bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rugwind van de WRR, tegenwind verzekerd
Authors: Fonteijn Chris 
Published: November 2015

Rugwind van de WRR, tegenwind verzekerd
De auteur is verheugd te zien dat er veel parallellen zijn tussen de aanbevelingen van de WRR en de strategie en werkwijze van ACM. ACM voelt zich daardoor gesteund, want hun opvattingen en de daarop gebaseerde toezichtstijl zijn niet zonder controverse. Veranderingen gaan nu eenmaal nooit zonder slag of stoot. De auteur gaat op enkele van de aanbevelingen in het bijzonder in.
De responsieve toezichthouder
Authors: van Erp Judith , van Wingerde Karin 
Published: November 2015

De responsieve toezichthouder
In deze bijdrage vragen de auteurs aandacht voor een aspect van responsive regulation dat beter aansluit bij de handhavingspraktijk; namelijk dat het de vraag adresseert hoe toezichthouders gebruik kunnen maken van het maatschappelijke krachtenveld dat bestaat uit verschillende publieke en private partijen. Deze zogenoemde tripartite handhaving is ten onrechte onderbelicht gebleven en biedt aanknopingspunten om aan de maatschappelijke functie van toezicht die de WRR bepleit, verder invulling te geven.
Juridische ruggengraat toezicht mag niet ontbreken
Authors: Ottow Annetje , de Cock Buning Madeleine 
Published: November 2015

Juridische ruggengraat toezicht mag niet ontbreken
Juridische aspecten van het toezicht komen in het WRR-rapport slechts incidenteel aan de orde. In deze bijdrage gaan de auteurs door waar de WRR op dit punt ophield door nadere kleuring te geven aan de voor toezicht zo bepalende juridische context.
Toezicht: politiek opportunisme versus het veiligstellen van publieke belangen
Authors: de Bijl Paul 
Published: November 2015

Toezicht: politiek opportunisme versus het veilig stellen van publieke belangen
De WRR neemt een toezichtparadox waar. Er is een roep om meer toezicht, want er gaat van alles mis, en tegelijkertijd een roep om minder toezicht, want er zijn te veel regeltjes. Toezicht staat daarmee in de schijnwerpers. Het speelt niet direct een glansrol in deze voorstelling. De avond zou kunnen eindigen met applaus van het publiek – maar als er tussentijds gejoel uitbreekt, is het nog maar de vraag hoe de voorstelling zal aflopen.
Het publieke belang van professionele toezichthouders
Authors: de Ridder Ko 
Published: November 2015

Het publieke belang van professionele toezichthouders
In dit artikel bespreekt de auteur het WRR-rapport vanuit het perspectief van de toezichthouder. Hiermee doelt hij op de ‘toezichthoudende instantie’ maar meer nog op de ‘persoon van de inspecteur’
Toezicht op publieke belangen, een reactie
Authors: Roeters Annette , Verkroost Jos 
Published: November 2015

Toezicht op publieke belangen, een reactie
De auteurs bekijken het rapport vanuit het perspectief van de toezichthouder. Zij geven aan dat het rapport nog aanvulling verdient in het leggen van een verbinding met de medewerkers van de inspecties die het werk op straat, in de bedrijven en in de instellingen uitvoeren en die aan de reflecties gestalte moeten geven.
Repliek vanuit de Wetenschappelijke Raad voor het Regeringsbeleid
Authors: Knottnerus André , Bokhorst Meike , de Goede Peter , Welp Pieter 
Published: November 2015

Repliek vanuit de Wetenschappelijke Raad voor het Regeringsbeleid
Het feit dat een groot aantal experts de tijd en moeite heeft genomen om te reflecteren op het advies past goed bij wat de WRR beoogt: het entameren van een brede discussie over de toekomst van het overheidstoezicht. In hun reactie op de bijdragen in dit nummer gaan de medewerkers van de WRR kort in op de relevante observaties, opmerkingen en ideeën die naar voren zijn gebracht.
Safety and Efficacy of the Treatment of Cellulite and Contour Irregularities Utilizing a Petite Handpiece with a Dual Wavelength Laser-Suction Device with Massage
Authors: Saluja Raminder , Dumais Bonnie 
Published: November 2015

