

Abstract

Background

Clostridium difficile (CD) is the most common pathogen causing nosocomial diarrhea. The clinical presentation ranges from mild diarrhea to severe complications, including pseudomembranous colitis, toxic megacolon, sepsis, and multi-organ failure. When the disease takes a fulminant course, death ensues rapidly in severe and complex cases. Preventive screening or current prophylactic therapies are not useful. Therefore, this study was conducted to detect risk factors for a fulminant CD infection (CDI) in patients undergoing cardiac surgery.

Methods

Between April 1999 and April 2011, a total of 41,466 patients underwent cardiac surgery at our institution. A review of our hospital database revealed 1256 patients (3.0%) with post-operative diarrheal disease who tested positive for CD; these patients comprised the cohort of this observational study. A fulminant CDI occurred in 153 of these patients (12.2%), which was diagnosed on the basis of gastrointestinal complications, e.g. pseudomembranous colitis, and/or the need for post-cardiac surgery laparotomy. Demographic, peri-operative, and survival data were analyzed, and predictors of a fulminant CDI were assessed by binary logistic regression analysis.

Results

The 30-day mortality was 6.1% (n = 77) for the entire cohort, with significantly higher mortality among patients with a fulminant CDI (21.6% vs. 4.0%, p <  0.001). Overall mortality (27.7%, n = 348) was also higher for patients with a fulminant course of the disease (63.4% vs. 22.8%, p <  0.001), and a laparotomy was required in 36.6% (n = 56) of the fulminant cases. Independent predictors of a fulminant CDI were: diabetes mellitus type 2 (OR 1.74, CI 1.15–2.63, p = 0.008), pre-operative ventilation (OR 3.52, CI 1.32–9.35, p = 0.012), utilization of more than 8 units of red blood cell concentrates (OR 1.95, CI 1.01–3.76, p = 0.046) or of more than 5 fresh-frozen plasma units (OR 3.38, CI 2.06–5.54, p <  0.001), and a cross-clamp time > 130 min (OR 1.93, CI 1.12–3.33, p = 0.017).

Conclusions

We identified several independent risk factors for the development of a fulminant CDI after cardiac surgery. Close monitoring of high-risk patients is important in order to establish an early onset of therapy and thus to prevent a CDI from developing a fulminant course after cardiac surgery.

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VideoEndocrinology™ High-Impact Videos

VideoEndocrinology™
The Official Journal of: American Thyroid Association

FREE ACCESS through October 8, 2018.
Watch now:

Transoral Endoscopic Thyroidectomy Vestibular Approach: Technical Tips and Tricks
Gustavo G. Fernandez Ranvier, Patrick Neshiwat, William B. Inabnet III

Central Neck Dissection: The Five Key Steps
Nathaniel J. Walsh, Asif M. Talukder, David J. Terris 

Transoral and Submental Thyroidectomy
Yufei Chen, Kathryn H. Chomsky-Higgins, Iheoma Nwaogu, Carolyn D. Seib, Jessica E. Gosnell, Wen T. Shen, Quan-Yang Duh, Insoo Suh 

Robotic Resection of an 8 mm Nonexophitic Pancreatic Insulinoma
Colleen M. Kiernan, Paula Marincola Smith, Zuliang Feng, Carmen C. Solórzano 

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.

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Reply to: letter to the editor about the article published in Clinical Oral Investigations tilted: impacted and transmigrated mandibular canines: an analysis of 3D radiographic imaging data (Bertl MH, Frey C, Bertl K, Giannis K, Gahleitner A, Strbac GD (2018) Clin Oral Investig, doi: 10.1007/s00784-018-2342-0

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Reply to: letter to the editor about the article published in Clinical Oral Investigations tilted: impacted and transmigrated mandibular canines: an analysis of 3D radiographic imaging data (Bertl MH, Frey C, Bertl K, Giannis K, Gahleitner A, Strbac GD (2018) Clin Oral Investig, doi: 10.1007/s00784-018-2342-0

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Direct Oral Anticoagulants (DOACs) and Medical Comorbidities in Patients Needing Dental Extractions: Management of the Risk of Bleeding

The purpose of this study was to measure the frequency of bleeding during and after tooth extraction in patients exposed to DOACs and identify risk factors for prolonged or excessive bleeding.

