bluuebunny/crossref_metadata_2025_split huggingface dataset:
Empfehlungen zur Überprüfung der Wirksamkeit und Verlaufsdokumentation von Dupilumab bei chronischer Rhinosinusitis mit Nasenpolypen (CRSwNP) im deutschen Gesundheitssystem
Authors: Klimek L. , Förster-Ruhrmann U. , Olze H. , Beule A. G. , Chaker A. M. , Hagemann J. , Huppertz T. , Hoffmann T. K. , Dazert S. , Deitmer T. , Strieth S. , Wrede H. , Schlenter W. , Welkoborsky H. J. , Wollenberg B. , Becker S. , Klimek F. , Sperl A. , Casper I. , Zuberbier J. , Rudack C. , Cuevas M. , Hintschich C. A. , Guntinas-Lichius O. , Stöver T. , Bergmann C. , Pfaar O. , Gosepath J. , Gröger M. , Beutner C. , Laudien M. , Weber R. K. , Hildenbrand T. , Hoffmann A. S. , Bachert C. 
Published: September 2022

Zusammenfassung
Hintergrund Die chronische Rhinosinusitis mit Nasenpolypen (CRSwNP) ist eine multifaktorielle entzündliche Erkrankung der Schleimhäute von Nase und Nasennebenhöhlen. Eine Typ-2-Inflammation als immunologischer Mechanismus wird als häufigster Endotyp beschrieben. Der Anti-IL-4-/-IL-13-Antikörper Dupilumab ist seit Oktober 2019 als Zusatztherapie zu intranasalen Glukokortikosteroiden für die Behandlung Erwachsener mit schwerer chronischer Rhinosinusitis mit Nasenpolypen zugelassen, wenn systemische Glukokortikosteroide oder eine Operation keine ausreichende Krankheitskontrolle bewirken. Während nationale und internationale Empfehlungen für den Einsatz von Dupilumab bei CRSwNP existieren, ist bislang nicht hinreichend festgelegt worden, wie diese Therapie überwacht und wann sie ggf. beendet werden sollte.
Methoden In einer Literatursuche wurden die bisherigen Daten zur Behandlung der CRSwNP mit Dupilumab analysiert und die vorhandene Evidenz durch Recherchen in MEDLINE, PubMed sowie den nationalen und internationalen Studien- und Leitlinienregistern und der Cochrane Library ermittelt. Es wurden Humanstudien berücksichtigt, die im Zeitraum bis einschließlich 05/2022 publiziert wurden.
Ergebnis Basierend auf der internationalen Literatur und bisherigen Erfahrungen werden von einem Expertengremium Empfehlungen für die Verlaufskontrolle, das Einhalten von Therapieintervallen und eventuelle Therapiepausen sowie eine Beendigung der Therapie bei Anwendung von Dupilumab für die Indikation CRSwNP im deutschen Gesundheitssystem auf der Grundlage eines Dokumentationsbogens gegeben.
Schlussfolgerungen Das Verständnis über die immunologischen Grundlagen der CRSwNP eröffnet neue nichtoperative Therapieansätze mit Biologika für Patienten mit schweren, unkontrollierten Verlaufsformen. Wir geben hier Empfehlungen für die Verlaufskontrolle, das Einhalten von Therapieintervallen, eventuelle Therapiepausen oder eine Beendigung der Therapie bei einer Dupilumab-Behandlung als Zusatztherapie mit intranasalen Glukokortikosteroiden zur Behandlung von erwachsenen Patienten mit schwerer CRSwNP, die mit systemischen Glukokortikosteroiden und/oder chirurgischem Eingriff nicht ausreichend kontrolliert werden können.
Assessment of Small Bowel Motility and SMA Blood Flow Studied with Transabdominal Ultrasound
Authors: Nylund Kim , Gjengstø Andreas Jessen , von Volkmann Hilde Løland , Gilja Odd Helge 
Published: September 2022

