bluuebunny/crossref_metadata_2025_split huggingface dataset:
Microcirculatory effect of topical vapocoolants
Authors: Galdyn Izabela , Swanson Edward , Gordon Chad , Kwiecien Grzegorz , Bena James , Siemionow Maria , Zins James 
Published: March 2018

Background Vapocoolant sprays are commonly used to minimize pain following minor interventions such as venipuncture, shave biopsy or needle insertion. Although these sprays have been widely used in clinical practice, little is known about their effect on microcirculation or cutaneous blood flow. Objective To evaluate the real-time effect of a topical vapocoolant using a well-established, rat cremaster muscle microcirculatory model, allowing direct measurement of changes in vessel diameter, capillary density and leukocyte behaviour. Method Fifty rats were divided into a control and four experimental groups: group 1: 4 s spray with vapocoolant at 18 cm distance; group 2: 10 s spray at 18 cm distance; group 3: 4 s spray at 8 cm distance; and group 4: 10 s spray at 8 cm distance. Vessel diameters, capillary density and leukocyte behaviour were monitored for 1 h thereafter. Muscle was harvested for immunohistochemistry analysis of proangiogenic markers (vascular endothelial growth factor and von Willebrand factor), leukocyte behaviour markers (E-selectin, vascular cell adhesion molecule, intercellular adhesion molecule), pimonidazole-hypoxia staining and ApopTag (Millipore, USA) staining for apoptosis. Gene expression for inflammatory markers (interleukin [IL]-1β, IL-2, IL-4, IL-6, IL-10, tumour necrosis factor-alpha and interferon-gamma) was evaluated using polymerase chain reaction and myeloperoxidase assay for inflammation was performed. Result The use of refrigerant spray decreased vessel diameter and capillary density initially, although none of these decreases were statistically significant. Polymerase chain reaction showed no significant changes. The myeloperoxidase assay showed statistically significant increase in myeloperoxidase activity in groups 2, 3 and 4. Immunohistochemistry was negative for angiogenic and proinflammatory markers. Conclusions The lack of statistically significant changes in vessel diameter and inflammatory markers corroborated the safety on microcirculation.
Minor surgery procedures: A retrospective review and prospective survey in a pediatric population
Authors: Chan Emily , Bucevska Marija , Verchere Cynthia 
Published: March 2018

Objective The present study evaluated minor surgery procedures undertaken by a single plastic surgeon at BC Children's Hospital (Vancouver, British Columbia) for patient and physician satisfaction, parent impressions, psychological concerns and complications. Methods Data were collected from a retrospective chart review and a prospective patient survey. Eligible subjects for the retrospective study included all pediatric patients undergoing minor surgery between May 2011 and April 2013. Parameters of interest included patient demographics, minor surgery specifics, complications and outcomes. Eligible subjects for the prospective patient survey included consecutive patients undergoing minor surgery between June 2013 and August 2013, as well as their parents. Results A total of 219 procedures were included in the retrospective review. The mean age of subjects was 13.1 years (range two weeks to 18 years). The median length of follow-up was 46 days (range four to 606 days). There were no major complications; however, 45 minor complications in 36 patients were found. Complications included crusting (4.6%), delayed wound healing (3.2%), hypersensitivity (2.3%), scar hypertrophy (1.8%), infection (0.9%) and other (7.8%). Outcomes were categorized as one of four outcomes: both satisfied (89.9%); patient satisfied but physician unsatisfied (0.8%); patient unsatisfied and physician satisfied (3.1%); and both unsatisfied (6.2%). In the prospective study, 32 subjects consented to participate in the survey. Of these subjects, 10 children and 12 parents responded to the questionnaires. Eighty-three percent of respondents indicated that their goals were accomplished by their procedure and that they would be willing to undergo minor surgery again. Conclusion Minor surgery is possible and practical in pediatric plastic surgery clinics, with few complications and high patient and surgeon satisfaction.
Examining perception and actual knowledge change among learners in a standardized burn course
Authors: Spiwak Rae , Lett Ronald , Rwanyuma Laurean , Logsetty Sarvesh 
Published: March 2018

