bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Double “C” Plication Technique: A Reliable Technique for Lower Facial Rejuvenation: Review of 1500 Cases
Authors: Sadati Kevin , Corrado Anthony C. 
Published: July 2017

Introduction: Facial rejuvenation procedures have evolved significantly since they were first performed at the beginning of the 20th century. Modern SMAS lifting techniques focus on providing natural facial rejuvenation, durable results, fewer complications, and reduced morbidity. Many techniques exist, each proposing different methods to attain a common goal, resuspension of the SMAS. A simple new technique for SMAS plication of lower face and neck is introduced, called double “C” plication. This technique is reproducible and simple, creating lasting results for a natural look with a low complication rate. Materials and Methods: In over 1500 face-lifts in the last 4 years, the author has evolved a simple technique with a natural look. All cases were done with oral sedation and local anesthesia. Patients were ambulatory immediately following surgery and had a rapid recovery with little edema or ecchymosis. Nerve injuries were avoided, and the temple hairline and earlobe clefts were preserved. There are no ridges, dimples, or “joker lines.” Revision rate was less than 0.7%. This technique utilizes double running plication sutures in a “C” shape pattern for SMAS suspension, which can be placed via traditional or short-scar face-lift incisions. This technique provides an evenly distributed multi vector radial traction on the SMAS and lateral platysma, allowing for a more uniform suspension compared to traditional single plication and purse string sutures, which provide point specific tension. This SMAS plication technique tightens up the face just like lacing a shoe, making the entire lower face firm and youthful. The neck plication pulls the platysma up behind the ear to maintain the earlobe up in its normal anatomical position. Results: Over a 4-year period, 1532 procedures were performed utilizing the aforementioned double “C” lift technique with average follow-up of 18 months. This is a retrospective chart review of a single surgeon's rhytidectomy practice. Of the 1532 patients, 110 had undergone previous rhytidectomy by a different surgeon. Complications included in the evaluation process were major hematoma 1.3%, minor hematoma 5%, infection 0.5%, facial nerve injury 0%, greater auricular nerve injury 0.1%, post auricular skin necrosis (>2 cm) 0.8%, and revision rate 0.7%. Conclusions: The double “C” plication technique is a reliable, simple, and reproducible technique with natural results and low complications. This technique involves a double running plication suturing of SMAS and lateral platysma in a “C” shape pattern.
Treatment of Gynecomastia: Suction Curettage with Riblike-Projections-Cannula
Authors: Boeni Roland 
Published: July 2017

Introduction: While excessive fat in pseudogynecomastia can easily be removed with standard liposuction methods, the removal of glandular tissue in gynecomastia often requires open excision. The objective of this study is to evaluate the efficacy of a cannula with riblike projections to remove glandular tissue in patients with gynecomastia. Materials and Methods: Forty-two male patients aged 21–67 years (mean age, 37.4 ± 13.9 years) with enlarged breasts were enrolled in the study. Over a 4-year period, all patients were treated with tumescent liposuction using 1 or 2 entry sites from the axillary fossa. Lipoaspiration of excessive breast fat was first performed with a standard liposuction cannula, thus isolating the breast gland. Glandular tissue was then broken down and removed with a cannula with riblike projections using the same entry sites. Results: No open excision or skin reduction procedures were required. None of the patients had early postoperative complications of infection, hematoma, or seroma. There were no treatment-induced asymmetries, dimples, or hyperpigmentation. Conclusions: Fibrous glands in gynecomastia can effectively be removed with a cannula with riblike projections, resulting in high patient satisfaction. This method does not result in additional scars and is safe and easy to use by the dermatologic surgeon.
Lipid Rescue: Lifesaving Treatment for Toxicity and Cardiac Arrest Secondary to Local Anesthetics Including Bupivacaine
Authors: Shiffman Melvin A. 
Published: July 2017

