bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of 494 Consecutive Breast Augmentation Patients: System to Improve Patient Outcomes and Satisfaction
Authors: Diaz John F. 
Published: October 2017

Background:
Breast augmentation continues to be one of the most common surgical procedures performed by plastic surgeons. As implant options expand, controlling the numerous variables required for a successful result will prove increasingly challenging. The purpose of this study was to outline specific steps that can be taken during the patient consultation and during surgery to decrease complications and improve overall patient satisfaction and patient outcomes.

Methods:
A retrospective review of 494 consecutive patients who underwent primary augmentation mammaplasty performed by a single surgeon was undertaken. Surgical outcomes were recorded and compared with previously published results. Patient satisfaction was measured using the BREAST-Q Augmentation Module.

Results:
Patients were followed for an average of 6 months (range, 0–45 months). Of the 494 patients, 1.3% developed capsular contracture. Other complications included 0.6% asymmetry, 0.4% malposition, 0.2% hematoma, and 0.2% rippling. The median BREAST Q score for the patient's overall satisfaction with outcome was 86%. The median BREAST Q score for patient's satisfaction with the plastic surgeon, medical team, and office staff was 100% in each case. The median score for psychological well-being, physical well-being, and sexual well-being was 100%, 90%, and 88%, respectively.

Conclusions:
The system outlined in this study showed very low rates of complications and high scores for patient satisfaction. Following a system like this will become increasingly important as breast augmentation continues to become more popular, implant options continue to expand, and social media continues to be used by patients to share surgical experiences.
Can Friedberg’s Triad Solve Persistent Anesthesia Problems? Over-Medication, Pain Management, Postoperative Nausea and Vomiting
Authors: Friedberg Barry L. 
Published: October 2017

Summary:
Friedberg’s Triad is (1) measure the brain; (2) preempt the pain; (3) emetic drugs abstain. Persistent anesthesia problems include over- and under-medication, postoperative pain management, and postoperative nausea and vomiting. Inspired by Vinnik’s diazepam-ketamine paradigm, Friedberg’s propofol ketamine paradigm was first published in 1993. The 1997 addition of the bispectral (BIS) index brain monitor made the propofol ketamine paradigm numerically reproducible. The 1998 addition of the frontalis electromyogram (EMG) as a secondary trend to the BIS transformed the time-delayed BIS monitor into a real-time, extremely useful device. Before BIS monitoring, anesthesiologists only had heart rate (HR) and blood pressure (BP) changes to guide depth of anesthesia. Not surprisingly, the American Society of Anesthesiologists’ Awareness study showed no HR or BP changes in half of the patients experiencing awareness with recall. HR and BP changes may only reflect brain stem signs while consciousness and pain are processed at higher, cortical brain levels. BIS/electromyogram measurement can accurately reflect propofol effect on the cerebral cortex in real time. Although propofol requirements can vary as much as a hundred-fold, titrating propofol to 60 < BIS < 75 with baseline electromyogram assures every patient will be anesthetized to the same degree and allows more scientific analysis of outcomes. Numerous publications are cited to support the author’s 25-year clinical experience. Over that period, no office-based, cosmetic surgery patients were admitted to the hospital for unmanageable pain or postoperative nausea and vomiting. Friedberg’s Triad appears to solve persistent anesthesia problems.
Psychometric Validation of the BODY-Q in Danish Patients Undergoing Weight Loss and Body Contouring Surgery
Authors: Poulsen Lotte , Klassen Anne , Rose Michael , Roessler Kirsten K. , Juhl Claus Bogh , Støving René Klinkby , Cano Stefan , Sørensen Jens Ahm 
Published: October 2017

Background:
A well-developed patient-reported outcome instrument is needed for use in Danish bariatric and body contouring patients. The BODY-Q is designed to measure changes in important patient outcomes over the entire patient journey, from obesity to post-body contouring surgery. The current study aims to psychometrically validate the BODY-Q for use in Danish patients.

Methods:
The process consisted of 3 stages: translation and linguistic validation, field-test, and data analysis. The translation was performed in accordance with the International Society for Pharmacoeconomics and Outcomes Research and World Health Organization guidelines, and field-test data were collected in 4 departments in 2 different hospitals. Field-test data were analyzed using Rasch Measurement Theory.

