bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Allogeneic Hematopoietic Stem Cell Transplantation on Nutritional Status and Intake in Children
Authors: Kvammen Janne Anita , Thomassen Rut Anne , Buechner Jochen , Sitsabesan Ajiitha , Bentsen Beint Sigmund , Bechensteen Anne Grete , Henriksen Christine
Published: August 2022

Objectives:

This study aimed to describe the impact of allogeneic/haploidentical hematopoietic stem cell transplantation on nutritional status and intake in a group of children aged 2 to 18 years.

Methods:

In an observational study, data were collected prospectively. Patients were prescribed individual nutritional support by hospital routines. Anthropometrics were measured pre‐transplant at hospital admission and weekly from the day of transplant (day 0) until day +28. z scores for weight, height, and BMI were calculated using Norwegian growth references to assess nutritional status. Pre‐transplant diet was assessed on the day of hospitalization. Nutrient provision from enteral nutrition (EN = oral and tube) and parenteral nutrition (PN) was assessed by daily records from day +1 until day +28, or previous discharge, and compared with recommendations (RI) from the Nordic Nutrition Recommendations and ESPGHAN guidelines. Total energy intake was presented as the percentage (%) of basal metabolic rate (BMR) calculated by the Schofield equation. Macro‐ and micronutrient provisions were presented as medians (interquartile range) and the % of RI.

Results:

Twenty‐eight patients, mean age 10.3 years (range 3.5–16.6), were included. Two‐thirds (n = 18) had malignant diseases. At admission, mean weight Z‐score was −0.3, height z scores −0.7, and BMI Z‐score 0.1. Eighteen percent (n = 5) were stunted and 25% (n = 7) had overweight. At admission, 25% (n = 7) had established tube feeding, and 7% (n = 2) also had PN. No significant changes in weight z scores were detected during the studied weeks (P = 0.454). The median daily energy provision was 115% (110–123) of BMR and proteins 1.5 (1.3–1.8) g/kg. EN was provided during a median of 93% of the studied days and provided 21% of the energy. PN was given on a median of 96% of the studied days and provided 79% of energy. RI for vitamins, magnesium, and zinc was met. Provision of copper, iodine, selenium, calcium, and phosphate was below RI.

Conclusions:

Combined EN and PN providing 115% of BMR and 1.5 g/kg protein ensured stable weight by day +28 and covered RI, except for trace elements and minerals.
Ambulatory Oncology Nurses Weigh in About 12-Hour Shifts
Authors: Jabaley Terri , Bagley Janet , Beardslee Brian , Hammer Marilyn J.
Published: August 2022

BACKGROUND

Studies conducted in hospital settings have associated negative clinical outcomes with 12-hour shifts. Despite this, 12-hour shifts are common in nursing and popular among nurses. Little is known about outcomes associated with 12-hour shifts in ambulatory care settings.

OBJECTIVE

A mixed-methods, quality improvement project was conducted in a large, ambulatory cancer center to evaluate oncology nursing staff perspectives on 12-hour shift work.

METHODS

One hundred ambulatory oncology nurses completed surveys and 11 participated in focus group interviews.

FINDINGS

Nurses expressed predominately positive perspectives about 12-hour shift work in ambulatory oncology care.

CONCLUSIONS

Ambulatory oncology nurses perceived benefits to quality, safety, and satisfaction for both nurses and patients related to 12-hour shifts. Further evaluation of patient, nurse, and organizational outcomes unique to ambulatory settings is essential for nurse executives in formulating data-driven staffing plans. The incorporation of 12-hour shifts should be considered.
Full Practice Authority for APRNs to Meet the Needs of Underserved Communities: An Interview With Monica O'Reilly-Jacob
Authors: Reid Ponte Patricia
Published: August 2022

In this column, Dr Reid Ponte interviews Monica O'Reilly-Jacob, PhD, FNP-BC, Assistant Professor of Nursing, Connell School of Nursing, Chestnut Hill, MA. Dr O'Reilly-Jacob addresses her personal and professional commitment to timely and cost-effective healthcare provided by nurse practitioners working at their full scope of practice.
Nurses as Clinical Advisors in an Interprofessional COVID-19 Crisis Command Center
Authors: Sansolo Homey , Wuerz Lorelle , Grandstaff Katie , Schwartz Tzipora , Perez-Mir Ernesto
Published: August 2022

The use of nurses as clinical advisors in an interprofessional COVID-19 crisis command center proved successful. By engaging nurses as clinical advisors in the command center structure, one organization was able to facilitate optimal decisions around nursing leadership and advocacy, capacity and staffing, the development and implementation of innovative novel care models, clinical training and upskilling, and maintaining the safest possible environment for the patients and team members. Including a nurse-led clinical advisor role within future command center structures is an important strategy to reshaping how organizations effectively respond in times of crisis.
BREAST-Q Breast-Conserving Therapy Module: Normative Data From A Dutch Sample of 9059 Women
Authors: Oemrawsingh Arvind , Clarijs Marloes E. , Pusic Andrea L. , Lingsma Hester F. , Verhoef Cornelis , Hazelzet Jan A. , Koppert Linetta B.
Published: August 2022

Background:

The BREAST-Q, a patient-reported outcome measure for cosmetic and reconstructive breast surgery, is widely used in both clinical research and practice. The aim of this study was to acquire normative data of the BREAST-Q’s Breast-Conserving Therapy module from a Dutch population sample and to compare it to existing normative BREAST-Q values.