AbstractPurpose Gastrointestinal ultrasound (GIUS) is a noninvasive imaging technique that may be used to study physiological changes in the small bowel. The aim of the study was to investigate the feasibility of measuring blood flow (BF) in the superior mesenteric artery (SMA) and regional motility in the small bowel with GIUS before and after a test meal and to compare ultrasound parameters to demographic factors such as age, sex, height, weight, and smoking habits.Materials and Methods 122 healthy volunteers aged 20 to 80 were examined after an overnight fast. Small bowel motility was registered in the upper left and lower right quadrants (ULQ and LRQ) with TUS and BF in the SMA with pulsed wave Doppler. The first 23 volunteers also received a 300 Kcal test meal and were re-examined 30 min postprandial.Results The feasibility of measuring BF was 97% in fasting patients while motility could be detected in 52% and 62% in the ULQ and LRQ, respectively. Females had a lower resistive index (RI) and a higher mean velocity than males, while the overall BF correlated with height. The RI had a negative correlation with age. Healthy volunteers with motility in the ileum were on average younger than those without motility. After the test meal, motility could be detected in the ULQ and LRQ in 95% and 90%, respectively, and the mean number of contractions in the ULQ increased significantly. As expected, there was a clear increase in all BF-parameters postprandially.Conclusion Regional motility in the small bowel was easier to detect after a test meal. There were some associations between demographic parameters and ultrasound parameters but overall the effects were relatively small.
From Esthetic Medicine to Optimizing Reconstructive Outcome: A Feasibility Trial on Secondary Refinement of Fasciocutaneous Anterolateral Thigh Flaps with Cryolipolysis
Authors: Nagel Sarah S. , Rauh Annika , Siegwart Laura C. , Hundeshagen Gabriel , Kotsougiani-Fischer Dimitra , Kuepper Simon , Kneser Ulrich , Hirche Christoph 
Published: September 2022

Abstract
Background Free adipocutaneous anterolateral thigh (ALT) flaps have evolved as workhorse flaps to reconstruct complex, multicompound defects. While coverage is safely achieved, flaps may remain bulky. As a standard of care, flaps are refined with liposuction, partial excision, or combination of both. Cryolipolysis is widely used for fat reduction in esthetic medicine. This pilot comparative study analyses whether cryolipolysis may serve as a safe alternative method to effectively reduce volume in fasciocutaneous flaps. Moreover, patients' satisfaction with the procedure is evaluated.
Methods In this single-center, retrospective, interventional comparative cohort study, 10 patients with free subfascial ALT flaps for distal extremity reconstruction underwent cryolipolysis (60 minutes, −9°C). Circumference of the extremities and subcutaneous fat thickness were determined before (T1) and 12 weeks (T2) after cryolipolysis. Patient satisfaction was evaluated with a questionnaire of Likert's scale questions. Duration of hospital stay, intervention time, costs, and possible complications were analyzed and compared with surgical flap contouring (n = 12).
Results All patients undergoing cryolipolysis were male, with a median age of 52 years without arterial disease-like state or deep vein thrombosis (DVT). At T2, a significant reduction of circumference of 1.8 ± 0.9 cm (p < 0.001) and subcutaneous fat layer of 7.7 ± 3.0 mm (p < 0.0001) was recorded. Overall, 90% of the patients were satisfied with the result. Cryolipolysis was well tolerated. One patient developed a second-degree frostbite which healed without further intervention. Cryolipolysis proofed to be as safe as surgical flap contouring. Hospital stay was significantly shorter (p < 0.01) and personal resources were spared when flap contouring was performed with cryolipolysis.
Conclusion This is a novel application of evolving body-contouring cryolipolysis from esthetic medicine into optimizing outcomes in reconstructive surgery. Cryolipolysis has been shown to be relatively safe and effective to reduce ALT's volume with high patients' satisfaction. This successful pilot study encourages further investigation with a prospective randomized control trial.
Three-dimensional Printer Molds for Vaginal Agenesis: An Individualized Approach as Conservative Treatment
Authors: Fernandes Marina Silva , Takano Claudia Cristina , Chrispin Thyeres Teixeira Bueno , Marquini Gisele Vissoci , Girão Manoel João Batista Castello , Sartori Marair Gracio Ferreira 
Published: September 2022