Results:
A total of 495 patients completed the Danish BODY-Q field-test 1–4 times, leading to a total of 681 assessments with an overall response rate at 76%. Cronbach α values were ≥ 0.90, and person separation index values were in general high. The Rasch Measurement Theory analysis provided broad support for the reliability and validity of the Danish version of the BODY-Q scales. Item fit was outside the criteria for 34 of 138 items, and of these, 21 had a significant chi-square P value after Bonferroni adjustment. Most items (128 of 138) had ordered thresholds, indicating that response options worked as intended.

Conclusion:
The Danish version of the BODY-Q is a reliable and valid patient-reported outcome instrument for use in Danish bariatric and body contouring patients.
A Breast Reconstruction Using a Breast Prosthesis and Capsular Flap for a Lymphocele Patient
Authors: Yano Tomoyuki , Shimizu Daisuke , Ishii Yoshitaka , Ito Osamu , Sawaizumi Masayuki 
Published: October 2017

Summary:
We encountered a very rare condition where the patient had a lymphocele under the skin envelope of the breast following mastectomy during the course of breast reconstruction with a tissue expander. The incidence rate of axillary lymphoceles is reported as 2.2–50% in breast cancer patients, but there have been no reports mentioning lymphoceles under the breast skin during the course of breast reconstruction with a prosthesis. The patient had a lymphocele in the lower lateral part of the breast following mastectomy and had multiple cellulitis-like inflammations. These inflammations were treated with conservative therapy such as administration of antibiotics, resting, and cooling. After 6 months of the initial surgery, the patient underwent complete resection of the lymphocele, preventative elimination of a possible lymphatic leakage, and breast reconstruction using a prosthesis combined with a capsular flap. The capsular flap is a transposition flap that uses capsular tissue around the expander to cover adjacent thinned skin. There were no postoperative complications such as breast skin necrosis, exposure of the prosthesis, or recurrence of the lymphocele and cellulitis. The patient had a successful breast reconstruction even though a lymphocele of the breast was observed. Even though a patient may have a lymphocele in the breast following mastectomy, with careful resection of the lymphocele, complete elimination of possible lymphatic leakage, and by performing the capsular flap technique, complete breast reconstruction with a breast prosthesis may be successful.
Infectious Complications following Breast Reconstruction Using Tissue Expanders in Patients with Atopic Dermatitis
Authors: Taminato Mifue , Tomita Koichi , Yano Kenji , Hosokawa Ko 
Published: October 2017

Summary:
Infectious complications represent one of the most prominent factors contributing to tissue expander (TE) loss in breast reconstruction procedures. Several patient characteristics that increase the risk for surgical-site infection or TE infection have been reported, but no study has focused on the relationship between atopic dermatitis (AD) and TE infection or surgical-site infection. Recently, we investigated 203 cases of breast reconstruction surgeries performed using TEs and noted that all 3 patients who had AD developed infectious complications that ultimately led to TE removal. Considering its pathophysiology, it is likely that patients with AD relatively easily develop infectious complications due to barrier dysfunction, abnormalities in innate immune responses, or colony formation by Staphylococcus aureus. Particular caution should be exercised for breast reconstruction using man-made materials in cases complicated by AD.
RESIDUAL CHOROIDAL VESSELS IN ATROPHY CAN MASQUERADE AS CHOROIDAL NEOVASCULARIZATION ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY
Authors: Nesper Peter L. , Lutty Gerard A. , Fawzi Amani A. 
Published: October 2017

Purpose:
To present a postprocessing approach in optical coherence tomography angiography (OCTA) to facilitate the visualization and interpretation of lesions in age-related macular degeneration with coexisting atrophy and choroidal neovascularization (CNV).

Methods:
This retrospective study included 32 eyes of 26 patients with atrophy and treated CNV and 8 eyes with treatment-naive geographic atrophy. En face optical coherence tomography slabs highlighting atrophy were pseudocolored and merged with the corresponding OCTA. Cross-sectional optical coherence tomography and postprocessed OCTA were analyzed to identify CNV and normal choroidal vessels in relationship to the atrophy. We correlate the OCTA findings with those in a donor eye with treatment-naive geographic atrophy studied with transmission electronic microscopy.