The occurrence of toxicity from local anesthetics has been reported, including cardiac toxicity resulting in cardiac arrhythmias and/or asystole. A variety of techniques have been used to treat local anesthetic toxicities; however, with cardiac arrest, a relatively new concept—lipid rescue—has been formulated that appears to be relatively successful. The author discusses the literature on local anesthetic toxicities and fatalities, animal research concerning lipid rescue, local anesthetic toxicities, and fatalities treated with lipid rescue, as well as the Practice Advisory on Treatment of Local Anesthetic Systemic Toxicity.
In vivo Endoscopy of Septal Fibers following Different Liposuction Techniques Reveals Varying Degrees of Traumatization
Authors: Fatemi Afschin 
Published: July 2017

Introduction: The removal of fat via liposuction requires disruption of adipose tissue and the intrinsic collagen-based septal fiber network that supports and protects the blood and nerve supply to adipose tissue. Using septal fiber preservation as a marker for the relative trauma of a given liposuction technique, we quantified and compared the number of intact septal fibers following various liposuction methods using in vivo endoscopy. Materials and Methods: Pilot studies using endoscopic imaging and quantification were conducted in 3 study groups that included 52 abdominoplasty patients, 12 cadavers, and 32 liposuction patients. Liposuction techniques performed included laser-assisted (924/975-nm LAL), power-assisted (PAL), suction-assisted (SAL), ultrasound-assisted (UAL), and power water-assisted liposuction (WAL). Gross dissection and in vivo endoscopy were used to qualitatively and quantitatively evaluate septal fiber preservation. Results: The highest numbers of intact septal fibers were observed following either 924/975-nm LAL or PAL. SAL treatments left, on average, two thirds the number left after LAL or PAL. UAL and WAL were the most damaging, leaving one half or one third the number of fibers seen after LAL or PAL, respectively. In addition, 924/975-nm LAL and PAL were associated with less skin necrosis and blood in the aspirate as compared with WAL. Microscopy studies revealed that the greatest adipocyte cell membrane disruption occurred following 924/975-nm LAL. Conclusions: These findings demonstrate that 924/975-nm LAL and PAL were associated with the greatest preservation of septal fibers while UAL and WAL were the most damaging. The 924-nm LAL was also the most effective technique for disrupting adipocyte cell membranes.
Surgical Management of Symptoms and Aesthetic Sequels of a Spontaneously Resolved Vulvar Hemangioma
Authors: Hailparn Troy Robbin 
Published: July 2017

Introduction: A spontaneously resolved vulvar hemangioma can cause clinical symptoms and aesthetic deformities. Reduction and reconstruction of the affected labia majora can restore gross and functional anatomy and offers an opportunity to gain greater insight into the emotional and physical effects of labial problems. This report shares a unique case in which an elective reduction and reconstruction of the left labium majus were performed on a 16-year-old young woman. Materials and Methods: Surgical reduction and reconstruction were performed under general anesthesia. Prophylactic intravenous antibiotics were provided 30 minutes before surgical intervention. Results: Restoration of gross and functional anatomy was achieved with satisfactory aesthetic results. There were no intraoperative, short-term, or long-term complications. Minimal blood loss was recorded. Postoperative course and recovery were uneventful. The patient was satisfied on multiple levels. Her body image and daily quality of life were markedly improved. Conclusions: In this case, reduction and reconstruction of the labium majus for a spontaneously resolved hemangioma were well-tolerated, and complications were not observed. A satisfactory restoration of gross and functional anatomy resolved clinical symptoms and improved aesthetic appearance. It also helped alleviate the patient's emotional and body-image concerns.
Subcaruncular Approach for Medial Eyelid Repair: A Simplified Technique
Authors: Goel Shubhra , Lemke Bradley N. , Burkat Cat N. 
Published: July 2017