Introduction: To evaluate the safety and efficacy of a petite handpiece with a low-level, dual-wavelength laser energy and massage device for the treatment of cellulite and contour irregularities. Materials and Methods: Thirteen female subjects with mild to moderate cellulite and contour irregularities were enrolled in the study. Eight treatments, delivered twice weekly, were performed with the low-level, dual-wavelength laser and massage device using a new petite handpiece. Digital photography, weight, body mass index, and circumference measurements were recorded at baseline, 1 week, 1 month, and 3 months. Patient satisfaction surveys were conducted via a 6-point numerical grading system (ranging from 1 = extremely dissatisfied to 6 = extremely satisfied) at 1 week, 1 month, and 3 months after treatment. Results: Improvement in the appearance of cellulite and circumference reduction was found to be highest in patients receiving treatment to smaller areas (arms, knees, and upper back). The patient satisfaction rating was very high, and all patients would recommend the treatment to a friend or family member. Conclusions: Low-level, dual-wavelength laser energy and massage treatment using the petite handpiece safely improves the appearance of cellulite affecting the upper back, arms, abdomen, and knees.
Ptosis Due to Levator Disinsertion: A Specific Entity
Authors: Irfan Sameera 
Published: November 2015

Introduction: The purpose of this study is to clarify that ptosis due to levator disinsertion (traumatic) is a distinct entity from levator dehiscence (involutional). Materials and Methods: This was a prospective study of 12 consecutive cases of levator disinsertion seen in the oculoplastic department of a tertiary referral center between October 2009 and June 2012. There were 5 men and 6 women, one of whom had bilateral ptosis. Their ages ranged between 57 and 64 years in 11 cases; the 12th case was a 20-year-old woman. Eleven cases had had cataract surgery 6 months to 2 years previously while the 20-year-old woman developed sudden ptosis after rubbing her eye because of vernal keratoconjunctivitis. All had severe to total ptosis with very poor levator function (<4.0 mm) and a margin reflex distance 1 (MRD1) between −2.0 mm to −4.0 mm. They were managed by levator reinsertion performed by a single surgeon (S.I.) and followed up at 1 week, 1 month, and 6 months postoperatively. Results: Intraoperatively, the levator aponeurosis was found detached from the tarsal plate and retracted high up in the upper fornix. Postoperatively, the patients had good cosmesis with symmetrical palpebral aperture heights of 9.0–9.5 mm, MRD1 of 4.0–5.0 mm, and symmetrical upper lid creases. There was no recurrence of ptosis in any patient. Conclusions: This study highlights the fact that levator disinsertion is a specific clinical entity. All of the patients presented with severe ptosis and a very poor to absent levator function. This situation should not entice a surgeon to perform a brow suspension, however; the patients simply need a levator reinsertion without a levator resection.
Prevention of Venous Thromboembolism in Abdominoplasty
Authors: Ferneini Elie , Sohn Andrew , Ferneini Christina , Tobin Howard 
Published: November 2015

Introduction: Venous thromboembolism is an important and life-threatening complication associated with abdominoplasty, a common cosmetic procedure. Materials and Methods: A retrospective study of 100 consecutive patients who underwent abdominoplasty in an outpatient setting. Results: The complication rate was 35%. The most common complication was wound separation. No patient developed deep vein thrombosis, although 2 patients developed postoperative abdominal hematoma due to Lovenox prophylaxis. Conclusions: Abdominoplasty was found to be a safe and predictable outpatient procedure in our patient population.
Treatment of Large Keloids with Secondary-Intention Healing
Authors: Young Phillip , Fisher Michelle , Segel Jamie , Stucker Fred , Becker Adam , Chen Achih 
Published: November 2015