Methods:

Flyers with QR-codes, WhatsApp, and one academic center’s Facebook and LinkedIn platforms were used to direct participants to self-complete an online version of four domains of the preoperative BREAST-Q Breast-Conserving Therapy module. BREAST-Q domain scores were log transformed to normalize the distribution. Univariable regression analyses were used to assess (non-linear) associations between age and BREAST-Q domain scores.

Results:

Overall, 9 059 questionnaire responses were analyzed. Median BREAST-Q domain scores were 64.0±SD 18.0 (“Satisfaction with Breasts”), 69.0±SD 21.0 (“Psychosocial Wellbeing”), 92.0±SD 20 (“Physical Wellbeing”) and 59.0±SD 15.0 (“Sexual Wellbeing”). Age as a linear term was associated with log-transformed “Satisfaction with Breasts”, “Psychosocial Wellbeing” and “Physical Wellbeing”, while “Sexual Wellbeing” was a quadratic functions of age. Prior non-breast cancer-related surgery was a significant predictor for higher log-transformed “Satisfaction with Breasts” (β=0.04, p<0.001) and higher “Sexual Wellbeing” (β=–0.05, p<0.001) scores. Compared to previously published normative data, small differences were found in mean BREAST-Q domain scores (mean differences ranging between 2.45 – 6.24).

Discussion:

Normative Dutch BREAST-Q scores follow similar patterns across domains in comparison to previously published normative data. Normative Dutch BREAST-Q data enables future comparisons in breast-related satisfaction and quality of life issues of Dutch breast cancer patients against their age-matched peers.
A Prospective, Randomized Comparison of Clinical Outcomes with Different Processing Techniques in Autologous Fat Grafting
Authors: Hanson Summer E. , Garvey Patrick B. , Chang Edward I. , Reece Gregory P. , Liu Jun , Baumann Donald P. , Butler Charles E.
Published: August 2022

Introduction:

Autologous fat grafting is a useful tool in breast reconstruction. The authors have previously demonstrated a difference in the rate of processing adipose grafts in a randomized time and motion clinical trial. The purpose of this study is to compare clinical outcomes in commonly used grafting systems.

Methods:

Three methods to prepare adipose grafts were compared: a passive washing-filtration system (PureGraft TM system–PF), an active washing-filtration system (Revolve TM system–AF) or centrifugation (Coleman technique, C). Postoperative complications, rates of fat necrosis, revision procedures, and additional imaging were recorded.

Results:

Forty-six patients were included in the prospective, randomized study (15 AF, 15 PF and 16 C). The mean age was 54 years and mean body mass index was 28.6 kg/m2. The mean length of follow-up was 16.9 ± 4 months. The overall complication rate was 12.1%. The probability of fat necrosis was no different between the groups (AF=15% versus PF=14.3% versus C=8%; p=0.72). Fat necrosis was highest in patients with breast conservation prior to grafting (60%, p=0.011). There was no significant difference in contour irregularity (AF=40% versus PF=38% versus C=36%, p=0.96) or additional grafting (AF=40% versus PF=24% versus C=32%, p=0.34).

Conclusions:

This is the first prospective, randomized study to compare clinical outcomes of adipose graft preparation. There is no significant difference in early complications, fat necrosis or rates of additional grafting among the study groups. There was significantly higher risk of fat necrosis in patients with prior breast conservation treatment regardless of processing technique.
How does oncoplastic surgery compare with standard partial mastectomy? A systematic review of patient reported outcomes.
Authors: Char Sydney , Bloom Joshua A. , Erlichman Zachary , Jonczyk Michael , Chatterjee Abhishek , Guo Lifei
Published: August 2022

Introduction:

Many breast conservation surgical options exist for breast cancer. Surgical choices can have lasting impacts on a patient’s life, so patient satisfaction is important to assess. Patient reported outcome measures (PROMs) provide important tools when evaluating surgical modalities. This systematic review aims to evaluate how patients describe breast conservation surgical choices in standard partial mastectomy and oncoplastic surgery options.

Methods:

A PubMed PRISMA search was performed for studies discussing standard partial mastectomy (PM) or oncoplastic surgery (OPS) and measurement of preoperative and postoperative patient-reported outcomes using the BREAST-Q or other validated PROMs. We further categorized OPS into volume displacement and volume replacement categories. Articles in non-English languages, not involving PM or OPS, or not measuring patient-reported outcomes were excluded. Weighted proportions were generated and analyzed with a welch t-test.

Results:

Of 390 articles, 43 articles met inclusion criteria, and 8784 patients were included in a pooled database. While standard PM scored well, OPS performed significantly better than PM in all postoperative BREAST-Q categories: satisfaction with breasts (74.3 vs. 65.7), psychosocial well-being (81.3 vs. 78.0), sexual well-being (61.6 vs. 54.9), and satisfaction with outcome (85.4 vs. 62.2). Level 2 volume displacement surgery had the most favorable scores.

Conclusions:

Breast conservation surgical choices that include a variety of OPS and PM all score well in PROMs, with OPS significantly preferred over PM. OPS should be considered in all cases and the appropriate breast conservation surgical choice should depend on the patient’s tumor presentation and anatomy.
Prepectoral direct-to-implant breast reconstruction without placement of acellular dermal matrix or mesh after nipple sparing mastectomy
Authors: Urban Cicero , Gonzales Eduardo , Fornazari Alessandra , Berman Gastón , Spautz Cléverton , Kuroda Flávia , Anselmi Karina Furlan , Rabinovich Iris , Dória Maíra , Nissen Leonardo , Junior Eduardo Schünemann , Sobreiro Bernardo , Lima Rubens
Published: August 2022

Objective:

The aim of this study was to report the results of prepectoral direct-to implant (DTI) reconstruction in nipple-sparing mastectomy (NSM), without acellular dermal matrices (ADM) or mesh.