Results:
Medium-sized choroidal vessels were displaced anteriorly in areas of atrophy in all 40 eyes (100%), visualized in the choriocapillaris slab in all eyes, and in the outer retinal slab in 30 of 40 eyes (75.0%). Cross-sectional OCTA was used to confirm the presence of CNV. Postprocessing successfully highlighted the CNV and distinguished it from choroidal vessels in atrophy. Donor eye transmission electronic microscopy confirmed the anterior displacement of medium-sized choroidal vessels in geographic atrophy.

Conclusion:
The anterior displacement of larger choroidal vessels in atrophy requires clinician vigilance to avoid misinterpreting these vessels as CNV on en face OCTA. Our proposed postprocessing approach offers a potential solution to facilitate the interpretation of en face OCTA in these cases. In the absence of other tools, clinicians are encouraged to rely on the location of flow relative to Bruch membrane on cross-sectional OCTA flow images.
PREFERRED RETINAL LOCUS LOCATIONS IN AGE-RELATED MACULAR DEGENERATION
Authors: Erbezci Murat , Ozturk Taylan 
Published: October 2017

Purpose:
An evaluation of the preferred retinal locus (PRL) in patients with age-related macular degeneration and a central scotoma is becoming a standard of care in the practice of low-vision rehabilitation. This is a retrospective study of PRL specifications and whether they have a correlation with the best-corrected visual acuities of patients with age-related macular degeneration.

Methods:
Seventy-two patients with macular degeneration (144 eyes) were included in the study. The PRLs were evaluated monocularly with a scanning laser ophthalmoscope. Each PRL's location, the fovea-PRL distance, the PRL edge of the lesion distance, and PRL stability were measured with the built-in caliper of the ophthalmoscope.

Results:
The most frequent location of a PRL was nasal (29.2%). The PRL was located in the left visual field of 34.0% of the patients. The best-corrected visual acuity values were positively correlated with the lesion's vertical and horizontal dimensions, as well as its surface area, the PRL-fovea distance, the PRL border of the lesion distance, and PRL stability.

Conclusion:
The clinical PRL evaluation methodology that we describe can be used to facilitate making decisions on how to provide best visual rehabilitation to patients with a central scotoma.
Drugs in Dermatology
Authors: Eng David J. , Grigsby Phillip M. , Jacob Sharon E. 
Published: October 2017

ABSTRACT
A drug is a substance used to cause a physiological change in the human body. In dermatology, drugs that treat different disorders usually fall into three categories: oral, topical, and biologic medications. Topical drugs include antibacterial and antifungal creams, corticosteroids, and gels. This column will explore the mechanism of action of Ameluz as well as its efficacy, dosage, administration, adverse effects, and alternatives.
Increasing the Accessibility of Sexual Assault Forensic Examinations: Evaluation of Texas Law SB 1191
Authors: Davis Robert C. , Auchter Bernard , Howley Susan , Camp Torie , Knecht Ilse , Wells William 
Published: October 2017

Introduction:
Texas SB 1191 was enacted in 2013 with the intent of increasing access to medical forensic examinations for sexual assault victims by requiring every hospital with an emergency department to be prepared to provide a medical forensic examination if requested by a sexual assault victim. To realize that goal, the law also required basic forensic training for medical professionals before conducting a medical forensic examination as well as a requirement that hospitals develop a “plan to train personnel on sexual assault forensic evidence collection.”

Methods:
Interviews were conducted in 18 healthcare facilities (five with sexual assault nurse examiner [SANE] programs and 13 without SANE programs) in Dallas, Lubbock, and Austin to determine their awareness and compliance with SB 1191.

Results:
The data suggest that the law had a little effect on actual practice, and sexual assault survivors still sought a SANE program for a medical forensic examination.

Discussion:
Although SB 1191 is an important state level effort to make forensic examinations more readily available, it did not fully account for the challenges faced by smaller hospitals that do not see enough sexual assault victims to justify training staff to SANE standards and did not adequately address the training required by medical professionals to feel prepared to conduct a medical forensic examination.
Red blood cell distribution width independently predicts 1-month mortality in acute decompensation of cirrhotic patients admitted to emergency department
Authors: Turcato Gianni , Campagnaro Tommaso , Bonora Antonio , Vignola Nicola , Salvagno Gian Luca , Cervellin Gianfranco , Ricci Giorgio , Maccagnani Antonio , Lippi Giuseppe 
Published: October 2017

Aim
The aim of this study was to explore whether red blood cell distribution width (RDW) can help predict the risk of short-term mortality in patients with acute decompensation of cirrhosis.