Introduction: The use of secondary-intention healing for the treatment of large keloids of the neck and chest is described. Materials and Methods: Three patients presenting for treatment of large keloids in an academic and private practice setting were treated by resection with the CO2 laser and healing by secondary intention. After epithelialization, Kenalog was injected at monthly intervals for a total of 6 injections. Photodocumentation was carried out after epithelialization, if any changes were noted, and at the end of injections to monitor any regrowth. If regrowth was noted after comparing photos with the patient's current status, steroids were resumed. Results: There were mild recurrences of the keloid after the procedure; however, the patients demonstrated a notable improvement from the preoperative state, and patient satisfaction was high. Conclusions: The use of secondary intension healing for large keloids in the neck and chest is a unique method in the armamentarium of treatments for a difficult problem.
Advanced Aesthetic Facial Rejuvenation: Sculptural Fat Restoration by Autologous Fat Transfer with Adipose-Derived Stem Cell Therapy
Authors: Schmid Peter Michael 
Published: November 2015

Introduction: The aging process uniquely challenges facial aesthetics by inherent variable soft-tissue and structural remodeling. Rejuvenation of the aging face by autologous fat transfer (AFT) enriched with adipose-derived stem cells (ADSCs) remains a treatment option for volume restoration and contour deficiencies, establishing facial harmony and beauty. Successful outcomes incorporate artistic principles and sound fat-grafting techniques. Materials and Methods: The author presents a review of current scientific PubMed literature and sculptural resources on facial aging, aesthetics, and autologous fat and stem cell grafting and describes advanced fat-grafting techniques for facial rejuvenation. Results: Improved clinical fat graft survivability and aesthetic outcomes have been observed in 50 patients treated by the proposed techniques of autologous fat graft and stem cell recipient bed preparation administered by sculptural fat transplantation. Conclusions: Sculptural fat restoration integrated with AFT and selective ADSC seeding is an important key to facial rejuvenation, producing aesthetically pleasing and lasting results.
A Pilot Prospective Comparative Trial of High-Intensity Focused Ultrasound versus Cryolipolysis for Flank Subcutaneous Adipose Tissue and Review of the Literature
Authors: Friedmann Daniel P. , Mahoney Leysin , Fabi Sabrina , Goldman Mitchel P. 
Published: November 2015

Introduction: Multiple treatment modalities exist for noninvasive body sculpting and reduction of focal adipose deposits, including high-intensity focused ultrasound (HIFU) and cryolipolysis. The focus of this study was to compare the efficacy of HIFU and cryolipolysis in the reduction of localized subcutaneous adipose tissue in the flank region. Materials and Methods: Eight female patients with subcutaneous adipose tissue localized to the bilateral flanks were randomized to a single treatment with either HIFU or cryolipolysis to each flank. Weight and widest-point waist circumference were recorded at baseline and at 4 monthly follow-up visits, with no significant change in weight over the study period. Two blinded investigators graded baseline and 4-month follow-up photographs for improvement using a 5-point global aesthetic improvement scale. Results and Discussion: Although both HIFU and cryolipolysis led to modest reductions in localized flank subcutaneous adipose tissue, there was a trend toward greater improvement in the HIFU treatment group.
Finger Dissection Followed by Squeeze Method for Cosmetic Excision of Subcutaneous Lipoma and its Results: Our Experience
Authors: Khan Parwez Sajad , Hayat Humera 
Published: November 2015

Introduction: We used finger dissection followed by the squeeze method for subcutaneous lipoma excision and report the aesthetic and treatment results of this procedure. Materials and Methods: A small cosmetic skin incision was made that would allow one finger for dissection. The lipoma was freed along all its sides and base and finally delivered by applying constant but gentle squeezing until the lipoma was completely delivered. Results: From June 2008 through June 2010, a total of 200 patients with subcutaneous lipomas who were attending our outpatient department were included in the present study. The patients were subjected to cosmetic excision of subcutaneous lipomas using finger dissection followed by the squeeze method. No technical difficulties were encountered in treating any of the patients. All of the patients were satisfied with the procedure, especially with the cosmetic wound scar. Conclusions: Our study supports the use of finger dissection followed by the squeeze method for cosmetic excision of subcutaneous lipoma.
Weight Loss Tongue Patch: An Alternative Nonsurgical Method to Aid in Weight Loss in Obese Patients
Authors: Chugay Paul N. , Chugay Nikolas V. 
Published: November 2015