Methods:

Multicenter cohort of patients, from 2013 to 2020, where all sizes and types of breasts, either for prophylactic or therapeutic surgical purposes were included, except those with previously failed reconstruction, previous radiotherapy with severe skin damage, locally advanced breast cancer, gigantomasty, severe degree of ptosis, tumors closer to NAC (<1cm on MRI), and combined autologous-based reconstruction.

Results:

280 immediate breast reconstructions were performed in 195 patients. The mean age was 45, and 32.8% were post-menopausal. The mean follow-up was 16.5 (±17.43) months. Eighty-five (43.6%) underwent bilateral mastectomy; 116 (41.4%) mastectomies were prophylactic and 164 (58.6%) were therapeutic. Sixty-eight (24%) reconstructions had at least one acute complication, the most common was implant explantation (9.2%), which were more frequent in smokers. Late complications like rippling grades III and IV, were observed in 7 (3.8%) cases, capsular contracture Baker II-IV in 29 (15.7%), being 22 as Baker II (11.9%), 6 Baker III (3.3%) and 1 Baker IV (0.5%). One implant rotation was observed. No deformity animation was observed. Cosmetic results were considered good or excellent in 87.3%.

Conclusions:

Overall complications were like ADM, mesh, or subpectoral reported series, except by a higher explantation rate. This technique is safe and economically advantageous, as it is a one-stage technique without ADM and mesh. However, this is a preliminary data and larger and comparative studies are required.
Aging of the nose: a quantitative analysis of nasal soft tissue and bone on computed tomography
Authors: Wang Dawei , Xiong Shixuan , Wu Yiping , Zeng Ning
Published: August 2022

Background:

Morphological and anatomical changes of the aging nose affect the surgical strategy of rhinoplasty in the elderly, but age-related changes in noses have yet to be fully characterized. This study aimed to determine the evolution of nasal soft tissue and bone in aging noses utilizing computed tomography (CT).

Methods:

The CT images of two hundred Asian patients were included. The study population was divided into two groups according to age and sex: young group aged 20 to 35 years, and old group aged 65 to 80 years. The measurements of nasal soft tissue and bone on CT were performed by software Osirix 9.0.

Results:

With regard to soft tissue changes, the nasal SSTE thickness at rhinion, supratip, and nasal tip significantly increased with aging in either sex. Besides, the increase of the nasal depth and the decrease of nasolabial angle were significant in either sex. The nasal length and nasofrontal angle showed significant age-related increases in men, as well as the decrease of nasal tip angle and the increase of pyramidal angle were significant in women. With regard to nasal bone changes, the bone length decreased significantly in women, and the bone thickness decreased significantly in either sex. Also, the nasofrontal angle in men and the pyramidal angle in women increased significantly.

Conclusion:

These results suggest that the aging process leads to drooping of the nasal tip, thickened nasal skin and soft tissue, and resorption of the nasal bone, providing a reference for rhinoplasty in the elderly.
Complications and Functional Outcomes following Trigger Finger Release: a Prospective Cohort Study of 1879 Patients
Authors: Koopman Jaimy E. , Hundepool Caroline A. , Duraku Liron S. , Smit Jeroen M. , Zuidam J. Michiel , Selles Ruud W. ,   the Hand-Wrist study group, Wouters Robbert M.
Published: August 2022

Background:

Although Trigger Finger Release (TFR) is considered a safe procedure, large cohort studies reporting consistent complication rates and functional outcomes are scarce. Further insight into outcomes of this commonly performed procedure is essential for adequate treatment evaluation and patient counseling. Therefore, the aim of this study was to assess the complication rates and functional outcomes following TFR.

Methods:

This is an observational prospective multi-center cohort study of patients undergoing TFR. The primary outcome included the occurrence of complications. The secondary outcome was change in hand function (Michigan Hand outcomes Questionnaire [MHQ]) from baseline to three months postoperatively.

Results:

Complications were observed in 17.1% of 1879 patients. Most complications were minor, requiring hand therapy or analgesics (7.0% of all patients), antibiotics or steroid injections (7.8%). However, 2.1% required surgical treatment and 0.2% developed Complex Regional Pain Syndrome. The MHQ total score improved from baseline to three months postoperatively with 12.7 points, although we found considerable variation in outcomes with less improvement in patients with better baseline scores.

Conclusions:

This study demonstrates that TFR results in improved hand function, although complications occur in 17%. Most complications are minor and can be treated with non-surgical therapy, resulting in improved hand function as well. However, additional surgical treatment is required in 2% of patients. In addition, we found that change in hand function depends on the baseline score, with less improvement in patients with better baseline scores. Future studies should investigate factors that contribute to the variability in treatment outcomes following TFR.
Multidetector-row Computed Tomography Analysis of the Superficial Palmar Branch of Radial Artery Perforator Flaps: A Retrospective Anatomical Study
Authors: Nguyen Doan Tien Linh , Ono Shimpei , Akiyama Goh , Cho Hoyu , Hayashi Hiromitsu , Ogawa Rei
Published: August 2022

Background:

Soft-tissue defects in the hand and digits can be effectively covered by using the free superficial palmar branch of radial artery (SPBRA) flap, which is harvested from the radial volar wrist. Since previous anatomical studies on this flap are limited, multidetector-row computed tomography (MDCT) angiography of the upper limbs was conducted to characterize the three-dimensional anatomical structure of the SPBRA and its perforators in living patients.

Methods:

This retrospective anatomical study was conducted in 2014–2019. All DICOM data were analyzed by DICOM viewer. SPBRA diameter and the location where it bifurcated from the radial artery were recorded, as were the number, location, branching patterns, and diameters of its perforators and their lengths.