Patients and methods
We carried out a retrospective analysis of all patients consecutively admitted to the emergency department (ED) of the University Hospital of Verona (Italy) for acute decompensation of liver cirrhosis, between 1 June 2013 and 31 December 2016. The RDW value was measured at ED admission, along with collection of clinical features and other laboratory data, and was then correlated with severity of disease (Chronic Liver Failure Consortium Acute Decompensation score; CLIF-C AD score) and 1-month mortality.

Results
The final study population consisted of 542 patients, 80 (14.8%) of whom died within 30 days after ED admission. The median RDW of patients who died was significantly higher than the median RDW of those who survived (17.4 vs. 15.5%; P<0.001). The percentage of patients who died significantly increased across different RDW quartiles (6.8, 9.7, 11.5 and 32.1%, P<0.001). In univariate analysis, significant correlation was observed between RDW and clinical severity of acute decompensate cirrhosis (Child–Pugh score: r=0.198, P<0.001; Model for End-Stage Liver Disease score: r=0.311, P=0.001; CLIF-C AD: 0.127, P=0.005). The combination of RDW and CLIF-C AD score exhibited better performance for predicting 1-month mortality than the CLIF-C AD score alone (area under the curve=0.769 vs. 0.720; P=0.006). In multivariate analysis, RDW was independently associated with a 1.2–2.3 higher risk of 1-month mortality.

Conclusion
The assessment of RDW at ED admission may improve risk stratification of patients with acute decompensation of cirrhosis.
Efficacy and Acceptability of Psychotherapy for Anxious Young Children
Authors: Zhang Hanping , Zhang Yuqing , Yang Lining , Yuan Shuai , Zhou Xinyu , Pu Juncai , Liu Lanxiang , Jiang Xiaofeng , Xie Peng 
Published: October 2017

Abstract
We aimed to provide an overview of psychotherapy in young anxious children (mean age, <7 years). Seven electronic databases, including PubMed, EMBASE, Cochrane, Web of Science, PsycINFO, CINAHL, and ProQuest Dissertations, were searched. Randomized controlled trials that compared psychotherapies with control conditions were included. Efficacy (score change on an anxiety rating scale and rate of being freed from anxiety) and acceptability (discontinuations due to any event) were evaluated. Six of the total seven studies included in our study adopted cognitive behavioral therapy (CBT), with only one adopting behavior therapy (BT). Psychotherapy effectively reduced anxiety symptoms (standardized mean difference = −0.83; 95% confidence interval [CI], −1.08 to −0.57), and its rate of freeing patients from anxiety was high (risk ratio [RR] = 0.30; 95% CI, 0.19 to 0.47). No remarkable difference for acceptability was found between the two therapy types (RR = 0.54; 95% CI, 0.25 to 1.18). Psychotherapy, both CBT and BT, benefits young anxious children.
Efficacy of Armeo® Robotic Therapy Versus Conventional Therapy on Upper Limb Function in Children With Hemiplegic Cerebral Palsy
Authors: El-Shamy Shamekh Mohamed 
Published: October 2017

Objective
The aim of this study was to examine the efficacy of Armeo robotic therapy, compared with conventional therapy, on upper limb function in children with hemiplegic cerebral palsy.

Design
Thirty children with hemiplegic cerebral palsy, with ages ranging from 6 to 8 yrs, were selected for this randomized controlled study and randomly assigned to two groups. The study group (n = 15) received 12 wks of Armeo robotic therapy (45 min/session, 3 days/wk) and the control group (n = 15) received conventional therapy for the same period. The measured outcomes were the Modified Ashworth Scale and the Quality of Upper Extremity Skills Test, measured at baseline and after 12 wks of intervention.

Results
Children in the study group showed significant improvement in the mean values of all the measured variables, compared with those in the control group (P < 0.05). Postintervention Modified Ashworth Scale scores for the study and control groups were 1.6 (0.3) and 2 (0.5), respectively. Postinterventional Quality of Upper Extremity Skills Test total scores for the study and control groups were 84.6 (2.7) and 79.1 (2), respectively.