Introduction: Laxity of the medial canthal tendon (MCT) is commonly encountered in clinical practice. The techniques described in the literature to correct MCT laxity often involve extensive dissection, with potential risk to the lacrimal system. We describe a simple and minimally invasive MCT repair in which the medial eyelid is secured to the anterior central portion of the MCT via a subcaruncular approach without disturbing the normal eyelid position or the lacrimal system. Materials and Methods: A retrospective analysis of 30 patients undergoing MCT repair in all 4 eyelids was performed. Eyelids with moderate to severe MCL laxity were treated by this technique. Results: Patient age ranged between 55 and 90 years, with a mean of 74.2 years. Upper lid distraction ranged from 8–20 mm (mean 13 mm). Lower lid distraction ranged from 14–30 mm (mean 23.4 mm). In 87% of patients, eyelid laxity diminished postoperatively, and 13% had incomplete correction of the laxity with recurrence of symptoms. Recurrence was attributed to sutures pulling through attenuated lax lids and to mechanical eyelid stretching caused by sleeping on the face and/or rubbing the eyes. After reoperation in 3 patients, the lids regained normal position and tone, and symptomatic improvement was noted. No patients had postoperative complications involving the lacrimal system with this approach. Conclusions: The described MCT repair technique is an anatomically simple approach for eyelids with moderate to severe MCT laxity; it may be useful for surgeons who otherwise would defer complex repair of the MCT.
One Hundred Consecutive Lipoabdominoplasty Procedures: Modified Avelar Technique for Full Abdominoplasty without Panniculus Undermining—Advances, Morbidity, and Complications
Authors: Rodriguez Filiberto , Borsand Marvin A. 
Published: July 2017

Introduction: Abdominoplasty can be limited by preexisting scars and is associated with postoperative drains, seromas, and deep vein thrombosis (DVT). The Avelar technique has been described as an alternative to extensive flap dissection. We adopted this technique in 2007. Materials and Methods: The lower abdomen is marked for planned resection. Liposuction is performed throughout the entire abdomen below Scarpa's fascia and superficially in the lower abdomen to thin the redundant pannus. The skin is sharply incised, and the thinned pannus is bluntly avulsed, leaving the subcutaneous fat and vessels intact. The upper abdominal skin can be slid over the deep fascia, preserving the perforating vessels. A narrow tunnel is dissected from the umbilicus to the xiphoid for rectus plication. The umbilicus is transposed in the usual manner. All patients receive DVT prophylaxis with perioperative heparin, sequential compression devices, and Lovenox. Surgery is ambulatory, and drains are not routinely used. Results: Between April 2007 and December 2010, 100 consecutive lipoabdominoplasty procedures were performed. There were no DVTs and no deaths. One patient sustained small-bowel injury during liposuction, which was immediately recognized and successfully repaired. Five hematomas (28 ± 28 mL) occurred within the early postoperative period, 2 of which became infected. Four hematomas responded to local drainage, but 1 required surgical evacuation 3 months later. The incidence of late seroma was 0%. Two marginal skin necroses occurred in patients with preexisting Kocher and laparotomy scars, which healed without ill effect. Conclusions: The incidence of wound dehiscence, seroma, hematoma, and DVT after lipoabdominoplasty is less than that reported for traditional abdominoplasty.
Periorbital Edema following Hyaluronic Acid Gel Injection: A Retrospective Review
Authors: Griepentrog Gregory J. , Lucarelli Mark J. , Burkat Cat N. , Lemke Bradley N. , Rose John G. 
Published: July 2017

Introduction: The purpose of this study is to investigate the incidence, clinical features, and treatment of prolonged periorbital edema following the injection of hyaluronic acid gel to the infraorbital hollows. Materials and Methods: Retrospective descriptive study. The medical records of patients from 4 physician practices with prolonged (≥1 month) periorbital edema following the placement of hyaluronic acid gel to the infraorbital hollows, diagnosed between January 1, 2008 and December 31, 2011, were reviewed. Results: A total of 51 charts were reviewed, of which 12 (24%) patients were diagnosed with prolonged periorbital edema with a mean follow-up time of 7.1 ± 4.2 months (range, 1.5–15.3 months). The mean patient age was 50.4 years (range, 36.4–64.9 years), and the edema lasted an average of 5.4 months (range, 2.7–5.3 months). A minority of patients had a preprocedural history of fluid retention (17%), seasonal allergies (25%), previous lower eyelid or midface surgery (25%), or festoons on examination (0%). Hyaluronidase was used to treat 3 of the 12 affected patients. Conclusions: In this retrospective review of patients undergoing hyaluronic acid gel injection to the periorbital region, prolonged periorbital edema of varying severity occurred in approximately 1 in 4 patients. There were no clinical symptoms or signs prior to injection that consistently identified patients susceptible to the edema. Most patients treated with hyaluronidase had successful improvement of their swelling.
Brow Suspension Suture Procedure
Authors: Barbarino Sheila Chang , Forouzanpour Faradad 
Published: July 2017

