bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Ritonavir on 99mTechnetium–Mebrofenin Disposition in Humans: A Semi‐PBPK Modeling and In Vitro Approach to Predict Transporter‐Mediated DDIs
Authors: Pfeifer ND , Goss SL , Swift B , Ghibellini G , Ivanovic M , Heizer WD , Gangarosa LM , Brouwer KLR 
Published: January 2013

A semiphysiologically based pharmacokinetic (semi‐PBPK) model was developed to describe a unique blood, liver, and bile clinical data set for the hepatobiliary imaging agent 99mTechnetium–mebrofenin (99mTc–mebrofenin), and to simulate sites/mechanisms of a 99mTc–mebrofenin–ritonavir drug–drug interaction (DDI). The transport inhibitor ritonavir (multiple‐dose: 2 × 300 mg) significantly increased systemic 99mTc–mebrofenin exposure as compared with control (4,464 ± 1,861 vs. 1,970 ± 311 nCi min/ml; mean ± SD), without affecting overall hepatic exposure or biliary recovery. A novel extrahepatic distribution compartment was required to characterize 99mTc–mebrofenin disposition. Ritonavir inhibited 99mTc–mebrofenin accumulation in human sandwich‐cultured hepatocytes (SCH) (half maximal inhibitory concentration (IC50) = 3.46 ± 1.53 µmol/l). Despite ritonavir accumulation in hepatocytes, intracellular binding was extensive (97. 6%), which limited interactions with multidrug resistance protein 2 (MRP2)‐mediated biliary excretion. These in vitro data supported conclusions from modeling/simulation that ritonavir inhibited 99mTc–mebrofenin hepatic uptake, but not biliary excretion, at clinically relevant concentrations. This integrated approach, utilizing modeling, clinical, and in vitro data, emphasizes the importance of hepatic and extrahepatic distribution, assessment of inhibitory potential in relevant in vitro systems, and intracellular unbound concentrations to assess transporter‐mediated hepatic DDIs.CPT: Pharmacometrics & Systems Pharmacology (2013) 2, e20; doi:10.1038/psp.2012.21; advance online publication 2 January 2013
A Seventeenth-Century Source of Ornamentation for Voice and Viol: British Museum MS. Egerton 2971
Authors: Cyr Mary 
Published: January 2013

Many aspects of the performance of early seventeenth-century monodic song remain a mystery. On the basis of the musical notation alone, we might be tempted to wonder, as did Charles Burney,… how pleasing effects could be produced by such simple, unadorned, and almost unaccompanied melodies …. the expression of the Music of this period in Italy is so entirely lost, that, like a dead language, no one is certain how it was pronounced.
Making use of the vignette technique to examine methods of bereavement counselling: An exploratory study
Authors: Munday Helen 
Published: January 2013

AbstractAim: The principal objective of this small‐scale study was to examine methods of bereavement counselling because of their lack of clarity. Method: The study made use of the vignette technique along with six semi‐structured interviews analysed by means of thematic analysis. Findings: Results showed that bereavement counsellors are using a multitude of different and diverse methods of counselling, characteristic of postmodernism. Advantages of these postmodern methods are that bereavement counselling methods are rich, creative, supportive, pluralistic and attentive to otherness. However, disadvantages of these postmodern methods have led to a lack of consensus amongst experts, unclear methods and an anti‐methodological way of working by counsellors. Implications for practice: Postmodernism is inherent in bereavement counselling. As a result no two counsellors work in exactly the same way because of the difference in their background and experience similarly it can be said that no one counselling method has exclusivity due to the diverse nature of postmodernism.
Expression of Androgen, Estrogen, Progesterone, and Growth Hormone Receptors in Vascular Malformations
Authors: Kulungowski Ann M. , Hassanein Aladdin H. , Nosé Vânia , Fishman Steven J. , Mulliken John B. , Upton Joseph , Zurakowski David , DiVasta Amy D. , Greene Arin K. 
Published: January 2013

Background:
Vascular malformations frequently enlarge during adolescence, suggesting that hormones may be involved. The purpose of this study was to determine whether pubertal hormone receptors are present in vascular malformations and whether they differ from normal tissue.