Background Essential Burn Management (EBM) is a burn training program created for East Africa and aims to meet the needs of low- and middle-income countries. The authors present a report on objective testing of change in knowledge, with pre and post tests, and comparison of this testing with the self perception of knowledge gained to explore course utility. Objective To evaluate the ability of EBM to improve knowledge in burn care among course participants; and to explore whether participants' self-perception of knowledge gained is comparable with their actual change in knowledge. Methods Twenty health care providers from a variety of disciplines participated in EBM and completed the pre and post course burn care knowledge test. Participants also self-rated knowledge in burn care both pre and post course. All tests and self-rated assessments were anonymous and consent was obtained. Paired t tests were conducted on pre and post test scores. Improvements in pre-post scores according to module or topic area were examined to determine the proportion correct, and then analyzed using Wilcoxon signed-rank tests. Module scores pre-post course were compared with individuals' self-rating of knowledge both before and after the course for that particular module. Results Pre-post course tests reflected an increase in knowledge. An increase in self-rated knowledge was matched with a significant increase in module test scores for primary survey, burn resuscitation, wound management, infection control and electrical injury, but not inhalation injury and compartment syndrome modules. Conclusion Findings support a combination of self-report and objective pre-post testing to evaluate courses designed to teach burn management.
Does negative pressure wound therapy applied to closed incisions following ventral hernia repair prevent wound complications and hernia recurrence? A systematic review and meta-analysis
Authors: Swanson Edward W , Cheng Hsu-Tang , Susarla Srinivas M , Lough Denver M , Kumar Anand R 
Published: March 2018

Background Despite advances in surgical technique, ventral hernia repair (VHR) remains associated with significant postoperative wound complications. Objective A systematic review and meta-analysis was performed to identify whether the application of negative pressure wound therapy to closed incisions (iNPWT) following VHR reduces the risk of postoperative wound complications and hernia recurrence. Methods The PubMed/MEDLINE, EMBASE and SCOPUS databases were searched for studies published through October 2015. Publications that met the following criteria were included: adult patients undergoing VHR; comparison of iNPWT with conventional dressings; and documentation of wound complications and/or hernia recurrence. The methodological quality of included studies was independently assessed using the Methodological Index for Non-Randomized Studies guidelines. Outcomes assessed included surgical site infection (SSI), wound dehiscence, seroma, and hernia recurrence. Meta-analysis was performed to obtain pooled ORs. Results Five retrospective cohort studies including 477 patients undergoing VHR were included in the final analysis. The use of iNPWT decreased SSI (OR 0.33 [95% CI 0.20 to 0.55]; P<0.0001), wound dehiscence (OR 0.21 [95% CI 0.08 to 0.55]; P=0.001) and ventral hernia recurrence (OR 0.24 [95% CI 0.08 to 0.75]; P=0.01). There was no statistically significant difference in the incidence of seroma formation (OR 0.59 [95% CI 0.27 to 1.27]; P=0.18). Conclusion For patients undergoing VHR, current evidence suggests a decreased incidence in wound complications using incisional NPWT compared with conventional dressings.
Forty-five degree cutting septoplasty
Authors: Hsiao Yen-Chang , Chang Chun-Shin , Chuang Shiow-Shuh , Kolios Georgios , Abdelrahman Mohamed 
Published: March 2018

Background The crooked nose represents a challenge for rhinoplasty surgeons, and many methods have been proposed for management; however, there is no ideal method for treatment. Accordingly, the 45° cutting septoplasty technique, which involves a 45° cut at the junction of the L-shaped strut and repositioning it to achieve a straight septum is proposed. Methods From October 2010 to September 2014, 43 patients underwent the 45° cutting septoplasty technique. There were 28 men and 15 women, with ages ranging from 20 to 58 years (mean, 33 years). Standardized photographs were obtained at every visit. Established photogrammetric parameters were used to describe the degree of correction: Correction rate = (preoperative total deviation - postoperative residual deviation)/preoperative total deviation x 100% was proposed. Results The mean follow-up period for all patients was 12.3 months. The mean preoperative deviation was 64.3° and the mean postoperative deviation was 2.7°; the overall correction rate was 95.8%. One patient experienced composite implant deviation two weeks postoperatively and underwent revision rhinoplasty. There were no infections, hematomas or postoperative bleeding. Conclusion Based on the clinical observation of all patients during the follow-up period, the 45° cutting septoplasty technique was shown to be effective for the treatment of crooked nose.
From WWII to Kingston, Ontario: The History of Queen's University School of Medicine, Division of Plastic and Reconstructive Surgery
Authors: Chung Karen , Wyllie Kenneth , Davidson John 
Published: March 2018