Introduction: Despite efforts on the part of patients, some are not able to achieve significant weight loss because of poor compliance with balanced diets and exercise programs. The tongue patch is a means of ensuring that the patient abides by a strict low-calorie diet plan to achieve maximal weight loss, while engaging in a moderate exercise regimen. Materials and Methods: A retrospective chart review was performed on patients who underwent the tongue patch procedure from 2009 to 2013. All patients had a piece of marlex mesh affixed to the tongue using prolene sutures. At the 30-day mark, each patient's weight was recorded. Data were then tabulated. Complications were also identified from the patient charts and analyzed. Results: A total of 81 patients received the tongue patch. Mean weight loss was 7.26 kg (16.0 lb; range = 0–16.8 kg/0–37 lb). The total weight lost by all participants was 501 kg (1104.5 lb). The average starting body mass index was 32.4 kg/m2 (range = 24.3–45.3 kg/m2) and average change in body mass index was 2.9 kg/m2 (range = 0–5.1 kg/m2). No serious complications were noted. Conclusions: While maintaining a strict low-calorie diet plan and adhering to a regular exercise regimen, patients using a tongue patch can achieve significant weight loss over a 30-day period with relatively minimal procedural risk.
Small-Incision Lower Lid Entropion Repair: Description of a Novel Procedure
Authors: Ramey Nicholas A. , Woodward Julie A. , Rose John G. 
Published: November 2015

Introduction: To describe a novel technique for lower lid entropion repair using a small incision with minimal dissection. To present surgical indications, initial outcomes, and complications associated with this technique. Materials and Methods: The small-incision lower lid entropion repair technique is described. A retrospective chart review of the first 5 consecutive patients undergoing this procedure in 2011 was conducted at the Dean Clinic of Madison, Wis. The medical records of these adult patients undergoing the small-incision repair were reviewed for surgical outcome, complications, and reoperation period, if applicable. Results: Of the first 5 consecutive patients undergoing this technique for small-incision entropion repair in 2011, all patients experienced surgical success. One patient experienced recurrence 6 months after the operation, following cataract surgery. Conclusions: This small-incision procedure is a safe and fast technique suitable for selected cases of involutional lower lid entropion.
Upper Eyelid Fat Excision through a Brow-Lift Incision: An Investigation of Technique and Anatomic Landmarks
Authors: Fattal Michael H. , Spiegel Jeffrey H. 
Published: November 2015

Introduction: Brow-lift and upper blepharoplasty are often done sequentially to achieve adequate rejuvenation of the upper face. We describe the feasibility of a novel method of addressing both the aged forehead and upper eyelid fat pseudoherniation via an open brow-lift approach. Materials and Methods: We performed our technique on 6 cadaver and 3 human subjects. A brow-lift was performed in open fashion followed by upper eyelid fat excision through the superiorly exposed orbital septum. Position of the orbital fat from this approach and its ease of excision were recorded. Results: In all cases, the medial and central fat compartments were medial and lateral to the supraorbital nerve, respectively. Fat was accessible and amenable to excision from this approach. There were no complications related to this technique. Conclusions: When upper eyelid dermatochalasia is resolved when an open brow-lift is performed, this technique addresses upper eyelid fat pseudoherniation through the same brow-lift incision. Although this procedure is feasible and safe, long-term results in a greater number of patients are needed to confirm its role in aesthetic surgery.
Abdominoplasty Combined with Cesarean Section: Discussion of the Evidence
Authors: Benn Teri E. , Spera Carlos E. 
Published: November 2015

Introduction: Many women are interested in having abdominoplasty performed at the time of cesarean section. Women would like to remove the excess skin and stretch marks that form during pregnancy. Abdominoplasty has been combined with other procedures and appears to be safe. Therefore, a literature review was done to investigate the data regarding combination abdominoplasty cesarean section. Materials and Methods: A literature search was done in PubMed, EBSCO, and the Cochrane Database using search terms for abdominoplasty and cesarean section. No articles were found in EBSCO or Cochrane databases, but PubMed yielded results. Results: One clinical research study was found that specifically compared abdominoplasty with combined abdominoplasty cesarean section. This study recommended against combining these procedures. Based on this literature search as well as the literature search reported by this article, there are no other studies that investigated this combined procedure. Conclusions: Given the one clinical study as well as general logistics and safety of combining abdominoplasty with cesarean section, more research may not be needed into this procedure. Combining abdominoplasty with other gynecologic procedures seems to have different risks and aesthetic outcomes than when combined with cesarean section.
Low-Level Laser Therapy: An Alternative Treatment for Capsular Contraction
Authors: Johnson Jason D. , Glat Paul M. , Scarlett William L. 
Published: November 2015