Abstract
Objective The aim of this study was to evaluate the use of vaginal molds, made with three-dimensional (3D) printing, for conservative treatment through vaginal dilation in patients with vaginal agenesis (VA).
Methods A total of 16 patients with a diagnosis of VA (Mayer-Rokitansky-Küster-Hauser syndrome, total androgen insensitivity syndrome, and cervicovaginal agenesis) from the Federal University of São Paulo were selected. Device production was performed in a 3D printer, and the polymeric filament of the lactic polyacid (PLA) was used as raw material. A personalized treatment was proposed and developed for each patient.
Results There were 14 patients who reached a final vaginal length of 6 cm or more. The initial total vaginal length (TVL) mean (SD) was 1.81(1.05) and the final TVL mean (SD) was 6.37 (0.94); the difference, analyzed as 95% confidence interval (95% CI) was 4.56 (5.27–3.84) and the effect size (95% CI) was 4.58 (2.88–6.28).
Conclusion The 3D printing molds for vaginal dilation were successful in 87.5% of the patients. They did not present any major adverse effects and offered an economical, accessible, and reproducible strategy for the treatment of VA.
Late Seroma in Breast Implants: A Coronavirus Disease 2019 Phenomenon?
Authors: Chan Stephanie L.S , Mok James Wan Loong 
Published: September 2022

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has been challenging in all aspects of the medical field with new clinical presentations constantly arising. Plastic surgeons are not immune to this and need to be aware of their implications. There has been a recent report of late periprosthetic seroma (breast implant) as a clinical manifestation of COVID-19 infection. To our knowledge, this phenomenon has not been further reported. We present a 53-year-old immunocompromised lady who developed late seroma after COVID-19 infection. She eventually required explantation of the implant and is awaiting autologous reconstruction. It is likely that we will increasingly continue to see this phenomenon of implant complications as a result of COVID-19 infection and should be watchful, especially regarding potential immunocompromised patients.
A Cross-Sectional Analysis of Breast Reconstruction with Fat Grafting Content on TikTok
Authors: Gupta Rohun , John Jithin , Gupta Monik , Haq Misha , Peshel Emanuela , Boudiab Elizabeth , Shaheen Kenneth , Chaiyasate Kongkrit 
Published: September 2022

AbstractAs of November 2021, TikTok has one billion monthly active users and is recognized as the most engaging social media platform. TikTok has seen a surge in users and content creators, ranging from athletes to medical professionals. In the past year, content creators have utilized the app to advocate for social reforms, education, and other uses that were not previously considered. Breast cancer is the most commonly diagnosed cancer in women, with an expected 281,550 new cases of invasive breast cancer in 2021. As more individuals with breast cancer choose to undergo resection, the demand for autologous fat grafting in breast reconstruction has increased due to the natural look and feel of breast tissue. The purpose of this article is to analyze content related to breast reconstruction with fat grafting found on TikTok and recommend methods to improve patient education, care, and outcomes.We searched TikTok on November 1, 2021, for videos using the phrase “breast reconstruction with fat grafting.” The top 200 videos retrieved from the TikTok search algorithm were analyzed, and all commentaries, duplicates, and nonrelevant videos were removed. Video characteristics were collected, and two independent reviewers generated a DISCERN scoreA total of 131 videos were included in the study. They were found to have a combined 1,871,980 likes, 41,113 comments, and 58,662 shares. The videos had an average DISCERN score of 2.16. Content creators had an overall low DISCERN score in items involving the use of references, disclosure of risks for not obtaining treatment, and support for shared decision-making. When stratified, the DISCERN score was higher for videos created by physicians (DISCERN average 2.48) than for videos created by nonphysicians (DISCERN average 1.99; p < 0.001).Content creators can improve the quality of their videos by disclosing treatment risks, benefits and risks, discussing risks for not obtaining treatment, and advocating for shared decision-making. Furthermore, including citations and academic references may offer increased credibility and promote evidence practice. This article is limited by the variability seen on the TikTok platform that is influenced by algorithmic trends. The top 200 search results vary, making each compilation of videos selected for analysis unique. Furthermore, although DISCERN is a reliable source to assess patient information, it has not been tested for its reliability with videos such as on TikTok. Despite TikTok being developed as a social media platform, it has shown to be a medium for patient outreach and an educational tool.
Rhinoplasty with Recycled Dorsum Preservation: Technique and Outcomes
Authors: Rodriguez Carlos A. , Al-Sakkaf Ali M. , Verbauvede Mauricio 
Published: September 2022