Objective To describe the origin and development of the Division of Plastic and Reconstructive Surgery at the Queen's University School of Medicine (Kingston, Ontario). Methods Resarch ethics board approval and privacy agreements from the Kingston General Hospital (KGH, Kingston, Ontario) medical archives were obtained. Primary and secondary data sources were identified. A systematic examination of newspaper archives, research literature, KGH medical advisory committee meeting minutes, and testimonies from Dr Kenneth Wyllie and Dr John Davidson were obtained. Results In 1949, Dr Albert Ross Tilley arrived at Queen's University in Kingston, Ontario. There, Tilley initiated the Burn Unit at the KGH and began monthly teaching during the academic semester. Ken Wyllie (Meds '55), Lloyd Carlson (Meds '57) and John Emery (Meds '57) were the notable progeny of his early initiatives. In 1963, Kenneth Wyllie founded the Division of Plastic and Reconstructive Surgery in Kingston, Ontario, having completed plastic surgery training in Toronto and Edinburgh with experiences in Stockholm (Sweden), Paris (France) and Baltimore (Maryland, USA). He was shortly joined by Pat Shoemaker (Meds '66). John Davidson (Meds '82) arrived in 1989, bringing an interest in microsurgery and critical inquiry to the division. Five notable surgeons, Cartotto (Meds '88), Watkins, Watters, Meathrel (Meds '03) and McKay, further enhanced the Division's clinical and academic mission. Conclusions The collective activity of the Division of Plastic and Reconstructive Surgery at Queen's School of Medicine in its 66-year history has encouraged more than 40 others to pursue distinguished careers in the specialty throughout North America, including three past presidents of the Canadian Society of Plastic Surgeons.
A Tale of Two Health-Care Systems: Cost-Utility Analysis of Open Carpal Tunnel Release in Canada and the United States
Authors: Cheung Kevin , Kaur Manraj N. , Tolliver Tyson , Longo Christopher J. , Naam Nash H. , Thoma Achilles 
Published: March 2018

Purpose: Canadian health care is often criticized for extended wait times, whereas the United States suffers from increased costs. The purpose of this pilot study was to determine the cost-utility of open carpal tunnel release in Canada versus the United States. Methods: A prospective cohort study evaluated patients undergoing open carpal tunnel release at an institution in Canada and the United States. All costs from a societal perspective were captured. Utility was measured using validated health-related quality of life (HRQOL) scales—the EuroQol-5D and the Michigan Hand Outcome Questionnaire. Results: Twenty-one patients at the Canadian site and 8 patients at the US site participated. Mean total costs were US $1581 ± $1965 and $2179 (range: $1421-$2741) at the Canadian and US sites, respectively. Health-related quality of life demonstrated significant improvements following surgery ( P < .05). Patient utilities preoperatively and at 6 weeks and 3 months postoperatively were 0.72 ± 0.20, 0.86 ± 0.11, and 0.83 ± 0.16 at the Canadian site and 0.81 ± 0.09, 0.86 ± 0.10, and 0.86 ± 0.12 at the US site. Improvements in HRQOL directly related to surgery were not significantly different between patients in Canada and the United States. American patients, however, attained improved HRQOL sooner due to shorter wait times (27 ± 10 vs 214 ± 119 days; P < .001). The incremental cost-utility of the US system was $7758/quality-adjusted life year gained compared to the Canadian system. Sensitivity analyses confirmed that these results were robust. Conclusion: This pilot study suggests that carpal tunnel surgery is more cost-effective in the United States due to prolonged wait times in Canada.
Complementary and Alternative Medicines and Patients With Breast Cancer: A Case of Mortality and Systematic Review of Patterns of Use in Patients With Breast Cancer
Authors: Roumeliotis Grayson A. , Dostaler Genevieve , Boyd Kirsty U. 
Published: March 2018