Introduction: This article describes a safe, effective, straightforward brow-suspension lifting technique that minimizes surgical time and can be performed under local anesthesia with predictable outcomes. Mersilene suture and a Keith needle were used to lift the medial and/or lateral brow, producing excellent surgical results. Materials and Methods: A retrospective study of 9 patients with medial or lateral brow ptosis were included in the study based on the following criteria: men with a brow height below the superior orbital rim either medially, laterally, or both; women with a brow position at or lower than the superior orbital rim medially, laterally, or both. The details of the procedure are presented. Results: All 9 patients who had the brow-suspension suture procedure reported a satisfactory result: normal brow level was restored for both men and women. Patients experienced no pain during the procedure, which was done under local anesthesia, and all were able to return to daily activities the next day. All patients indicated that if they had to undergo a brow lift again, they would prefer to have this procedure instead of the more conventional brow-lifting procedures. All of the procedures, including those that involved both medial and lateral brows, were performed under 30 minutes. Conclusions: The brow-suspension suture procedure is a safe, straightforward, minimally invasive alternative to conventional brow-lifting surgeries. It is time and cost efficient and produces effective outcomes.
Relationship between the method of detection and prognostic factors for breast cancer in a community with a screening programme
Authors: Baré Marisa , Bonfill Xavier , Andreu Xavier ,   The BCSP Research Group, Castanyer Eva , Darnell Ana , Florensa Ramon , Font Josep , Gallardo Xavier , Ganau Sergi , Montes Joan , Planas Jaume , Rabanal Elena , Rosell Ramon , Sáez Amparo , Seguí M. Ángel , Sentís Melcior , Tortajada Lídia , Villajos Maite 
Published: July 2017

Objectives To analyse and compare the prognostic factors of breast cancer in the target population of our community-screening programme as a function of the method of detection and to analyse the differences in the prognostic factors as a function of the patient's age and the screening episode. Setting A Breast Cancer-Screening Programme (BCSP) in Northeast Spain. Methods Observational study of all primary malignant breast lesions diagnosed in a woman between 50 and 69 years of age between 18 October 1995 and 31 December 2002. The 16 centres that women from the target population might have attended were contacted. Results A total of 225 (37.2%) of the lesions included were diagnosed through the BCSP, 59 (9.7%) interval cancers were detected, and 321 (53.1%) were detected through other circuits. Node involvement was significantly lower in the lesions detected at screening (32%) in comparison to the interval cancers (41.8%) and those detected through other circuits (47.5%). A significantly larger percentage of the interval tumours (28.6%) and the lesions diagnosed outside the BCSP (22.1%) scored 5.4 on the Nottingham Prognostic Index (NPI) than those diagnosed within the programme (10.9%). The relation between the NPI and the detection method was only statistically significant in the 65-69-year-old age group. The NPI score of the tumours detected by the BCSP showed a statistically significant association with age. Conclusion This analysis has shown notable differences in some prognostic factors for breast cancer according to the method of detection. Association between age and the a priori prognosis of the malignant lesions arises.
Number and characteristics of breast cancer cases diagnosed in four periods in the screening interval of a biennial population-based screening programme
Authors: Hofvind Solveig , Bjurstam Nils , Sørum Ragnhild , Bjørndal Hilde , Thoresen Steinar , Skaane Per 
Published: July 2017