Results:

In total, 30 patients met all eligibility criteria. All had the SPBRA. The vessel bifurcated from the radial artery on average 13.2 mm proximally from the radial styloid process. The 30 patients had 40 SPBRA perforators in total. Their average SPBRA-to-dermis length was 6.43 mm. All patients had at least one direct cutaneous perforator. Nine and one also had one musculocutaneous perforator and another direct perforator, respectively. All direct cutaneous perforators were located inside a 16.4 mm-diameter circle with an origin on the scaphoid tubercle. The mean diameters of the SPBRA and its perforators were 1.12 and 0.62 mm, respectively.

Conclusion:

All patients had at least one reliable SPBRA perforator in the radial volar wrist. Our results suggest that plastic surgeons can easily and safely plan the SPBRA flap design, potentially without preoperative perforator mapping.
In Vivo Analysis of the Superficial and Deep Fascia
Authors: Hammoudeh Diya’ S.N. , Dohi Teruyuki , Cho Hoyu , Ogawa Rei
Published: August 2022

Background:

Key risk factors for hypertrophic scarring and surgical site infections are high tension on the wound, fat necrosis, and dead space. All could be prevented by appropriate superficial fascia (SF) suturing. To improve SF suturing, the as-yet poorly researched anatomy of the SF should be delineated. This study is the first to quantify SF throughout the human body in-vivo.

Methods:

Ultrasound was used to analyze the SF and deep fascia (DF) of ten volunteers at 73 points on 11 body regions, including the upper and lower trunk and limbs. Number of SF layers, average SF-layer thickness, total SF thickness, percent SF relative to subcutaneous-tissue thickness, and DF and dermis thickness were measured at each point.

Results:

730 ultrasound images were analyzed. Body regions varied markedly in terms of subcutaneous variables. Posterior chest had the thickest DF and dermis and the highest average SF-layer thickness (0.6 mm; 95%CI=0.6–0.7 mm). Anterior chest had the most SF layers (3.7; 95%CI=3.5-3.8). Posterior and anterior chest had among the highest percent SFs. Abdomen and especially gluteus had low percent SFs (32%, 95%CI=29–35%; and 23%, 95%CI=19–27%, respectively). Covariate analyses confirmed that posterior and anterior chest generally had higher SF content than gluteus and abdomen (both P<0.001). They also showed that the dermis in the posterior and anterior chest increased proportionally to total fascia (SF+DF) thickness.

Conclusions:

The SF, DF, and dermis tend to be thick in high-tension areas such as the upper trunk. A site-specific surgical approach is recommended for subcutaneous sutures.
The Asian Eye: Anthropometric Eye Measurements of Attractiveness in Young East Asian Women
Authors: Patel Anooj A. , Wan Rou , Garg Stuti , Ullrich Peter , Vaca Elbert E. , Alghoul Mohammed S. , Ellis Marco , Galiano Robert D.
Published: August 2022

Background:

Due to the high volume of Asian eyelid surgeries performed and the complexity of the Asian eye, there is a need to define exactly what anthropometric measurements determine attractiveness.

Methods:

Eye photographs of young East Asian women were collected from publicly available sources online. Photographs were evaluated on Likert scale of 1-5 for attractiveness. Thirty-seven anthropometric measurements were collected using ImageJ from the most attractive and least attractive eyes to discover which features play the most important role in attractiveness.

Results:

A total of 322 right eye photographs were evaluated for attractiveness. Sixty-six eyes received a median score of ≥4.0 and were included in the attractive cohort. Forty-three eyes received a score of ≤ 2.0 and were included in the unattractive cohort. The superior brow peak was more lateralized compared to the upper lid crease and upper lash line peaks in attractive eyes. A greater palpebral aperture height to upper lid show ratio was found to be more associated with attractive eyes than unattractive. At the mid-pupillary line, the ratio was on average 1.58 ± (0.32) in attractive eyes vs 1.22 ± (0.43) in unattractive, p<0.001. Eyes with convergence of the upper lid crease with the upper lash line were more likely to be deemed unattractive (p<0.001).

Conclusion:

East Asian eyes have specific anthropometric measurements that are more associated with attractiveness. These ideal measurements are different from those in Caucasians suggesting ethnic variability in features defining attractiveness and a need to tailor surgical care appropriately.
The preliminary application of a novel autologous “scrotal dartos flap method” for enlargement of penile girth in males with small penis syndrome
Authors: LEI Junhao , GUO Yuming , LUO Chunhua , SU Xinjun
Published: August 2022

Background:

Augmentative phalloplasty is a controversial issue. A safe, stable, and efficient surgical method for penile girth enlargement (PGE) was not avaliable. This paper introduces a novel autologous scrotal flap-turning procedure “scrotal dartos flap method” for males with small penis syndrome (SPS) and addresses its efficacy and safety.

Methods:

A single‐centered, prospective study was conducted at the Zhongnan Hospital of Wuhan University, where 29 patients were treated with “scrotal dartos flap method”. The key procedure for this technique is fully turning the scrotal dartos flap to the loose plane just between the superficial penile fascia and Buck’s fascia to increase the circumference of the penis. Penile girth improvement and adverse events (AEs) were recorded.

Results:

Complete follow‐up data were collected for 27/29 (93.1%) of the patients. It yielded a 3.59 ± 0.80 cm (50.8%) girth improvement. This enlargement surpassed that of most previous published surgical procedures. Additionally, there were no serious AEs (such as penile fibrosis, flap infection, sclerosis, or removal) during the 6-month follow-up. Wound infection (n = 1), hematoma (n = 2), and folding (n = 1) were all slight.