Background: The use of complementary and alternative medicines (CAMs) is common among women being treated for breast cancer. A recent mortality associated with CAM at our center precipitated a systematic review of the Cochrane, EMBASE, and PubMed databases to identify English manuscripts including “CAM” and “breast cancer.” Methods: Papers included for review were selected based on predefined inclusion and exclusion criteria. The primary outcome was the use of CAM by women with breast cancer. Secondary outcomes included timing of use along disease trajectory, attitudes toward CAM by allopathic practitioners, and patient disclosure of CAM use to treating allopathic physicians. Results: Of 701 titles identified by the search strategy, 36 met the inclusion criteria. The weighted average proportion of women with breast cancer who use CAM was 40% (standard deviation: 18%). The diagnosis of breast cancer also prompts the initiation or increase of CAM use. However, up to 84% of patients do not disclose the use of CAM to their allopathic practitioners. Conclusions: Although CAM is often dismissed as a harmless addition to allopathic therapy, significant complications and interactions can occur. Our review and the dramatic case example provided highlight the need for physicians to educate themselves regarding CAM and to engage with their patients regarding its use.
Textured Breast Implants: A Closer Look at the Surface Debris Under the Microscope
Authors: Webb Leland H. , Aime Victoria L. , Do Annie , Mossman Kenneth , Mahabir Raman C. 
Published: March 2018

Background: Texturing of breast implants is done to decrease the risk of associated complications. Each manufacturer utilizes unique and at times proprietary techniques to texture the surface of their implants. Little is known about the integrity of this surface structure texturing or the propensity for the surfaces to shed particulate matter. This study aimed to determine the extent of surface particulate shedding from 3 textured implants approved by the US Food and Drug Administration (FDA), which are manufactured by Allergan, Mentor, and Sientra. Methods: Control images of each of the 3 textured breast implants were obtained with scanning electron microscopy (SEM). A liquid adhesive, ethylene vinyl acetate (EVA) copolymer was then applied to the external shell of the implants, allowed to cool, and peeled from the surface. Images of the EVA copolymer were taken with SEM to qualitatively analyze displacement of surface particulate debris. Scanning electron microscopy imaging of the implants was repeated for qualitative comparisons with the control images. Results: The peeled copolymer of the 3 implants exhibited surface shedding. Comparison of the 3 breast implants showed the shedding to be greatest for the Allergan implant. Conclusions: This study highlights the dynamic surface material properties of the 3 FDA-approved breast implants. Shedding of particulate matter from the implant surfaces can be precipitated by moderate adhesion. Our qualitative examination of SEM findings showed more debris shed from the Allergan breast implants than from the Mentor or Sientra implants.
Cases of Early Infectious Flexor Tenosynovitis Treated Non-Surgically With Antibiotics, Immobilization, and Elevation
Authors: DiPasquale Ashley M. , Krauss Emily M. , Simpson Andrew , Mckee Daniel E. , Lalonde Donald H. 
Published: March 2018

Background: Early infectious flexor tenosynovitis has been treated with urgent surgery by most surgeons since Bunnell wrote the first textbook of hand surgery in 1945. Some surgeons have good experience with non-surgical management of early presenting disease in some cases. Methods: This retrospective chart review included 12 inpatients with early infectious flexor synovitis who received conservative treatment with antibiotics, immobilization, and elevation without surgical drainage. Results: The mean time to resolution of infective symptoms for the 12 patients was 5 days (range: 2-11 days) for those receiving conservative management. Half of them required hand therapy. Eight of the 12 patients had good documentation of a full return of hand function. Conclusions: In some patients with early infectious flexor synovitis, urgent surgery may not be required. We present a brief synopsis of 12 such cases.
How to Prevent Costal Cartilage Graft Warping in Secondary Correction of Cleft Lip Nasal Deformity
Authors: Chen Hung-Chang , Yen Cheng-I , Yang Shih-Yi , Hsiao Yen-Chang 
Published: March 2018