Methods:
Tissue specimens (arteriovenous malformation, lymphatic malformation, and venous malformation) were prospectively collected from patients undergoing resection. Immunohistochemistry was used to determine the presence of androgen, estrogen, progesterone, and growth hormone receptors. The effects of age, sex, location, and malformation type on receptor expression were analyzed. Age-, sex-, and location-matched normal tissues served as controls.

Results:
Forty-five vascular malformation specimens were collected: arteriovenous malformation (n = 11), lymphatic malformation (n = 20), and venous malformation (n = 14). Growth hormone receptor expression was increased in arteriovenous malformation (72.7 percent), lymphatic malformation (65.0 percent), and venous malformation (57.1 percent) tissues compared with controls (25.8 percent) (p < 0.05). Growth hormone receptor was present primarily in the endothelium/perivasculature of malformations (93.1 percent), whereas in normal tissue growth hormone receptor was located only in the stroma (p < 0.0001). Neither age, nor sex, nor location influenced receptor expression (p = 0.9). No differences in androgen receptor, estrogen receptor, and progesterone receptor staining were found between malformations and control samples (p = 0.7).

Conclusions:
Growth hormone receptor is overexpressed and principally located in the vessels of vascular malformations. Growth hormone might contribute to the expansion of vascular malformations.
Comparison of Immediate Implant Placement versus the Staged Tissue Expander Technique in Breast Reconstruction
Authors: Roostaeian Jason , Sanchez Ivan , Vardanian Andrew , Herrera Fernando , Galanis Charles , Da Lio Andrew , Festekjian Jaco , Crisera Christopher A. 
Published: January 2013

Background:
Tissue expansion is currently the most common method used in prosthetic breast reconstruction. Skin-sparing mastectomy techniques have facilitated immediate placement of a permanent implant. Proposed benefits to immediate implants include less time and fewer operations to complete reconstruction. Whether it leads to poorer outcomes remains unknown. The authors compared immediate implant-based and staged tissue expander breast reconstruction.

Methods:
Thirty-five consecutive immediate implant-based breast reconstruction patients (62 breasts) and a matched group of 50 tissue expander immediate reconstruction patients (89 breasts) were identified. Normative data, complication rates, revision rates, number of office visits, total reconstructive time, and aesthetic outcomes were compared.

Results:
Demographic variables and surgical risk factors were similar in both groups. At a mean follow-up of 14 months, the overall complication rates were similar (p = 0.97), and the need for revision surgery was also similar (p = 0.94). Mean final implant volume did not differ between the two groups (397 ± 93 cc for implants and 386 ± 128 cc for expansion; p = 0.57). Mean number of office visits/time to nipple reconstruction was significantly different at 5.0 ± 4 versus 9.2 ± 3 visits (p < 0.001) and 22 ± 19 versus 43 ± 24 weeks (p < 0.001) in the implant versus tissue expander group, respectively. Aesthetic evaluation revealed no significant differences.

Conclusions:
Immediate implant-based breast reconstruction has similar complication rates, need for revision, and aesthetic outcomes but fewer office visits and less reconstructive time when compared with tissue expander immediate breast reconstruction. In the appropriately selected patient, it is a safe option that provides similar outcomes in less time compared with staged expander-based reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
The Effects of Acellular Dermal Matrix in Expander-Implant Breast Reconstruction after Total Skin-Sparing Mastectomy
Authors: Peled Anne Warren , Foster Robert D. , Garwood Elisabeth R. , Moore Dan H. , Ewing Cheryl A. , Alvarado Michael , Hwang E. Shelley , Esserman Laura J. 
Published: January 2013

Background:
Neither outcome after total skin-sparing mastectomy and expander-implant reconstruction using acellular dermal matrix nor a strategy for optimal acellular dermal matrix selection criteria has been well described.

Methods:
Prospective review of three patient cohorts undergoing total skin-sparing mastectomy with preservation of the nipple-areola complex and immediate expander-implant reconstruction from 2006 to 2010 was performed. Cohort 1 (no acellular dermal matrix) comprised 90 cases in which acellular dermal matrix was not used. Cohort 2 (consecutive acellular dermal matrix) included the next 100 consecutive cases, which all received acellular dermal matrix. Cohort 3 (selective acellular dermal matrix) consisted of the next 260 cases, in which acellular dermal matrix was selectively used based on mastectomy skin flap thickness. Complication rates were compared using chi-square analysis.