Introduction: Fibrous capsular contracture is the most frequent complication leading to patient dissatisfaction after breast augmentation and breast reconstruction. This multi-factorial phenomenon has been treated both surgically and nonsurgically with mixed results. At the present time, the more severe grades of capsular contracture are treated most successfully by surgical means. Materials and Methods: The LTU-904 laser was used on 33 patients with grades III and IV capsular contractures. Patients underwent laser treatments once a week for a period of 6 weeks. They received a 10-minute treatment using the 904-nm laser with a 2-cm square grid pattern with 1 minute of treatment in each area (300 mJ/1 min treatment = 1.5 J/cm2). Patients were administered a posttreatment survey to determine their level of improvement and satisfaction. Results: Surgical intervention was avoided in 93.9% of patients with grade III and IV capsular contraction. Of the patients who avoided surgery, the laser improved the stiffness of the breast by 10–95% (average, 43.6%) and an overall improvement in comfort ranging from 10–95% (average, 48.2%). Conclusions: Low-level laser therapy is a promising alternative treatment for grades III and IV capsular contracture. In most cases, both the patient and surgeon observed significant tissue softening and improved breast contour after treatment while avoiding surgical intervention.
Intense Pulsed Light vs Intense Pulsed Light Plus Oral Isotretinoin in Facial Rejuvenation
Authors: Hernández-Pérez Enrique , Duque Ricardo Ramírez , Khawaja Hassan Abbas 
Published: November 2015

Introduction: Because intense pulsed light (IPL) and oral isotretinoin (ISOT) are capable of improving photoaging, we tried to demonstrate if IPL alone is as effective as a combination of both procedures. Materials and Methods: We carried out an open, randomized, comparative, and descriptive trial in 18 Hispanic women with cutaneous aging grades II and III (Glogau). Patients were divided into 2 groups. In the frst group, only IPL was used with an Alma Laser Harmony XL machine, and 5 sessions of IPL were performed, with an interval of 2 weeks between them. At the beginning, the fluence was 12 J/cm2 and the time 12 ms, then it was increased to 13 J/cm2 and 12 ms, respectively. The second group received the same number and type of sessions of IPL, but we added oral ISOT, 20 mg 3 times a week for 10 weeks. Two 3-mm punch biopsies were taken, always from the same site: the first one, immediately prior to the beginning, and the second one 3 weeks after the end of the study. Follow-up was made 6 months after finishing the study. Controls were performed supported upon the physician, 1 nurse (always the same), and the patient herself, microscopic (2 dermatopathologists), and statistical. Conclusions: At the end, the combination IPL/ISOT proved to be better than IPL alone, not only clinically, but microscopically and statistically. No side effects were observed.
Treatment of Submental Fat Deposit with Cholanic Acid Intra-Adipocyte Lipolysis Compared with Liposuction Prospective Study
Authors: Makkar Rami M. 
Published: November 2015

Introduction: Over the years, liposuction has been the standard treatment for localized fatty deposit. Lipolysis is a controversial procedure based generally on phosphatidylcholine and deoxycholate injection. The purpose of this study was to compare the efficacy of cholanic acid Aqualyx with the efficacy of liposuction in women with moderate submental fatty collection. Materials and Methods: A prospective randomized study of 30 women with moderate submental fatty collection. Half of the subjects were treated with cholanic acid Aqualyx and the other half with liposuction. Responses were assessed clinically and statistically. Results: Although the lipolysis group showed a better response, it is difficult to conclude that adipocytolisis leads to greater fat reduction compared with liposuction.