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Evidence-Based Clinical Criteria for Computed Tomography Imaging in Odontogenic Infections

Odontogenic infections are a common problem in emergency departments and impose a burden on hospital budgets and provider time. Compounding this, is the lack of evidence guiding the patient's initial evaluation. The purpose of this study is to derive evidence-based guidelines for the use of computed tomography (CT) imaging in the management of odontogenic infections.

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The Biaxial Double Barrel Fibula Flap – A Simplified Technique for Fibula Maxillary Reconstruction

Previously described techniques for microvascular fibula reconstruction of Brown Class II-IV maxillectomy defects are complex, require multiple osteotomies, result in a short pedicle length, and inadequately reconstruct the dental alveolus in preparation for endosseous implants [1-4].We describe a simplified technique for Brown class II-IV defects that recreates facial support, allows for dental reconstruction with appropriately positioned implants, and maintains adequate pedicle length.

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Postoperative Quality-of-Life Analysis of Open Versus Closed Reduction of Mandibular Condyle Fractures: Our Experience

The treatment of unilateral mandibular condylar fractures remains a topic that continues to elicit controversy. Closed reduction with maxillomandibular fixation (CRMMF) and open reduction with internal fixation (ORIF) are two widely accepted treatment options. Several studies attempted to illustrate the advantage of ORIF by demonstrating better anatomical reduction and functional outcomes (Throckmorton & Ellis, 2000; Ishihama et al., 2007; Singh et al., 2011). However, a number of studies showed no significant differences in functional outcomes between the two procedures, and some favored CRMMF due to the lack of potential complications of ORIF, such as facial nerve paralysis and scarring (Landes et al., 2008; Leon et al., 2011; Gupta et al., 2012).

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Utilizing the Epidemiology of Head, Face and Neck Injuries Sustained By US and UK Military Personnel in Iraq and Afghanistan to Identify the Surgical Training Requirements for Future Conflicts

The conflicts in Iraq and Afghanistan saw a greater proportion of head, face, and neck (HFN) injuries sustained by United States (US) and United Kingdom (UK) service personnel than that experienced in previous conflicts [1,2]. Military surgeons managing such wounds had to relearn skills not required since the Vietnam and Falklands campaigns. One method for optimizing training and tailoring the skill sets required in readiness for future conflicts is the accurate identification of the types of injuries sustained in previous conflicts.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OWBXk1

Direct Oral Anticoagulants (DOACs) and Medical Comorbidities in Patients Needing Dental Extractions: Management of the Risk of Bleeding

The purpose of this study was to measure the frequency of bleeding during and after tooth extraction in patients exposed to DOACs and identify risk factors for prolonged or excessive bleeding.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DvvKKg

Evidence-Based Clinical Criteria for Computed Tomography Imaging in Odontogenic Infections

Odontogenic infections are a common problem in emergency departments and impose a burden on hospital budgets and provider time. Compounding this, is the lack of evidence guiding the patient's initial evaluation. The purpose of this study is to derive evidence-based guidelines for the use of computed tomography (CT) imaging in the management of odontogenic infections.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2NIWv2L

The Biaxial Double Barrel Fibula Flap – A Simplified Technique for Fibula Maxillary Reconstruction

Previously described techniques for microvascular fibula reconstruction of Brown Class II-IV maxillectomy defects are complex, require multiple osteotomies, result in a short pedicle length, and inadequately reconstruct the dental alveolus in preparation for endosseous implants [1-4].We describe a simplified technique for Brown class II-IV defects that recreates facial support, allows for dental reconstruction with appropriately positioned implants, and maintains adequate pedicle length.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2DGhbnc

Postoperative Quality-of-Life Analysis of Open Versus Closed Reduction of Mandibular Condyle Fractures: Our Experience

The treatment of unilateral mandibular condylar fractures remains a topic that continues to elicit controversy. Closed reduction with maxillomandibular fixation (CRMMF) and open reduction with internal fixation (ORIF) are two widely accepted treatment options. Several studies attempted to illustrate the advantage of ORIF by demonstrating better anatomical reduction and functional outcomes (Throckmorton & Ellis, 2000; Ishihama et al., 2007; Singh et al., 2011). However, a number of studies showed no significant differences in functional outcomes between the two procedures, and some favored CRMMF due to the lack of potential complications of ORIF, such as facial nerve paralysis and scarring (Landes et al., 2008; Leon et al., 2011; Gupta et al., 2012).