AbstractRhinoplasty is one of the first surgical procedures described with evidence in the history of medicine. At first, these were performed for the reconstruction of traumatic defects caused by punishments, sequels of war, and then it had been reused after suffering from diseases such as syphilis. Many techniques have been developed from the need of aesthetics outcomes in this field.The objective of our work is to describe a modified approach of recycled dorsum preservation procedure that we have proposed as a safe and reliable technique.In this work, we have showed that this technique has a marked advantage of preserving the natural tissue with satisfactory postoperative result. We had no functional complications up to date. We recommend that every specialist in the field of rhinoplasty should be able to use it as a reproducible and feasible alternative.
Outcomes of Closed versus Open Rhinoplasty: A Systematic Review
Authors: Gupta Rohun , John Jithin , Ranganathan Noopur , Stepanian Rima , Gupta Monik , Hart Justin , Nossoni Farideddin , Shaheen Kenneth , Folbe Adam , Chaiyasate Kongkrit 
Published: September 2022

AbstractOpen and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case–control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.
Mandibular Fracture in a Hemifacial Microsomia Patient following Implant Failure and Hardware Infection: A Case Report
Authors: Ali Kausar , Dibbs Rami P. , Maricevich Renata S. 
Published: September 2022

AbstractHemifacial microsomia (HFM) is a complex congenital condition with heterogeneous malformations of the facial skeleton that almost always involves mandibular hypoplasia. Here we introduce a unique case in which a patient with HFM had initially successful optimization of facial symmetry using a polyetheretherketone implant for mandibular augmentation. However, multiple factors associated with the intraoperative and postoperative course, including hardware failure and infection, led to diminished mechanical strength of the mandible, ultimately resulting in a mandibular fracture. In this unique case presentation of HFM, we discuss the various factors that contributed to mandibular weakness and increased susceptibility to fracture.
Evaluation of Breast Animation Deformity following Pre- and Subpectoral Direct-to-Implant Breast Reconstruction: A Randomized Controlled Trial
Authors: Dyrberg Diana L. , Bille Camilla , Koudahl Vibeke , Gerke Oke , Sørensen Jens A. , Thomsen Jørn B. 
Published: September 2022

Abstract
Background The incidence of breast animation deformity (BAD) is reported to be substantial after direct-to-implant breast reconstruction with subpectoral implant placement. It has, however, never been examined if BAD can occur following prepectoral implant placement. Our primary aim was to compare the incidence and degree of BAD after direct-to-implant breast reconstruction using either subpectoral or prepectoral implant placement. Secondary aim of this study was to assess and compare the level of pain between sub- and prepectoral reconstructed women.
Methods In this randomized controlled trial, patients were allocated to reconstruction by either subpectoral or prepectoral implant placement in accordance with the CONSORT guidelines. The degree of BAD was assessed by the “Nipple, Surrounding skin, Entire breast (NSE)” grading scale 12 months after surgery. The level of postoperative pain was assessed on a numerical pain rating scale.
Results We found a significant difference in the degree of BAD favoring patients in the prepectoral group (23.8 vs. 100%, p < 0.0001; mean NSE grading scale score: 0.4 vs. 3.6, p < 0.0001). The subpectoral reconstructed group reported higher levels of pain on the three subsequent days after surgery. No significant difference in pain levels could be found at 3 months postoperatively.
Conclusion The incidence and degree of BAD was significantly lower in women reconstructed by prepectoral direct-to-implant breast reconstruction. Unexpectedly, we found mild degrees of BAD in the prepectoral group. When assessing BAD, distortion can be challenging to discern from rippling.
Free Flap Salvage in the Ischemic Foot: A Case Report
Authors: Seo Dongkyung , Dannnoura Yutaka , Ishii Riku , Tada Keisuke , Kawashima Kunihiro , Yoshida Tetsunori , Horiuchi Katsumi 
Published: September 2022