Results:
The study included 450 cases in 288 patients. Mean follow-up was 25.5 months. Infection occurred in 27.8 percent of the no–acellular dermal matrix cases, 20 percent of the consecutive cases, and 15.8 percent of the selective cases (p = 0.04). Unplanned return to the operating room was required in 23.3, 11, and 10 percent of cases, respectively (p = 0.004). Expander-implant loss occurred in 17.8, 7, and 5 percent of cases, respectively (p = 0.001). Additional analysis of the odds ratios of developing complications after postmastectomy radiation therapy demonstrated a specific protective benefit of acellular dermal matrix in irradiated patients.

Conclusions:
Acellular dermal matrix use in expander-implant reconstruction after total skin-sparing mastectomy reduced major postoperative complications in this study. Maximal benefit is achieved with selected use in patients with thin mastectomy skin flaps and those receiving radiation therapy.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Bone Biology and Physiology
Authors: Buck Donald W. , Dumanian Gregory A. 
Published: January 2013

Summary:
The principles of bone biology and physiology permeate all subspecialty practices in plastic and reconstructive surgery from hand surgery to aesthetic surgery. Despite its importance in our practices, the biology of bone healing and bone physiology rarely surfaces within textbooks, literature reviews, or residency curricula. In this article, the authors present the first of a two-part series reviewing the important concepts of bone biology and bone physiology relevant to plastic surgery in an effort to ameliorate this educational gap.
An Analysis of the Experiences of 62 Patients with Moderate Complications after Full-Face Fat Injection for Augmentation
Authors: Kim Sung Min , Kim Young Seok , Hong Jong Won , Roh Tai Suk , Rah Dong Kyun 
Published: January 2013

Background:
Recently, fat injection has been performed across the globe and has several advantages. However, there have not been many studies regarding the relationship between complications and contributing factors. The authors analyzed factors present when complications occurred during fat injections into the face.

Methods:
A retrospective chart review was performed for 62 patients who had moderate complications among the 1261 persons who had received full-face fat injection between April of 2004 and July of 2008. Complications included chronic edema, calcification, fibrosis, acne, headache, dysesthesia, drooping, and irregularity.

Results:
There were no differences among the first, second, and third injection groups regarding age, body weight, height, or body mass index. However, there were statistically significant differences in injection amount and complication occurrence time (p < 0.0001). There were statistically significant differences in injection amount and complication occurrence time between the fresh and frozen fat (p < 0.0001). There were statistically significant differences regarding age, injection amount, and complication occurrence time according to the complication groups (p < 0.0001). There was also a difference between timing of the injection and the complication frequency (Fisher's exact test, p < 0.0001) and between fat status and the complication frequency (Fisher's exact test, p = 0.005).

Conclusions:
Chronic edema, calcification, fibrosis, acne, headache, dysesthesia, drooping, and irregularity after full-face fat injection were observed as moderate complications. Although further study will be needed for the effective analysis of complications according to the number of injection or fat status, the authors found significant differences in age, complication occurrence time, and injection amount between some complication groups.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.
Current Surgical Management of Bilateral Cleft Lip in North America
Authors: Tan Stephan P. K. , Greene Arin K. , Mulliken John B. 
Published: January 2013

Background:
This study was undertaken to determine contemporary surgical management of bilateral cleft lip.

Methods:
A survey was sent to North American cleft surgeons. Variables included number of bilateral cleft lip repairs per year, surgical specialty, and methods of nasolabial correction. The authors analyzed possible relationships between surgical specialty/volume and operative techniques.