Conclusions
Armeo robotic therapy is significantly more effective than conventional therapy in improving the upper limb quality of movement in children with hemiplegic cerebral palsy.
Osteogenesis of Crouzon-Mutated Cells in an Experimental Model
Authors: Alcon Andre , Metzler Philipp , Eswarakumar Jacob , Wilson Alexander T. , Steinbacher Derek M. 
Published: October 2017

Abstract
Crouzon syndrome is an autosomal-dominant congenital disease due to a mutation in the fibroblast growth factor receptor 2 protein. The purpose of this study is to evaluate wound-healing potential of Crouzon osteoblasts and adipose-derived stem cells (ADSCs) in a murine model. Parietal skull defects were created in Crouzon and mature wild-type (WT) CD-1 mice. One group of WT and Crouzon mice were left untreated. Another group was transplanted with both WT and Crouzon adipose-derived stem cells. Additional groups compared the use of a fibrin glue scaffold and periosteum removal. Skulls were harvested from each group and evaluated histologically at 8-week and/or 16-week periods. Mean areas of defect were quantified and compared via ANOVA F-test. The average area of defect after 8 and 16 weeks in untreated Crouzon mice was 15.37 ± 1.08 cm2 and 16.69 ± 1.51 cm2, respectively. The average area of the defect in untreated WT mice after 8 and 16 weeks averaged 14.17 ± 1.88 cm2 and 14.96 ± 2.26 cm2, respectively. WT mice with autologous ADSCs yielded an average area of 15.35 ± 1.34 cm2 after 16 weeks while Crouzon mice with WT ADSCs healed to an average size of 12.98 ± 1.89 cm2. Crouzon ADSCs transplanted into WT mice yielded an average area of 15.47 ± 1.29 cm2 while autologous Crouzon ADSCs yielded an area of 14.22 ± 3.32 cm2. ANOVA F-test yielded P = .415. The fibroblast growth factor receptor 2 mutation in Crouzon syndrome does not promote reossification of critical-sized defects in mature WT and Crouzon mice. Furthermore, Crouzon ADSCs do not possess osteogenic advantage over WT ADSCs.
Primary Central Nervous System Lymphoma of Optic Chiasma: Endoscopic Endonasal Treatment
Authors: Ozdemir Evin Singar , Yildirim Ali Erdem , Can Aslihan Yavas 
Published: October 2017

Background:
Isolated primary central nervous system lymphoma arising from anterior visual pathway is very rare.

Patient Presentation:
A 76-year-old immunocompetent previously healthy man presented bilateral decreased visual acuity in 1 month. Pituitary magnetic resonans imaging (MRI) showed a lobulated mass with homogeneous enhancement after gadolinium administration that arising from optic chiasm suggested that inflammatory disease or an optic glioma. The patient underwent an extended endoscopic endonasal transsphenoidal surgery. Postoperative course and outcomes were wonderful. Histopathological diagnosis was diffuse large B-cell lymphoma. The patient underwent investigations for systemic lymphomatous involvement, did not detect any evidence of systemic disease.

Conclusion:
In this case, we claimed that differential diagnoses of anterior visual pathway lesions are difficult because of similarity of lesions on clinical and radiological examinations. Biopsy is essential for these lesions. As a biopsy technique, endoscopic endonasal transsphenoidal approach is safer and more effective than open procedures.
Dermal Regenerative Template as a Cost-Effective Alternative for Complex Scalp Reconstruction
Authors: Agochukwu Nneamaka B. , Wong Lesley , Liau James Y. 
Published: October 2017

Background:
Use of dermal regeneration template (DRT) is well documented in the literature for complex wounds ranging from the scalp, trunk, and lower extremity.

Methods:
A retrospective cohort study was performed of the use of dermal regeneration template and skin grafting. A literature review was performed of all studies where DRT was used for scalp reconstruction.

Results:
Patients in the DRT cohort had an average age of 70, with wounds averaging 108 cm2 in size. These patients also had a relatively low rate of complications (0.4), a short hospital stay (average 2 days), and a relatively short operating room time (114 minutes).

Conclusion:
This study demonstrates dermal regeneration template to be an effective and reliable option for soft tissue reconstruction with minimal morbidity and complications in patients with extensive medical comorbidities. Emerging applications include radiation exposure and hypercoaguable states.