Conclusions:

This novel autologous flap-turning procedure performed better than the majority of previously published PGE methods and was accompanied by only slight and acceptable AEs. “Scrotal dartos flap method” appears to be a viable method for the PGE treatment of SPS.
Brief Report: Effect of Antiretroviral Switch From Tenofovir Disoproxil fumarate to Tenofovir Alafenamide on Alanine Aminotransferase, Lipid Profiles, and Renal Function in HIV/HBV-Coinfected Individuals in a Nationwide Canadian Study
Authors: Sarowar Arif , Coffin Carla S. , Fung Scott , Wong Alexander , Doucette Karen , Truong David , Conway Brian , Haylock-Jacobs Sarah , Ramji Alnoor , Hansen Bettina E. , Janssen Harry L. A. , Cooper Curtis
Published: August 2022

Objective:

Tenofovir alafenamide (TAF) achieves increased renal safety and improved alanine aminotransferase (ALT) normalization but increased lipid profile in hepatitis B virus (HBV)–monoinfected patients switched from tenofovir disoproxil fumarate (TDF). It is unclear whether HIV coinfection perturbs these biochemical changes. To this end, we assessed these parameters in HIV/HBV-coinfected patients switched from TDF to TAF.

Design:

Retrospective, multicenter, observational study.

Methods:

HIV/HBV-coinfected patients switched from TDF to TAF-based antiretroviral therapy (ART) at 6 Canadian Hepatitis B Network (CanHepB) academic sites were included. Changes in lipid profile, estimated glomerular filtration rate (eGFR), and ALT were evaluated using linear mixed effect model regression.

Results:

Eighty-two HIV/HBV-coinfected patients with a mean 103-week follow-up duration were identified. At time of TAF switch, 80 of 82 (98%) were HBV virally suppressed, 29 of 82 (35%) had elevated ALT levels, and 63 of 82 (77%) had eGFR of ≥60 mL/min per 1.73 m2. Twenty-six/Eighty-two (32%) had preexisting renal comorbidities. There were no changes in total cholesterol, high-density lipoprotein, low-density lipoprotein, and triglyceride levels 2 years after TAF switch. Those with elevated ALT levels achieved greater ALT normalization after TAF switch (−0.004 [−0.008 to 0.0] log10U/L/mo, P = 0.03). eGFR decline rate while on TDF (−0.66 [−0.23 to −1.08] mL/min/month, P < 0.005) was diminished after switching to TAF (−0.02 [−0.16 to 0.11] mL/min/mo, P = 0.7) and those with eGFR of <60 mL/min experienced increase in eGFR after TAF switch (0.45 [0.03–0.87] mL/min/mo, P = 0.04).

Conclusions:

Our study supports switching from TDF to TAF with positive influence on overall long-term biochemical profile in HIV/HBV-coinfected individuals.
Breast Implant–Related Adverse Events During Mammography
Authors: Normandin Shanel , Safran Tyler , Abi-Rafeh Jad , Tremblay Francine , Winocour Sebastian J. , Chu Carrie , Davison Peter G. , Vorstenbosch Joshua
Published: August 2022

Background

Adverse events arising in patients with breast implants during mammography reported by the Food and Drug Administration include implant rupture, pain, and impaired visualization. However, data supporting these claims were collected in 2004, and since, newer implant generations have been developed with overall rate of implantation increasing by 48%.

Objectives

This article aims to determine the current incidence of implant-related adverse events arising during mammography.

Methods

We analyzed reports regarding silicone and saline breast implants published in the Food and Drug Administration Manufacturer and User Facility Device Experience database between 2008 and November 2018. Search terms included “mammogram,” “mammography,” “radiograph,” “breast cancer screening,” “breast cancer test,” and “x-ray.”

Results

Of the 20 539 implant-related adverse events available in the Manufacturer and User Facility Device Experience database, 427 were retrieved using our search strategy and 41 were related to mammography. Thirty-five of identified cases (85.4%) reported implant rupture, of which 19 (54.3%) were confirmed by a healthcare professional, 9 (25.7%) were clinically confirmed by saline implant deflation, and 7 (20.0%) were unverified reports by patients. Sixteen ruptures (45.7%) occurred with silicone implants, whereas 19 ruptures (54.3%) occurred with saline. Other adverse events included pain (29.3%), change in implant appearance (14.6%), and swelling (7.3%).

Conclusions

Although implant rupture, pain, change in implant appearance, and swelling may occur, minimal implant-related adverse events arise during mammography. Given the extremely low reported risk of implant rupture, this should neither prevent patients from adhering to breast cancer screening programs nor deter patients from seeking breast implants. Patients should be aware of these reported risks and discuss screening options with their breast cancer screening team.
Sacroperineal Reconstruction With Inferior Gluteal Artery Perforator Flaps After Resection of Locally Advanced Primary and Recurrent Anorectal Malignancy
Authors: Khalil Haitham H. , McArthur David , Youssif Sherif , Alsharkawy Kareem , Hendrickse Charles , Dilworth Mark , Karandikar Sharad
Published: August 2022

Modern interdisciplinary concepts with involvement of various surgical specialties can considerably reduce perioperative morbidity after sacroperineal resection of locally advanced primary or recurrent anorectal malignancies. Resultant defects can represent a major challenge for reconstruction particularly with chemoradiotherapy. The aim is to assess the long-term outcomes of sacroperineal reconstruction using inferior gluteal artery perforator flaps.

We performed a retrospective data analysis on 31 patients who were treated with inferior gluteal artery perforator flaps (n = 61) over the period 2009–2021. The demographic data, comorbidities, operative details, and outcomes with special focus on wound infection and dehiscence were recorded.