Results:
The response rate was 40 percent (241 of 600). Annual bilateral nasolabial repairs per surgeon were as follows: zero to two, 30 percent; three to five, 46 percent; and six or more, 25 percent. For bilateral complete cleft lip, dentofacial orthopedics was used by 71 percent of respondents; synchronous closure was most commonly performed (88 percent); infrequent techniques were preliminary labial adhesions (11 percent) and staged labial closure (1 percent); and 50 percent undertook primary nasal repair. One half of respondents used nostril splinting following primary or secondary nasal correction. For bilateral incomplete cleft lip, 90 percent of surgeons performed synchronous labial repair and 36 percent did primary nasal correction. For both complete and incomplete bilateral cleft lips, high-volume surgeons were more likely to excise prolabial vermilion and use lateral vermilion-mucosal flaps to form the median tubercle. For bilateral asymmetrical cleft lip, 85 percent of surgeons practiced synchronous labial repair and 54 percent used dentofacial orthopedics on the complete side.

Conclusions:
Synchronous repair was the most frequent method for bilateral cleft lip; one-half of surgeons practiced primary nasal correction. There were no associations between surgical specialty/volume and operative principles or techniques for bilateral nasolabial repair, except for construction of the median tubercle.
Robotic Latissimus Dorsi Muscle Harvest
Authors: Selber Jesse C. , Baumann Donald P. , Holsinger F. Chistopher 
Published: January 2013

Background:
The latissimus dorsi muscle is a workhorse of reconstructive surgery. Traditional harvest technique requires a long, posterior donor-site incision. Endoscopic harvest is limited by technical challenges. Robotic technology permits a simpler, minimally invasive harvest technique.

Methods:
Seven consecutive robotic latissimus dorsi muscle harvests were performed by a single surgeon. Two were used as free flaps for scalp reconstruction and the remaining five as pedicled flaps for breast reconstruction; three were for immediate, implant-based reconstruction with nipple-areola complex–sparing mastectomies, and two were for radiated breasts when the expander was exchanged for an implant. Harvest technique employed a short, axillary incision for pedicle dissection and two to three additional ports for robotic instrumentation.

Results:
All seven muscle flaps were harvested without converting to an open technique. Both free flaps were successfully transferred. All pedicled flaps resulted in successful breast reconstructions. Flap harvest complications included a single, temporary radial nerve palsy in the contralateral extremity, likely from positioning. There were no donor-site hematomas, seromas, or cutaneous thermal injuries. Robotic harvest time decreased from over 2 hours to about an hour over the study period.

Conclusions:
Robotic harvest of the latissimus dorsi is a novel and effective method of muscle harvest. It offers technical advantages over endoscopic harvest and aesthetic advantages over the open technique.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Body Contouring
Authors: Shermak Michele A. 
Published: January 2013

Learning Objectives:
After studying this article, the participant should be able to: 1. List patient selection factors for body lift surgery. 2. Describe operative approaches for brachioplasty, upper body lift, abdominoplasty, lower body lift, and thigh lift. 3. Identify complications and pitfalls related to body lifting and describe how to avoid them.

Summary:
The author discusses the preoperative assessment, surgical treatment plan, postoperative management, outcomes, and possible complications for a comprehensive spectrum of body-contouring surgical procedures. Preoperative planning includes medical history and physical examination, along with an open discussion with the patient. Surgical procedures for brachioplasty, upper back lift, abdominoplasty, lower back lift, gluteal augmentation and thigh lift are discussed. Postoperative management pearls are shared, as well as pitfalls to be avoided.
Assessing Strength of Evidence in Diagnostic Tests
Authors: Aliu Oluseyi , Chung Kevin C. 
Published: January 2013

Summary:
Clinical encounters between clinicians and patients begin with an attempt at diagnosis, a foundational element in determining a patient's ultimate outcome. Diagnosis that is expedient and accurate will result in a treatment that is expedient, appropriate, and cost-effective. In essence, evidence-based diagnosis is as vital as evidence-based intervention and treatment. If surgeons are committed to making expedient and accurate diagnoses, they must strive to apply diagnostic tests not just on the basis of ease, novelty, or availability but for the soundness of evidence behind them. In the scopes of both aesthetic and reconstructive surgery, advocating evidence-driven diagnostic test use is relevant. A pertinent example of how this relates to plastic surgery is the U.S. Food and Drug Administration recommendation to screen asymptomatic women with silicone breast implants with magnetic resonance imaging. For an important recommendation such as this that has tremendous cost implications to patients, sound study design and rigorous evaluation of the accuracy of magnetic resonance imaging as a screening tool has important health policy implications. The authors demonstrate how to determine the accuracy of diagnostic tests and, more importantly, illustrate the essential qualities of any study to establish the accuracy of a diagnostic test.
Complications in Surgery
Authors: Chung Kevin C. , Kotsis Sandra V. 
Published: January 2013