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QWK4ya

Utilizing the Epidemiology of Head, Face and Neck Injuries Sustained By US and UK Military Personnel in Iraq and Afghanistan to Identify the Surgical Training Requirements for Future Conflicts

The conflicts in Iraq and Afghanistan saw a greater proportion of head, face, and neck (HFN) injuries sustained by United States (US) and United Kingdom (UK) service personnel than that experienced in previous conflicts [1,2]. Military surgeons managing such wounds had to relearn skills not required since the Vietnam and Falklands campaigns. One method for optimizing training and tailoring the skill sets required in readiness for future conflicts is the accurate identification of the types of injuries sustained in previous conflicts.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2OWBXk1

The Infraorbital Artery: Clinical Relevance in Esthetic Medicine and Identification of Danger Zones of the midface

Over the past decade, cosmetic injections of dermal fillers or fat have become a popular procedure in facial rejuvenation in an overconsuming society. However, complications such as arterial embolism and occlusion can occur even with experienced injectors, especially in high-risks zones namely the glabella, the nasal dorsum or the nasolabial fold. The aim of this study was to define the vascular danger zones of the infraorbital area in order to provide guidelines helping avoid them.

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The Infraorbital Artery: Clinical Relevance in Esthetic Medicine and Identification of Danger Zones of the midface

Over the past decade, cosmetic injections of dermal fillers or fat have become a popular procedure in facial rejuvenation in an overconsuming society. However, complications such as arterial embolism and occlusion can occur even with experienced injectors, especially in high-risks zones namely the glabella, the nasal dorsum or the nasolabial fold. The aim of this study was to define the vascular danger zones of the infraorbital area in order to provide guidelines helping avoid them.

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The micromass formation potential of human adipose-derived stromal cells isolated from different various origins

Abstract

Background

Adult stem cells appear to be a promising subject for tissue engineering, representing an individual material for regeneration of aged and damaged cells. Especially adipose derived stromal cells (ADSC), which are easily to achieve, allow an encouraging perspective due to their capability of differentiating into miscellaneous cell types. Here we describe the in vitro formation of human subcutaneous, visceral and omental ADSC micromasses and compare their histological attributes while being cultivated on collagen membranes.

Methods

Subcutaneous, visceral and omental fat tissue derived cells were isolated and processed according to standard protocols. Positively stained cells for CD13, CD44 and CD90 were cultivated on agarose in order to study micromass formation using a special method of cell tracking. Stained paraffin-embedded micromasses were analysed morphologically before and after being plated on collagen membranes.

Results

The micromass formation process was similar in all three tissue types. Subcutaneous fat tissue derived micromasses turned out to develop a more homogeneous and compact shape than visceral and omental tissue. Nevertheless all micromasses adhered to collagen membranes with visible spreading of cells. The immune histochemical (IHC) staining of subcutaneous, visceral and omental ADSC micromasses shows a constant expression of CD13 and a decrease of CD44 and CD 90 expression within 28 days. After that period, omental fat cells don't show any expression of CD44.

Conclusion

In conclusion micromass formation and cultivation of all analysed fat tissues can be achieved, subcutaneous cells appearing to be the best material for regenerative concepts.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N6a8Uu

The micromass formation potential of human adipose-derived stromal cells isolated from different various origins

Abstract

Background

Adult stem cells appear to be a promising subject for tissue engineering, representing an individual material for regeneration of aged and damaged cells. Especially adipose derived stromal cells (ADSC), which are easily to achieve, allow an encouraging perspective due to their capability of differentiating into miscellaneous cell types. Here we describe the in vitro formation of human subcutaneous, visceral and omental ADSC micromasses and compare their histological attributes while being cultivated on collagen membranes.

Methods

Subcutaneous, visceral and omental fat tissue derived cells were isolated and processed according to standard protocols. Positively stained cells for CD13, CD44 and CD90 were cultivated on agarose in order to study micromass formation using a special method of cell tracking. Stained paraffin-embedded micromasses were analysed morphologically before and after being plated on collagen membranes.

Results

The micromass formation process was similar in all three tissue types. Subcutaneous fat tissue derived micromasses turned out to develop a more homogeneous and compact shape than visceral and omental tissue. Nevertheless all micromasses adhered to collagen membranes with visible spreading of cells. The immune histochemical (IHC) staining of subcutaneous, visceral and omental ADSC micromasses shows a constant expression of CD13 and a decrease of CD44 and CD 90 expression within 28 days. After that period, omental fat cells don't show any expression of CD44.