The median age was 42 year (range, 25–82 years) with preponderance of males (n = 21). The follow-up period ranged from 6 to 80 months. Early minor complications included superficial wound dehiscence (3), which was managed conservatively, whereas the major (2) included deep wound collection and infection (1), which required surgical drainage, and perineal hernia, which required repair. All flaps survived completely.

Inferior gluteal artery perforator flaps are safe, robust, and reliable with less donor side morbidity and positive impact on quality of life. It should be considered as a valuable tool in the reconstructive armamentarium of sacroperineal defects within a multidisciplinary setting.
Surgical Treatment of Parsonage Turner Syndrome With Primary Nerve Transfers
Authors: Winter Jessica , Karir Aneesh , Clark Tod A. , Giuffre Jennifer L.
Published: August 2022

Parsonage Turner syndrome (PTS) is the development of severe, spontaneous pain with subsequent nerve palsy. Unfortunately, many patients never achieve full functional recovery, and many have chronic pain. The use of nerve transfers in PTS has not been reported in the literature. We present 4 cases of PTS treated surgically with primary nerve transfer and neurolysis of the affected nerve following the absence of clinical and electrodiagnostic recovery at 5 months from onset. In addition, we present a cadaver dissection demonstrating an interfascicular dissection of the anterior interosseous nerve (AIN) into its components to enable a fascicular transfer in partial AIN neuropathy. Two patients with complete axillary neuropathy underwent a neurorrhaphy between the nerve branch to the lateral head of the triceps and the anterior/middle deltoid nerve branch of the axillary nerve. Two patients with partial AIN neuropathy involving the FDP to the index finger (FDP2) underwent a neurorrhaphy between an extensor carpi radialis brevis nerve branch and the FDP2 nerve branch. All patients had neurolysis of the affected nerves. All subjects recovered at least M4 motor strength. The cadaver dissection demonstrates 3 separate nerve fascicles of the AIN into FPL, FDP2, and pronator quadratus that can be individually selected for reinnervation with a fascicular nerve transfer. Functional recovery for patients with PTS with neurolysis alone is variable. Surgical treatment with neurolysis and a nerve transfer to improve functional recovery when no recovery is seen by 5 months is an option.
Facial Trauma Call Reimbursement Patterns Among American Society of Maxillofacial Surgery Members
Authors: Rivera Jean C. , Long Aaron S. , Shah Hemali P. , Hauc Sacha C. , Alper David P. , Almeida Mariana N. , Junn Adam H. , Lee Yan Ho , Persing John A. , Alperovich Michael
Published: August 2022

Facial trauma accounts for over 3 million emergency room encounters each year in the United States and places significant financial burden on the health care system and surgeons. However, data on facial trauma call practices among plastic surgeons are lacking. We surveyed members of the American Society of Maxillofacial Surgeons (ASMS) regarding their experience with facial trauma call. A 27-question online survey was distributed through e-mail to ASMS members. Forty-five ASMS members completed the survey, of whom 64% were required to take facial trauma call and 44% were compensated for call. Respondents in the North-East were less likely [odds ratio (OR): 0.234, confidence interval (CI), 0.054–1.015; P=0.052] to be compensated for taking call, whereas those who worked at level 1 trauma centers were more likely odds ratio: 5.42, CI, 0.892–32.89; P=0.066) to be compensated. Surgeons required to take facial trauma call were 4.646 (CI, 1.203–17.944; P=0.026) times more likely to take call ≥5 days per month. These results highlight a relatively low proportion of plastic surgeons receiving additional compensation for facial trauma call while work at a level 1 trauma center was associated with higher likelihood of compensation. Surgeons in the Northeast may be compensated less frequently than other regions. Plastic surgeons should be aware of these trends, as they decide how to incorporate facial trauma call into their practice.
A Rare Case of a Large Ameloblastoma and Cervical Lynphoepitelial Cyst Treated Simultaneously by an Intraoral Approach and Immediate Reconstruction
Authors: Filho Lopes , Mont’Alverne Antônio , Bortoluzzi Júnior Moisés J. , Pessoa Neto José V. , Maia Lucas A. , Santos Juliana M.O.
Published: August 2022

Ameloblastoma is a benign locally aggressive odontogenic tumor of epithelial origin with unlimited growth capacity. Cervical lymphoepithelial cyst is a developmental cyst located in the superior-lateral region of the neck with treatment consisting of surgical excision, which presents low recurrence rates. This article reports the case of patient J.G.S.L., 24 years old, female, who reported to the service with a histopathological evaluation compatible with intraosseous mandibular ameloblastoma. On physical examination, a nontender swelling was palpable along the body of left mandible where the ameloblastoma was located, with a fluctuant region detected just below it. Imaging exams confirmed the suspicion of two independent lesions. The treatment plan consisted of two stages: first, mandibular resection of the area affected by the ameloblastoma, followed by reconstruction with a titanium plate simultaneous to excisional biopsy of the as yet undiagnosed lesion, both through intraoral access; second, mandibular reconstruction with iliac crest graft. Histopathological examination of the second lesion indicated a diagnosis of cervical lymphoepithelial cyst, being the first case in the literature with these concomitant lesions. Currently, the patient is in her third postoperative year with no signs of recurrence.
Use of Submental Intubation in the Full-Face Makeover (Orthognathic Surgery, Facial Prosthesis Combined With Rhinoplasty)
Authors: Vellone Valentino , De Tomaso Silvia , Marianetti Tito M. , Sabelli Vittorio , Ramieri Valerio
Published: August 2022

Background:

Submental intubation is an intubation technique used for the management of airways in patients who suffered from complex maxillofacial trauma. Few studies focused on the role of submental intubation during Full-Face Makeover, like orthognathic surgery, facial prothesis, and rhinoplasty.