Objective To describe the distribution and prognostic tumour characteristics of interval breast cancers diagnosed in four periods after index screen (1-6, 7-12, 13-18 and 19+ months) in a population-based screening programme inviting women aged 50–69 years to biennial screening. Setting The Norwegian Breast Cancer Screening Programme (NBCSP) Methods In all, 848 interval breast cancer cases were diagnosed in 437,235 screening examinations. The distribution and prognostic tumour characteristics of the interval cancers diagnosed in four periods in the screening interval will be described. Proportions and rates will be compared by χ2-test. Results A total of 70% of the interval cancers in the NBCSP were diagnosed in the second year of the interval. Except for tumour size (P = 0.027), we found no evidence of adverse prognostic breast characteristics (grade, lymph node involvement, oestrogen and progesterone receptor positive) in invasive tumours diagnosed during the second versus the first year of the screening interval (Chi square P 0.05 for all). The prognostic characteristics of the tumours did not differ by age groups. It was a decreasing interval cancer rate per 10,000 women-years by age. Conclusion The risk of interval cancer increases by time after index screen, and 70% of the interval cancers in the NBCSP were diagnosed in the second year of the interval. Prognostic histological tumour characteristics did not differ by time after index screen, thus mean sojourn time (tumour growth rate) seems important for stating an optimal screening interval in a population-based screening programme.
Public awareness of human papillomavirus
Authors: Cuschieri K S , Horne A W , Szarewski A , Cubie H A 
Published: July 2017

Objectives The main objective of this study was to review the evidence relating to the level of awareness of human papillomavirus (HPV) in the general population and the implications for the potential introduction of HPV vaccination and HPV testing as part of screening. Methods PubMed search performed on terms: ‘HPV education’, ‘HPV awareness’ ‘Genital Warts Awareness’ Results Public awareness of HPV is generally very low, particularly with respect to its relation to abnormal smears and cervical cancer although knowledge levels vary to some extent according to sociodemographic characteristics. There is also much confusion around which types cause warts and the types that can cause cancer. The sexually transmissible nature of the infection is of major concern and confusion to women. Conclusions Due to the lack of current awareness of HPV, significant education initiatives will be necessary should HPV vaccination and/or HPV testing be introduced. Organized edification of healthcare workers and the media, who constitute the two most preferred sources of information, will be crucial.
Acceptability of unsupervised HPV self-sampling using written instructions
Authors: Waller J , Mccaffery K , Forrest S , Szarewski A , Cadman L , Austin J , Wardle J 
Published: July 2017

Objectives The study measured the acceptability of self-sampling for human papillomavirus (HPV) testing in the context of cervical cancer screening. Women carried out self-sampling unsupervised, using a written instruction sheet. Setting Participants were women attending either a family planning clinic or a primary care trust for routine cervical screening. Methods Women (n = 902) carried out self-sampling for HPV testing and then a clinician did a routine cervical smear and HPV test. Immediately after having the two tests, participants completed a measure of acceptability for both tests, and answered questions about ease of using the instruction sheet and willingness to use self-sampling in the future. Results The majority of women found self-sampling more acceptable than the clinician-administered test, but there was a lack of confidence that the test had been done correctly. Significant demographic differences in attitudes were found, with married women having more favourable attitudes towards self-sampling than single women, and Asian women having more negative attitudes than women in other ethnic groups. Intention to use self-sampling in the future was very high across all demographic groups. Conclusion Self-sampling for HPV testing was highly acceptable in this large and demographically diverse sample, and women were able to carry out the test alone, using simple written instructions. Consistent with previous studies, women were concerned about doing the test properly and this issue will need to be addressed if self-sampling is introduced. More work is needed to see whether the demographic differences we found are robust and to identify reasons for lower acceptability among single women and those from Asian background.
Amalgamation of Talent and Knowledge Management Practices: A conceptual Research Model
Authors: Anbumathi R. , Sivasubramanian R. Chitra 
Published: July 2017

Purpose The major aim of the research is to review the talent management (TM) initiatives, knowledge management (KM) practices and the intervening effect of organizational culture, employee engagement and social capital on TM/KM relationship. Approach General review approach has been adopted, as the study reviews and discusses the TM initiatives and KM practices. Further, a theoretical model has been proposed amalgamating TM with KM practices. Originality/value Amalgamation of TM/KM has been discussed from the TM perspective in which this research has been designed in such a way that the impact of TM initiatives on KM practices is overviewed.