Conclusion

In conclusion micromass formation and cultivation of all analysed fat tissues can be achieved, subcutaneous cells appearing to be the best material for regenerative concepts.

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Miller Laryngoscope Blade: An Aid to Pediatric Laryngeal Surgery

Abstract

Pediatric upper airway disorders are a major cause of morbidity and mortality. They can be congenital or acquired and provide diagnostic and therapeutic challenge to the paediatrician and otolaryngologists. Though fibreoptic laryngoscopy or bronchoscopy is the initial mode of assessing the pathology, detailed assessment and therapeutic intervention can only be done combining both direct laryngoscopy and bronchoscopy. Any kind of intervention routinely requires rigid direct laryngoscope with suspension. Identifying the potential use of Miller laryngoscope blade for pediatric airway surgery is the aim of the study. We have included pediatric patients from new born to 12 years of age in our clinical study. We have been using Miller laryngoscope blade for approaching till the level of subglottis for diagnostic laryngoscopy along with Hopkins 0 degree endoscope and performing surgical procedures like supraglottoplasty, vallecular cysts, subglottic stenosis etc. Miller laryngoscope blade can be used as an aid to upper airway surgery for the otolaryngologists with minimal operating time and effort.

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The Soluble and Particulate Form of Alginates Positively Regulate Immune Response.

CONCLUSION: Alginate materials could affect immune response through different ways, including promoting inflammatory cytokine production, and activating dendritic cells. Therefore, alginate materials, especially in particulate form, have the potential to be applied in inflammation related diseases. PMID: 30246698 [PubMed - in process] (Source: Iranian Journal of Immunology)

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Designing and Expression of Recombinant Chimeric Protein Containing CtxB and OmpW from Vibrio Cholerae and Evaluation of Its Immunogenicity.

CONCLUSION: Chimeric construct is able to induce the immune system and provide up to 75% inhibition of toxin activity against 1 LD50 of Vibrio cholerae. PMID: 30246696 [PubMed - in process] (Source: Iranian Journal of Immunology)

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T Helper Cells Profile and CD4+CD25+Foxp3+Regulatory T Cells in Polycystic Ovary Syndrome.

CONCLUSION: In summary, Th1 and Th17 bias and reduction of Treg and Th2 cells as regulators of immune responses might be involved in the pathogenesis of PCOS. These results are suggestive of an altered immune response to inflammatory status in PCOS patients, likely causing some complications such as infertility in these patients. PMID: 30246693 [PubMed - in process] (Source: Iranian Journal of Immunology)

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Role of Interleukin-37 in Inflammatory and Autoimmune Diseases.

Authors: Wang X, Xu K, Chen S, Li Y, Li M Abstract Interleukin-1 family 7 (IL-1F7) is a novel member of IL-1F cytokines. IL-1F7 is more commonly known as IL-37. IL-37 can join the α-subunit of the IL-18 receptor, or IL-18 binding protein (IL-18BP), and binding of these proteins can enhance the IL-18 suppression. IL-37 also translocates to the cell nucleus and affects gene transcription. IL-37 inhibits the phosphorylation of p38 mitogen-activated protein kinases. Almost all reports showed that IL-37 has remarkable anti-inflammatory activity. IL-37 plays an important role in a variety of inflammatory and autoimmune diseases, as well. Recently, studies demonstrated that the expression of IL-37 is abnormal in many diseases such as inflammatory bowel diseases, inflammatory respiratory ...

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zvEpbD

Lower Frequency of HLA-DRB1*01 in Southwestern Iranian Patients with Atherosclerosis.

CONCLUSION: Our results demonstrated that DRB1*01 may be a protective allele against atherosclerosis in individuals who live in southwest of Iran. The mechanism of this protection needs further investigation. PMID: 30246695 [PubMed - in process] (Source: Iranian Journal of Immunology)

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Circulating Levels of Interleukin-10 and -17 in Patients with Cerebral Sinovenous Thrombosis (CSVT) in Acute and Subacute Stages: A Prospective Case-Control Study.

CONCLUSION: This study demonstrated the alteration of IL-10 and IL-17 levels in aseptic non-vasculitic CSVT. The rise in subacute IL-10 can be explained by the assumption that IL-10 is released as an anti-inflammatory response to subside the effects of IL-17 mediated reactions. More importantly, the immediate sampling in the acute stage did not allow enough time for triggering the immune system to produce such mediators. However, a balance was established between IL-10 and IL-17 in the subacute stage to prevent further tissue damage. PMID: 30246697 [PubMed - in process] (Source: Iranian Journal of Immunology)

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from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zvDoAl

Vitamin D3 Induced Decrease in IL-17 and Malondialdehyde, and Increase in IL-10 and Total Antioxidant Capacity Levels in Patients with Irritable Bowel Syndrome.