Methods:

Authors describe a case series of 5 patients who underwent to Full-Face Makeover with submental intubation to manage the airways. The authors started with the Le Fort I subspinal osteotomy. The maxillary repositioning was guided through a 3D printed intermediate splint in all cases (previously simulated with Dolphin software).

Subsequentially, the bilateral sagittal split osteotomy was performed. The mandibular repositioning was guided through a 3D printed final splint. The genioplasty was performed with a horizontal osteotomy after a labial mucosa incision. After the genioplasty, the authors used the incision previously used for the Le Fort I osteotomy to bluntly dissect the tissues in order to insert a custom-made polyether ether ketone zygomatic prosthesis. Lastly, an open rhinoplasty was performed.

Results:

All the surgery lasted a mean less 6 hours. The submental intubation was removed in the operating room, at the end of the surgery. The patients were then discharged from the hospital 2 days after the surgery in all cases.

Conclusions:

Submental intubation is a valid method for the airway management in maxillofacial trauma and can be extended in case of Full-Face Makeover like orthognathic surgery combined with rhinoplasty. The absence of nasal traumatism during surgery leads to a more accurate rhinoplasty, with a greater satisfaction for the patient.
Review of 451 Patients Presenting With Orbital Wall Fractures: A Retrospective Analysis
Authors: Ray Coby N. , Marsh Harrison D. , Gilmore Jane E. , Kirk Declan W. , Larumbe-Zabala Eneko , Freedman Kenn A.
Published: August 2022

A retrospective review of the electronic medical records of patients presenting to the University Medical Center in Lubbock, Texas with orbital wall fractures. Clinical data such as associated ocular injuries and different management approaches are analyzed and discussed to help clarify the specific indications for, and timing of, a formal ophthalmologic examination. All patients who presented to the emergency department for an orbital fracture after suffering various types of traumas between 2008 and 2017 were included. The study reviewed 451 patients with orbital wall fractures with a wide variety of presentations as well as demographics. There were 411 cases of adults presenting with an average age of 34 years and 40 pediatric presentations with an average age of 14 years. The average age of the combined study population was 30 years. Only 16.9% of patients required surgical correction for their orbital fractures and assault accounted for nearly 50% of all the orbital fractures reviewed in this study. In this large retrospective review, no notable relationship was found between orbital wall fractured and ocular injury. Alarm symptoms for more visual threatening injuries such as retinal tears, detachments, open globe injury, and extraocular muscle entrapment are all reasonable indications to consult ophthalmology emergently. Most orbital fractures are not vision threatening, do not usually require surgical correction, and typically occur in the setting of assault.
Improved Organ Utilization and Better Transplant Outcomes With In Situ Normothermic Regional Perfusion in Controlled Donation After Circulatory Death
Authors: Oniscu Gabriel C. , Mehew Jennifer , Butler Andrew J. , Sutherland Andrew , Gaurav Rohit , Hogg Rachel , Currie Ian , Jones Mark , Watson Christopher J.E.
Published: August 2022

Background

. We evaluated whether the use of normothermic regional perfusion (NRP) was associated with increased organ recovery and improved transplant outcomes from controlled donation after circulatory death (cDCD).

Methods

. This is a retrospective analysis of UK adult cDCD donors‚ where at least 1 abdominal organ was accepted for transplantation between January 1, 2011, and December 31, 2019.

Results

. A mean of 3.3 organs was transplanted when NRP was used compared with 2.6 organs per donor when NRP was not used. When adjusting for organ-specific donor risk profiles, the use of NRP increased the odds of all abdominal organs being transplanted by 3-fold for liver (P < 0.0001; 95% confidence interval [CI], 2.20-4.29), 1.5-fold for kidney (P = 0.12; 95% CI, 0.87-2.58), and 1.6-fold for pancreas (P = 0.0611; 95% CI, 0.98-2.64). Twelve-mo liver transplant survival was superior for recipients of a cDCD NRP graft with a 51% lower risk-adjusted hazard of transplant failure (HR = 0.494). In risk-adjusted analyses, NRP kidneys had a 35% lower chance of developing delayed graft function than non-NRP kidneys (odds ratio, 0.65; 95% CI, 0.465-0.901)‚ and the expected 12-mo estimated glomerular filtration rate was 6.3 mL/min/1.73 m2 better if abdominal NRP was used (P < 0.0001).

Conclusions

. The use of NRP during DCD organ recovery leads to increased organ utilization and improved transplant outcomes compared with conventional organ recovery.
Influence of the artificial sodium saccharin sweetener Sucram® on the rumen content and rumen epithelium microbiota in dairy cattle: A pilot study
Authors: Koester Lucas R , Daniels Karrie M , Anderson Chiron J , Tibbs-Cortes Bienvenido W , Lyte Mark , Schmitz-Esser Stephan
Published: August 2022