Introduction: Autologous costal cartilage dorsal onlay graft is widely used for dorsum and radix augmentation in secondary cleft lip nasal rhinoplasty. The most common drawback of costal cartilage dorsal onlay graft is warping. The purpose of this article is to describe our chimeric autologous costal cartilage graft technique, which prevents warping significantly. “Chimeric” means the combination of 2 different tissues (bone and cartilage) to make a single dorsal onlay graft. Patients and Methods: From June 2011 to June 2014, 16 cleft lip patients who underwent rhinoplasty and needed dorsal onlay grafts with costal cartilage graft using the chimeric autologous costal graft method were identified. All patients were operated by the corresponding author. Patients’ nasal profiles were documented and photographed preoperatively and postoperatively. Result: There were 5 males and 11 females with ages ranging from 20 to 52 years (averaging 29.5 years). There were 14 unilateral and 2 bilateral cleft lips. The average follow-up time was 12.1 months. Six patients received revision surgery, including 1 (6%) warping and 5 (30%) revisions. All patients were harvested rib cartilage graft as cartilage donor and there was no complication with the donor site. Conclusion: From the clinical observation of all patients during the follow-up period, this technique is effective for preventing cartilage warping.
Infusion of donor-derived CD8+ memory T cells for relapse following allogeneic hematopoietic cell transplantation
Authors: Muffly Lori , Sheehan Kevin , Armstrong Randall , Jensen Kent , Tate Keri , Rezvani Andrew R. , Miklos David , Arai Sally , Shizuru Judith , Johnston Laura , Meyer Everett , Weng Wen-Kai , Laport Ginna G. , Negrin Robert S. , Strober Sam , Lowsky Robert 
Published: March 2018

Key Points
Phenotypic TM isolation from unmanipulated donor apheresis via CD45RA depletion followed by CD8+ enrichment is feasible. TM infusion for patients with relapse after allogeneic HCT was safe and resulted in minimal GVHD.
Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature
Authors: Dal Jakob , Leisner Michelle Z , Hermansen Kasper , Farkas Dóra Körmendiné , Bengtsen Mads , Kistorp Caroline , Nielsen Eigil H , Andersen Marianne , Feldt-Rasmussen Ulla , Dekkers Olaf M , Sørensen Henrik Toft , Jørgensen Jens Otto Lunde 
Published: March 2018

Abstract

Context
Acromegaly has been associated with increased risk of cancer morbidity and mortality, but research findings remain conflicting and population-based data are scarce. We therefore examined whether patients with acromegaly are at higher risk of cancer.

Design
A nationwide cohort study (1978 to 2010) including 529 acromegaly cases was performed. Incident cancer diagnoses and mortality were compared with national rates estimating standardized incidence ratios (SIRs). A meta-analysis of cancer SIRs from 23 studies (including the present one) was performed.

Results
The cohort study identified 81 cases of cancer after exclusion of cases diagnosed within the first year [SIR 1.1; 95% confidence interval (CI), 0.9 to 1.4]. SIRs were 1.4 (95% CI, 0.7 to 2.6) for colorectal cancer, 1.1 (95% CI, 0.5 to 2.1) for breast cancer, and 1.4 (95% CI, 0.6 to 2.6) for prostate cancer. Whereas overall mortality was elevated in acromegaly (SIR 1.3; 95% CI, 1.1 to 1.6), cancer-specific mortality was not.
The meta-analysis yielded an SIR of overall cancer of 1.5 (95% CI, 1.2 to 1.8). SIRs were elevated for colorectal cancer, 2.6 (95% CI, 1.7 to 4.0); thyroid cancer, 9.2 (95% CI, 4.2 to 19.9); breast cancer, 1.6 (1.1 to 2.3); gastric cancer, 2.0 (95% CI, 1.4 to 2.9); and urinary tract cancer, 1.5 (95% CI, 1.0 to 2.3). In general, cancer SIR was higher in single-center studies and in studies with &lt;10 cancer cases.

Conclusions
Cancer incidence rates were slightly elevated in patients with acromegaly in our study, and this finding was supported by the meta-analysis of 23 studies, although it also suggested the presence of selection bias in some earlier studies.