CONCLUSION: Vitamin D3 supplementation reduces the serum IL-17 and MDA levels, and augments the serum IL-10 and TAC levels in IBS patients, particularly in IBS-D subtype. Thus, the present study demonstrates the beneficial effects of vitamin D on patients with IBS-D. PMID: 30246694 [PubMed - in process] (Source: Iranian Journal of Immunology)

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Soluble CD163 Levels and CD163+CD14+ Monocyte/Macrophage Counts in Patients with Asthma.

CONCLUSION: Increased sCD163 levels in sputum are associated with the impairment of lung function. PMID: 30246699 [PubMed - in process] (Source: Iranian Journal of Immunology)

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Bet v 1 sensitization modulates allergenic molecular 1 immune response.

Conclusions The present study demonstrates that Bet v 1 sensitization may significantly affect the sensitization pattern in children living in Genoa, a Mediterranean city located in a birch-free area. PMID: 30246512 [PubMed - as supplied by publisher] (Source: European Annals of Allergy and Clinical Immunology)

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Potential Pitfalls of the Humanized Mice in Modeling Sepsis.

Authors: Laudanski K, Stentz M, DiMeglio M, Furey W, Steinberg T, Patel A Abstract Humanized mice are a state-of-the-art tool used to study several diseases, helping to close the gap between mice and human immunology. This review focuses on the potential obstacles in the analysis of immune system performance between humans and humanized mice in the context of severe acute inflammation as seen in sepsis or other critical care illnesses. The extent to which the reconstituted human immune system in mice adequately compares to the performance of the human immune system in human hosts is still an evolving question. Although certain viral and protozoan infections can be replicated in humanized mice, whether a highly complex and dynamic systemic inflammation like sepsis can be accurately ...

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Miller Laryngoscope Blade: An Aid to Pediatric Laryngeal Surgery

Abstract

Pediatric upper airway disorders are a major cause of morbidity and mortality. They can be congenital or acquired and provide diagnostic and therapeutic challenge to the paediatrician and otolaryngologists. Though fibreoptic laryngoscopy or bronchoscopy is the initial mode of assessing the pathology, detailed assessment and therapeutic intervention can only be done combining both direct laryngoscopy and bronchoscopy. Any kind of intervention routinely requires rigid direct laryngoscope with suspension. Identifying the potential use of Miller laryngoscope blade for pediatric airway surgery is the aim of the study. We have included pediatric patients from new born to 12 years of age in our clinical study. We have been using Miller laryngoscope blade for approaching till the level of subglottis for diagnostic laryngoscopy along with Hopkins 0 degree endoscope and performing surgical procedures like supraglottoplasty, vallecular cysts, subglottic stenosis etc. Miller laryngoscope blade can be used as an aid to upper airway surgery for the otolaryngologists with minimal operating time and effort.

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The Soluble and Particulate Form of Alginates Positively Regulate Immune Response.

CONCLUSION: Alginate materials could affect immune response through different ways, including promoting inflammatory cytokine production, and activating dendritic cells. Therefore, alginate materials, especially in particulate form, have the potential to be applied in inflammation related diseases. PMID: 30246698 [PubMed - in process] (Source: Iranian Journal of Immunology)

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Designing and Expression of Recombinant Chimeric Protein Containing CtxB and OmpW from Vibrio Cholerae and Evaluation of Its Immunogenicity.

CONCLUSION: Chimeric construct is able to induce the immune system and provide up to 75% inhibition of toxin activity against 1 LD50 of Vibrio cholerae. PMID: 30246696 [PubMed - in process] (Source: Iranian Journal of Immunology)

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T Helper Cells Profile and CD4+CD25+Foxp3+Regulatory T Cells in Polycystic Ovary Syndrome.

CONCLUSION: In summary, Th1 and Th17 bias and reduction of Treg and Th2 cells as regulators of immune responses might be involved in the pathogenesis of PCOS. These results are suggestive of an altered immune response to inflammatory status in PCOS patients, likely causing some complications such as infertility in these patients. PMID: 30246693 [PubMed - in process] (Source: Iranian Journal of Immunology)

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