The aim of this pilot study was to identify changes in both the rumen content and rumen epithelial microbiota in response to the supplementation of Sucram ® , a sodium-saccharin-based sweetener (Pancosma S.A./ADM Groups, Rolle, Switzerland). Rumen microbial communities are essential for animal growth and performance, and changes in these communities can have major effects on these parameters. Little or no research is available regarding how saccharin-based artificial sweeteners, fed to cattle in attempts to increase palatability and encourage feed intake, affect rumen microbial communities.
The rumen epithelium and rumen content microbiota of five lactating Holstein-Friesian dairy cattle were compared before (baseline, BL) and after a 28-day supplementation of Sucram ® using Illumina MiSeq-based 16S rRNA gene sequencing. After supplementation of Sucram ® , significant changes in the abundance of specific taxa were detected: an increase in Prevotella and Sharpea species, a decrease in Treponema , Leptospiraceae , Ruminococcus and methanogenic archaea (p<0.05), but Sucram® did not affect the overall rumen microbial community structure. This is the first study to report an effect of Sucram ® on ruminant microbial communities.
Sensitivity and specificity of DPP® Fever Panel II Asia in the diagnosis of malaria, dengue and melioidosis
Authors: Amornchai Premjit , Hantrakun Viriya , Wongsuvan Gumphol , Boonsri Chaiyaporn , Yoosuk Sasinaphon , Nilsakul Jiraporn , Blacksell Stuart D. , West T. Eoin , Lubell Yoel , Limmathurotsakul Direk
Published: August 2022

Introduction. Rapid diagnostic tests (RDTs) that can facilitate the diagnosis of a panel of tropical infectious diseases are critically needed. DPP® Fever Panel II Asia is a multiplex lateral flow immunoassay comprising antigen and IgM panels for the diagnosis of pathogens that commonly cause febrile illness in Southeast Asia.

Hypothesis/Gap Statement. Accuracy of DPP® Fever Panel II Asia has not been evaluated in clinical studies.

Aim. To evaluate the sensitivity and specificity of DPP® Fever Panel II Asia for malaria, dengue and melioidosis.

Methodology. We conducted a cohort-based case–control study. Both cases and controls were derived from a prospective observational study of patients presenting with community-acquired infections and sepsis in northeast Thailand (Ubon sepsis). We included 143 and 98 patients diagnosed with malaria or dengue based on a positive PCR assay and 177 patients with melioidosis based on a culture positive for

Burkholderia pseudomallei

. Controls included 200 patients who were blood culture-positive for

Staphylococcus aureus

,

Escherichia coli

or

Klebsiella pneumoniae

, and cases of the other diseases. Serum samples collected from all patients within 24 h of admission were stored and tested using the DPP® Fever Panel II Asia antigen and IgM multiplex assays. We selected cutoff values for each individual assay corresponding to a specificity of ≥95 %. When assessing diagnostic tests in combination, results were considered positive if either individual test was positive.

Results. Within the DPP® Fever Panel II Asia antigen assay, a combination of pLDH and HRPII for malaria had a sensitivity of 91 % and a specificity of 97 %. The combination of dengue NS1 antigen and dengue antibody tests had a sensitivity of 61 % and a specificity of 91 %. The

B. pseudomallei

CPS antigen test had a sensitivity of 27 % and a specificity of 97 %. An odds ratio of 2.34 (95 % CI 1.16–4.72, P=0.02) was observed for the association between CPS positivity and mortality among melioidosis patients.

Conclusion. The performance of the DPP® Fever Panel II Asia for diagnosis of malaria was high and that for dengue and melioidosis was relatively limited. For all three diseases, performance was comparable to that of other established RDTs. The potential operational advantages of a multiplex and quantitative point-of-care assay are substantial and warrant further investigation.
LENZILUMAB OUTCOMES ACCORDING TO RACE OF COVID-19 PARTICIPANTS IN THE LIVE-AIR PHASE 3 TRIAL
Authors: Marconi Vincent C. , Kilcoyne Adrian , Cerasoli Franklin , Polk Christopher , Lewis Meghan , Burger Charles D. , Jordan Edward , Durrant Cameron , Chappell Dale , Temesgen Zelalem
Published: August 2022

RATIONALE

The hyperinflammatory immune response of COVID-19, in part orchestrated by granulocyte-macrophage colony-stimulating factor (GM-CSF) can lead to respiratory failure and death with disparities in outcomes between racial subgroups. In the LIVE-AIR trial, the GM-CSF neutralizing antibody lenzilumab improved survival without mechanical ventilation (SWOV) in COVID-19.

OBJECTIVE

An analysis of outcomes was performed to determine differences between Black/African American (B/AA) and White participants in LIVE-AIR.

METHODS

LIVE-AIR was a phase 3, randomized, double-blind, placebo-controlled trial. Participants hospitalized with COVID-19 pneumonia were randomized 1:1 to receive lenzilumab (1800 mg total) or placebo in addition to standard of care, including remdesivir and/or corticosteroids.

MEASUREMENTS AND MAIN RESULTS

Lenzilumab, compared to placebo, numerically improved the likelihood of SWOV (primary endpoint) in B/AA (n=71; 86.8% vs 70.9%; HR, 2.68; 95% confidence interval [CI], 0.88-8.11; p=0.0814) and White (n=343; 85.1% vs 80.8%; HR, 1.41; 95%CI, 0.85-2.35, p=0.182) participants. A statistically significant improvement in SWOV was observed in B/AA (HR: 8.9; 95%CI: 1.08, 73.09; p=0.0418) and White (HR: 2.32; 95%CI: 1.17, 4.61; p=0.0166) participants with baseline CRP<150 mg/L. Lenzilumab numerically, but not statistically, improved secondary endpoints of IMV, ECMO or mortality; ventilator-free days; ICU days and time to recovery in either race while ventilator-free days, ICU days, and time to recovery were statistically improved in B/AA participants with baseline CRP<150 mg/L. Lenzilumab was well tolerated without differences in serious adverse events regardless of race.

CONCLUSION

Lenzilumab significantly improved SWOV and some key secondary outcomes in B/AA COVID-19 participants with baseline CRP<150 mg/L. NCT04351152