Summary:
Patients expect to receive quality medical care by relying on the concepts of evidence-based medicine. This quality care is expected to be provided at decreased costs for payors, some of whom have stopped reimbursement for cases involving “reasonably preventable” surgical complications. The purpose of this article is to introduce root cause analysis as a tool for identifying the causes of surgical complications. The authors also discuss preventive measures, such as improved communication, checklists, reporting systems, and the use of evidence-based medicine, that have been implemented to decrease surgical complications. These preventive measures can be used alone or together to decrease complications and improve overall patient care.
Benchmarking Academic Plastic Surgery Services in the United States
Authors: Song Elaine Horibe , Shirazian Afshin , Binns Brian , Fleming Yuedi , Ferreira Lydia Masako , Rohrich Rod J. , Azari Kodi 
Published: January 2013

Summary:
Rising health care costs and increasingly demanding patients are only some of the challenges faced by academic plastic surgery services in their pursuit of excellence in education, research, and patient care. Benchmarking, when correctly applied, is a powerful tool that can help services learn from each other's experiences. This study aimed at creating the first benchmarking report summarizing performance indicators and management practices of some of the most complete academic plastic surgery units in the United States. Results provide an opportunity for plastic surgery leaders to benchmark against their own units, identify eventual gaps, and improve their performance as needed.
Teaching Plastic Surgery from Different Perspectives
Authors: Cable Christian , Chong Tae , Pratt Daniel D. 
Published: January 2013

Summary:
Just as everyone has a different learning style, teachers too approach the task from different perspectives. There are five basic teaching perspectives or styles: transmission, apprenticeship, developmental, nurturing, and social justice. The acronym BIAS is useful to describe the beliefs, intentions, assessments, and strategies associated with each perspective. The authors present a hypothetical 1-week rotation in plastic and reconstructive surgery in which a student encounters instructors who embody the five basic teaching perspectives. By presenting these perspectives, the authors introduce valuable teaching techniques that can benefit all those charged with the education of learners along the spectrum from premedical to continuing education venues. Educational objectives include the following: (1) explain and illustrate different approaches to effective teaching in plastic surgery; (2) introduce readers to the Teaching Perspectives Inventory as a means of determining their primary teaching style; and (3) argue for a “plurality of the good” in teaching.
The Battle of Words and the Reality of Never Events in Breast Reconstruction
Authors: Adetayo Oluwaseun A. , Salcedo Samuel E. , Biskup Nataliya I. , Gupta Subhas C. 
Published: January 2013

Background:
The Centers for Medicare and Medicaid Services has a list of 10 hospital-acquired conditions for which hospitals and physicians will not be reimbursed because it deems such conditions are preventable and should be considered “never events.” To evaluate the validity of this premise, the authors conducted a real-life analysis of the incidence and categories of never events occurring in a breast reconstruction cohort of a multisurgeon plastic surgery practice. Cost analysis of estimated revenue loss and risk factors associated with the development of never events are enumerated.

Methods:
A retrospective chart review of postmastectomy patients undergoing breast reconstruction from 2008 to August of 2010 was conducted. A total of 297 patients were identified and International Classification of Diseases, Ninth Revision codes corresponding to the never events of interest were applied to the study population.

Results:
Of the 297 patients, 24 (8.08 percent) developed never events in two categories: surgical-site infections (7.74 percent) and catheter-related urinary tract infections (0.34 percent). There were no complications in the remaining eight categories. Overweight body mass index and diabetes were strong independent risk factors for the development of never events (p < 0.0001). Cost estimates of associated revenue loss and economic analysis reveal substantial financial burdens to physicians and hospitals as a result of nonreimbursement.

Conclusions:
The “one-size-fits-all” approach of the Centers for Medicare and Medicaid Services may be misplaced and misleading. Certain risk factors are independent predictors of developing a never event, making it impossible to classify certain outcomes as “never” occurrences. The never events pendulum may have swung immensely to the left, and it is time to attain a much-needed equilibrium.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Risk, II.