AbstractWe performed distal bypass and free flap transfer in a single-stage operation to repair an extensive soft tissue defect in an ischemic foot of an 84-year-old woman. The nutrient artery of the free flap was anastomosed to the bypass graft in an end-to-side manner. Subsequently, the bypass graft became occluded on several occasions. Although intravascular and surgical interventions were performed each time, the bypass graft eventually became completely occluded. However, despite late occlusion of the nutrient artery, the free flap has remained viable and the patient is ambulatory. The time required for a transplanted free flap to become completely viable without a nutrient artery is likely longer for an ischemic foot compared with a healthy foot. However, the exact period of time required is not known. A period of month was required in our patient. We report this case to help clarify the process by which a free flap becomes viable when applied to an ischemic foot.
Use of Heparin Cream for Venous Congestion in the Extended Reverse Metacarpal Artery Flap: A Case Report
Authors: Tatar Burak Erguün , Sabancıoğullarından Fahri , Gelbal Caner , Bozkurt Mehmet 
Published: September 2022

AbstractFinger dorsum defects are a challenging situation. Many reconstruction methods are used in these defects. Extended reverse dorsal metacarpal artery (RDMA) flap is used in dorsal finger reconstruction. Venous congestion in this flap is most important cause of flap failure. In this case, we presented a case in which we used heparin cream due to development of venous congestion in our patient who underwent an extended RDMA flap. A 24-year-old female patient presented to the emergency department with a defect of dorsal of left-hand fourth finger. Defect was covered with an extended RDMA flap. On postoperative first day, venous congestion was observed, and heparin cream was applied three times a day on flap. The signs of venous congestion were regressed. Tissue healed as a result of superficial epidermolysis and skin grafting. No functional limitation was observed in sixth-month postoperative control. Venous congestion is the most important cause of flap failure of extended RDMA flaps. Generally, subcutaneous heparin administration and leech therapy are used. In our case, heparin was applied as a cream instead of subcutaneously, and flap healing was observed as a result of superficial epidermolysis. Heparin cream application can also be used as a treatment option in flaps with venous congestion.
Rare Tumors Causing Median Nerve Compression in Adults—A Narrative Review
Authors: Natroshvili Tinatin , Peperkamp Kirsten , Malyar Masoud A. , Wijnberg David , Heine Erwin P. , Walbeehm Erik T. 
Published: September 2022

AbstractThe median nerve can be compressed due to a tumor along the course of the median nerve, causing typical compression symptoms or even persistence or recurrence after an operation. The aim of this review is to provide a comprehensive overview of rare tumors described in recent publications that cause median nerve compression and to evaluate treatment options.The PubMed, Embase, and Web of Science databases were searched for studies describing median nerve compression due to a tumor in adults, published from the year 2000 and written in English. From 94 studies, information of approximately 100 patients have been obtained.
Results The rare tumors causing compression were in 32 patients located at the carpal tunnel, in 21 cases in the palm of the hand, and 28 proximal from the carpal tunnel. In the other cases the compression site extended over a longer trajectory. There were 37 different histological types of lesions. Complete resection of the tumor was possible in 58 cases. A total of 8 patients presented for the second time after receiving initial therapy. During follow-up, three cases of recurrence were reported with a mean follow-up period of 11 months.The most common published cause of median nerve compression is the lipofibromatous hamartoma. Besides the typical sensory and motor symptoms of median nerve compression, a thorough physical examination of the complete upper extremity is necessary to find any swelling or triggering that might raise suspicion of the presence of a tumor.